Investigating Measures of Social Context on 2 Population-Based Health Surveys, Hawaii, 2010-2012.

Measures from the Social Context Module of the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System were used on 2 population-based health surveys in Hawaii to explicate the role of the nonmedical and social determinants of health; these measures were also compared with conventional socioeconomic status (SES) variables. Results showed that the self-reported SES vulnerabilities of food and housing insecurity are both linked to demographic factors and physical and mental health status and significant when controlling for the conventional measures of SES. The social context module indicators should be increasingly used so results can inform appropriate interventions for vulnerable populations.

Weight reduction among people with severe and persistent mental illness after health behavior counseling and monitoring.

The high prevalence of obesity and associated chronic conditions in persons with severe and persistent mental illness has contributed to a mortality rate that is nearly two times higher than the overall population. In 2008, the Central O'ahu Community Mental Health Center of the Hawai'i State Department of Health, Adult Mental Health Division began an unfunded, health counseling intervention pilot project to address such concerns for the health of persons with severe and persistent mental illness. This article reviews the results of this intervention. Forty-seven persons with schizophrenia or related disorders were included in the intervention which involved health counseling and monitoring of weight as a risk factor for chronic disease. After five years of counseling and monitoring, medical chart reviews were conducted for each person for data on weight change. Analysis showed weight loss and improvements in body mass index. The results of this project show potential for long-term counseling and monitoring as an intervention for obesity in persons with severe and persistent mental illness.

Betel nut chewing in Hawai'i: is it becoming a public health problem? Historical and socio-cultural considerations.

This article examines the socio-cultural significance of betel nut use among Micronesians, in light of the recent migration of Micronesians to Hawai'i. The different ways of chewing betel nut are the result of historical changes within Micronesia over time due to Spanish and US colonialism as well as the introduction of tobacco. These divergent ways of chewing may have different risks or impacts on health and it remains to be seen whether or not betel nut will become a significant public health problem in Hawai'i.

Preview of Hawaii Cancer Facts and Figures 2010.

Each year, nearly 6,700 Hawaii residents are diagnosed with cancer and more than 2,000 die from the disease. Detailed data on the burden of cancer in Hawaii, including cancer incidence and mortality rates, are available in Hawaii Cancer Facts & Figures 2010 (CF&F). A collaborative effort of the Cancer Research Center of Hawaii, the American Cancer Society and the Hawaii Department of Health, this update of the original version published in 2003 is intended as a tool for public health education, research, and planning. The following are highlights of years 2000-2006 (a 6-year period) data as featured in Hawaii Cancer Facts & Figures 2010.

Overweight and at-risk for overweight among Hawai'i public school students entering kindergarten, 2002-2003.

Recent studies have pointed to an increasing problem of overweight and obesity in children in Hawai'i, but all of these studies have been conducted in specific communities or special population groups. No broad population-based studies have been conducted to document the extent of overweight in the general population of children in Hawai'i. To provide a population based estimate of overweight in Hawai'i's children, this study examined Student Health Records for 10, 199 children entering kindergarten in public schools during 2002-2003. Data on age, gender, height, and weight were used to calculate BMI (body mass index) scores. Because records for all students entering public school kindergarten were available for analysis, the data presented here represents the broadest estimates of overweight and at risk for overweight in Hawai'i's children published to date. The results illustrate that almost one-third of the children aged 4-6 years old entering Hawai'i public schools are either overweight or at risk for overweight. Rates are higher in rural school complexes than urban ones. Compared to a 1984 study that found 'no significant under or over nutrition' in Hawai'i's school children, our results suggest that almost one-third of children aged 4-6 entering Hawai'i public schools are either overweight or at risk for overweight. Physicians should be aware of this growing problem, and seek to implement practices to combat overweight among their pediatric patients and families.

Community based participatory approaches to address health disparities in Hawai'i: recent applications in cancer prevention, detection and treatment programs.

Assessment of recent trends in the prevalence and incidence of cancer, and its associated risk and protective factors in the State of Hawai'i illustrate that there are definite ethnic, socio-economic, and geographic health disparities. Disparities in access to health care are reflected in decreased and under utilization of all types of preventive cancer screening tests and decreased proportions of people with health insurance coverage. Increases in obesity mirror U.S. national trends and disproportionately affect certain ethnic groups and those with low income. Tobacco use has increased among at-risk populations including: certain ethnic groups, those with low-income and/or low education and those in rural areas. Data that reveal continuing or worsening health disparities imply that either the old methods have not been effective and/or resources are not available or are not being applied to address such disparities. Promising methodologies and programmatic focuses to reduce health disparities are needed as mechanisms for improving the circumstances of at-risk populations. Community based participatory approaches are described here for cancer prevention, detection, and treatment programs that utilize culturally appropriate methods.