Utilizing cultural immersion in a cultural competency curriculum: a conference report.

Overall, the evaluations of the conference were excellent and the speakers received high marks. Many participants were deeply moved and eager to share what they learned with colleagues and family. The constructive comments centered on the large number of topics covered in a short time. Requests that we decrease the number of speakers and increase the amount of time for discussion will be addressed in the planning of what will hopefully be another similar program next year. In summary, based on this experience, adding a cultural immersion experience to a cultural competency curriculum can be very successful because this approach enables learning to occur on several levels, not just from sitting in a lecture but through actual experiences of the culture--physically, emotionally, and spiritually.

Hypertension in elderly Japanese Americans and adult native Hawaiians.

POPULATION-BASED DATA ON HYPERTENSION IN HAWAII are limited. Two groups for which data from the 1980s exist are Japanese-American men ages 60 to 81 in the Honolulu Heart Program (HHP) and native Hawaiians ages 20 to 59 in the Molokai Heart Study (MHS). In the elderly HHP men, the mean systolic blood pressure (SBP) was higher and the mean diastolic blood pressure (DBP) was lower in the older age groups. In the MHS, both the mean SBP and the mean DBP were higher with increasing age in both sexes. Among Japanese-American men, 53% of those ages 60 to 64 were hypertensive (SBP greater than or equal to 140 mmHg or DBP greater than or equal to 90 mmHg, or taking antihypertensive medications), as were 59% of those ages 65 to 74, and 67% of those ages 75 to 81. Among native Hawaiians, 6% of men and 8% of women ages 20 to 24 were hypertensive, as were 37% of men and 41% of women ages 45 to 54. At ages 55 to 59 the prevalence for men was 31%; and for women, 33%. These data indicate that hypertension is relatively common in both ethnic groups; however, native Hawaiians appear to be at greater risk of cardiovascular disease overall.

Prevalence of obesity in a Native Hawaiian population.

Mortality data indicate that Native Hawaiians have higher death rates when compared with the US all-races population, and full-blooded Native Hawaiians are likely to have the highest mortality rates from heart disease in the nation. However, to date no comprehensive population-based study of risk factors in Native Hawaiians has been conducted. In this study of 257 Native Hawaiian adults, 62.8% of the women and 65.5% of the men were greater than or equal to 20% overweight by the second National Health and Nutrition Examination Survey (NHANES II) standards. Thirty-four percent of the women and 47% of the men were severely overweight. The mean body mass index (BMI, in kg/m2) was 30.3 in women and 30.9 in men. Women aged 45-54 y were heaviest with a mean BMI of 31.6. Of the men aged 25-34 y, 79.2% were overweight. The mean waist-to-hip ratio was 0.85 for women and 0.95 for men in this sample.

Cardiovascular risk factor levels in ethnic Hawaiians.

We report a cardiovascular risk factor survey of "native" Hawaiians 20-59 years old (70 percent, or 257), living on the Hawaiian Homestead lands on the island of Molokai, Hawaii. More than 60 percent of both sexes were overweight. Among males, 42 percent were smokers. The percent of the population with systolic blood pressure greater than 140 mm Hg or a diastolic pressure greater than 90 mm Hg or taking hypertensive medications was 14 percent of those ages 20-39 and 36 percent of those ages 40-59. The percent with serum cholesterol greater than or equal to 6.2 mmol/L ranged from 8 percent of those 20-29 years old to 46 percent in those 50-59 years old. Two percent of those ages 20-29 had a history of diabetes, or 2 + or greater glycosuria by dipstick, as did 23 percent of those ages 50-59. The majority of the known diabetics exhibited glycosuria and elevated glycohemoglobin levels, indicating poor control. Hypertension, although usually known to the participant, was frequently uncontrolled. From these data, it appears that among this group of Hawaiians major risk factors for cardiovascular disease were frequent, while at the same time the levels of awareness and/or control for most of these factors were low.