Hawai‘i State Department of Health

There are 1,506 businesses with 50 or more employees (excluding government and self-employed) in this state. While this number represents only five percent of the businesses in Hawai`i, these businesses employ 54 percent of the workforce. Researchers have demonstrated that people tend to make the best use of health promotion programs offeredat work, where more than 85 percent of the adult population spends much of their time. Employers can benefit from expected improvements in morale, decreased absenteeism and controlled health care costs. Nationally, in 1985, an estimated 65 percent of U.S. workplaces with more than 50 employees offered at least one health promotion activity. The programs that are most prevalent include smoking control, health risk assessment, back care, stress management, exercise/fitness and ergonomic training. There is currently no baseline data on educational programs in the workplace in Hawai`i. Therefore, there is not enough information with which to set an objective, even though this is clearly an important area.

Family takes a central role in many of the ethnic and cultural traditions of this state and is a key support for the promotion of health and well-being. The family is a place where lifestyle patterns are initiated, maintained, and altered over time. It is where risk factors tend to cluster, and in most cases, members have a genetic history that predisposes particular risks. Research on the family's impact on health provides evidence that family patterns influence such conditions as coronary heart disease, hypertension, diabetes, substance abuse, depression, etc. Therefore, it is crucial for families to have accurate, up-to-date information in these areas and to discuss its relevance within the family.

A national Gallup poll in 1985 found that a spouse or significant other was more likely to influence a person's health habits than anyone else, including the family doctor. For example, husbands were twice as likely to quit smoking (22 percent vs. 11 percent) and more likely to lose weight (42 percent vs. 31 percent) than single men. Only limited national baseline data exists related to these national objectives. Neither is baseline data available for Hawai`i for many dimensions of family life that relate to health status, and a specific objective has not yet been determined.

Immigrant and Native Hawaiian communities continue to lag behind the overall U.S. population and the general Hawai`i population in many health-related areas, leading to consequent loss of lives and productivity. Approximately 7,000 - 8,000 new immigrants arrive in Hawai`i annually(1993-94 data). Additionally, Native Hawaiians face cultural barriers to receiving appropriate health care. The 1990 census showed that 23 percent of Hawai`i residents speak a language other than English at home, and about 15 percent of the state population is foreign born.

Various services have been created which are appropriate linguistically and culturally for populations who have limited English ability, the majority of which are in the private non-profit sector. Also, several programs have been created and others have been adapted to be culturally appropriate for the Native Hawaiian population.

While most immigrant groups in Hawai`i have programs containing health promotion aspects directed to them, it is not known what proportion of each cultural and lingustic minority population is actually being reached by the existing programs. Data should be developed to measure this dimension. Also, information is needed regarding health needs and acculturation of Mexicans/Latinos and Tongans throughout the state.

Efforts are being made to disseminate health information to minority populations by programs offered by the Hawai`i Department of Health. These programs include Bilingual Health Education Aide (Chinese, Filipino, Samoan, Vietnamese, & Hawaiian); Lanakila Easy Access Project (Filipino, Chinese, Korean, Vietnamese); Tuberculosis outreach program (Filipino, Chinese, Korean, Vietnamese); Lanikila Immigrant Vaccination Evaluation (Laotian, Vietnamese, Filipino, Korean, Japanese); and Hansen's Disease (Samoan & Filipino).

Other programs which help distribute health information in various languages to minority communities includes the American Cancer Society and the Hepatitis B Immigration Program.

There are no Native Hawaiian health clinics, and the Office of Hawaiian Health no longer exists. However, there are Native Hawaiian health care systems which provide a variety of services including outreach services for Native Hawaiians for information and referrals to health and social services; nutrition counseling and education; immunizations; prevention and control of diabetes, high blood pressure, and otitis media; pregnancy and infant care.

The Native Hawaiian health care systems are listed below.

Hui No Ke Ola Pono (Maui)

Ke Ola Mamo (O`ahu) Na Pu`uwai (Moloka`i and Lana`i )

Hui Malama Ola Na`Oiwi (Island of Hawai`i)

Ho`ola Lahui Hawai`i (Kaua`i)

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