Ka Wai Ola - Office of Hawaiian Affairs, Volume 3, Number 7, 1 Iulai 1986 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Healih Questions by Kekuni Blaisdell, M.D.

Ninau: What were the results of the Moloka'i Heart Study that you referred to in your previous eolumn and what signifieanee do they have for the rest of us po'e Hawai'i? Pane: The First phase of the Moloka'i Heart Study, conducted in the Summer of 1985 by Na Pu'uwai on 250 po'e ho'oku'ono'ono

(homesteaders), revealed firstly, that rapport had to be established with the Native Hawaiian kaiaulu (eommunity). This required a door-to-door, "talk-story" approach led by co-investigator Kauka Emmett Aluli and coordinator Helen Kanawaliwali 0'Connor. When na po'e ho'oku'ono'ono realized that the examinations and the hua (results) would be explained individually to them with personalized ola (health) advice based on na hua, they became willing participants. The following cardiovascular risk findings were presented June 7 by Principal Investigator Kauka David Curb at a national halawainui in Wakinekona (Washington, D.C.). Compared to Mainland haole standards, na po'e ho'oku'ono'ono tended to be taller; 65 percent were at least 20 percent "overweight"; greater kino (body) mass indices were especially marked in those age 20-24; and average puhaka-kikala (waist-hip) ratio was larger. Kokopi'i (hypertension), with blood pressure values greater than 140/90 mmHg, was found in 38 percent of those age 40-59; of those taking hypertension la'au (medication), 84 percent did not have their kokopi'i under control. Koko (blood) cholesterol was elevated (greater than 240 mg/dl) in 46 percent of wahine age 5059, and 40 percent of kane age 40-49. Mimiko (diabetes), as evidenced by mimi (urine) sugar or history, occurred in 21 percent of those 40-59. Almost all with mimiko did not have adequate control of their ma'i (disease). Na mea puhi paka (cigarette-smokers) comprised 34 percent of na wahine and 42 percent of na kane. The foregoing represent the first carefully-collected, baseline, cardiovascular-risk prevalence data in any sizeable Hawaiian kaiaulu. All of the figures indicate high risk for coronary ma'i pu'uwai (heart disease), such as angina, infarction (heart attack), and heart failure, and enhanced risk for ulupo (stroke) and pu'upa'a

(kidney) failure, as judged from similar data and outeome results collected elsewhere in the world. Data yet to be analyzed are family history of cardiovascular ma'i, ka 'ai (diet), aleohol consumptbn, 'oihana (occupation), education, physical activity, ko'iko'i (stress), and mimi (urinary) sodium. Some of the relationships and mechanisms of these variables to cardiovascular ma'i have been covered in previous He Mau Ninau columns. Meanwhile, besides individual health counseling, Na Pu'uwai has started kaiaulu health education programs, such as a May 3 workshop on kokopi'i. The effects of these intervention and prevention efforts, carefully attuned to Moloka'i's traditional preferences for 'ohana (family) and other group activities, closeness to nature, and spirituality, may become evident in longitudinal, outcome statistics. The Hawai'i Heart Association and the World Health Organization provided $20,000 for the Phase 1 1985 study through the University of Hawai'i School of Public Health. Phase II will be a similar baseline study focusing on non-ho'oku'ono'ono native Hawaiians Hving on Moloka'i, from $6,000 awarded by the Straub Foundation. Will na hua be like (similar) ai'ole like'ole (or different)? E 'ike ana kakou (we shall see). Phase fflsa proposed precontact Hawaiian mea 'ai (diet) project, as previously described in this eolumn, now seeking grant funds from the Office of Hawaiian Affairs. Thus, Moloka'i Nui a Hina has pioneered in establishing loeal health programs for her po'e Hawai'i with the assistance of UH experts, servirig as a model to other Hawaiian kaiaulu. Other key lala (members) of Na Pu'uwai — all mamo Hawai'i — who are contributing to these health programs on moku Moloka'i are Jane Lee, Queen Lili'uokalani Children's Center social worker; Naomi Brath, nurse at Moloka'i General Hospital; Noelani Joy, mahi'ai (farmer); and William Akutagawa, Alu Like employment training officer. For their Phase I study, Na Pu'uwai received special 1986 Department of Health Community Health Promotion recognition by Govemor George Ariyoshi at Washington Plaee on June 13. E ho'omaika'i i na Pu'uwai o Moloka'i for this impressive evidence of self-determination, initiative, responsibility and malama, that we other na pua kaulana need to emulate i pae moku o Hawai'i nei. E pane mai kakou, e ka Lahui Hawai'i.