NRS 429 Health Promotion in Minority Populations

Sample Answer

An ethnic minority group refers to individuals who constitute less than half of the population in an entire State or country and whose members share common characteristics of language, culture, religion, or a combination of these. Socio-economic, cultural, and political factors often limit ethnic minority groups in the US from accessing quality health care. The purpose of this paper is to compare and contrast the health status of Native Hawaiians to the national average and discuss health promotion that can be applied to this minority group.

Identification and Description of Selected Minority Group

Native Hawaiians include people with origins in the original peoples of Hawaii, Samoa, Guam, or other Pacific Islands. The estimated population of Native Hawaiians as of July 2022 was 1,440,196 based on statistics from the .S. Census Bureau. Of this population, 5.7% are children below 5 years, 21.1% are persons below 18, and 19.6 % are adults above 65. Besides, females constituted 49.7% of the total population. The states with the highest population of Native Hawaiians are Hawaii, California, Washington, Texas, Utah, Florida, Nevada, Oregon, New York, and Arizona.

Native Hawaiians suffer from poor health outcomes, like high rates of overweight/obesity, hypertension, asthma, and cancer mortality (Long et al., 2022). The major mortality causes among this group are heart disease, unintentional injuries, cancer, stroke, and diabetes.

Health Disparities and Nutritional Challenges for Minority Group

Health disparities refer to the differences in access to healthcare and outcomes between groups. Health disparities among Hawaiians include a 37 times higher rate of TB and an 80% higher overweight/obesity rate. In addition, they are four times more likely to develop a stroke and 30% more likely to die from a stroke (Long et al., 2022). The group also has almost double the infant mortality rate of the general population. Furthermore, diabetes is a major cause of mortality in Native Hawaiians. Data shows that Hawaiians are 2.5 times more likely to be diagnosed with diabetes or die from the disease than whites (McElfish et al., 2019).

Statistics also reveal that 39% of the population has uncontrolled diabetes, which surpasses the Healthy People 2020 goal of 16.1%. The high rates of overweight/obesity, hypertension, and diabetes can be attributed to poor dietary habits. Long et al. (2022) explain that Native Hawaiians have a high incidence of food insecurity, contributing to chronic illnesses. The population has poor dietary habits high in complex carbohydrates, and has moderate amounts of vegetables and minimal lean animal food. Hawaiians’ diet comprises 78% carbohydrate, 12% protein, and 10% fat, which contribute to overweight and obesity.

Barriers to Health for Minority Group

Poor health outcomes among Native Hawaiians can be attributed to cultural, socioeconomic, educational, and sociopolitical factors. Language and cultural barriers hinder many Hawaiians from accessing quality healthcare. Most healthcare providers are not conversant with the group’s cultural beliefs and practices, which hinders them from understanding their health needs and the best measures to address their health problems (McElfish et al., 2019). The median household income for Native Hawaiians in 2019 was $66,695, lower than whites at $71,664.

Besides, more Hawaiians (15%) lived at or below the poverty level than whites 9%, and Hawaiians had higher unemployment rates (McElfish et al., 2019). These have affected access to health due to lack of insurance and limited access to healthy foods. Furthermore, 23% of Hawaiians face challenges paying medical bills compared to whites at 16%. The limitations in accessing health care contribute to poor health outcomes, lower quality of life, and inefficient use of health services. Hawaiians have a lower level of educational attainment than Whites.

Approximately 24% of Native Hawaiians have a bachelor’s degree or higher compared to 37% of whites. Besides, fewer Native Hawaiians have a graduate or professional degree than whites. Higher education levels are linked with better health outcomes and a longer lifespan. Native Hawaiians have a political history of long-term injustice and discrimination (Lee et al., 2022). They lost their agricultural and aquacultural way of life because of urbanization and had limited access to their Native foods limiting their ability to attain optimal health.

Health Promotion Activities Practiced by Minority Group

Native Hawaiians engage in various activities to improve and promote their health. They seek traditional healers’ services that provide massage and treatment with herbs. Hawaiians use massage to alleviate pain during childbirth and manage inflammation, rheumatism, asthma, and bronchitis to improve circulation to specific body parts (Kaholokula et al., 2018). Herbs are used to manage burns, headaches, high BP, GI distress, toothache, worm infections, respiratory symptoms, and hyperglycemia.

Three Levels of Health Promotion Prevention

Primary prevention would be the most effective level of health promotion for Native Hawaiians. The population has a high prevalence of chronic diseases associated with poor lifestyle practices like poor dietary habits (excess fat and energy intake), smoking, and inadequate physical activity. Primary prevention will focus on educating Hawaiians on measures to prevent these chronic illnesses, particularly lifestyle modification. Lee et al. (2022) recommend culturally-appropriate measures to increase physical activity among Hawaiians, which can alleviate high rates of overweight, obesity, and diabetes.

Hawaiians can be educated on reducing caloric consumption while considering their cultural practices. For instance, the health provider can help create a healthy meal plan using their native foods. Primary prevention is key to reducing the incidence of new diagnoses of chronic illnesses since it promotes behavior change.

Cultural Competent Health Promotion for Ethnic Minority Population

A health promotion care plan for a minority group should incorporate the population’s health beliefs, health and ethnic customs, religious practices, diet customs, and interpersonal customs. Leininger’s Culture Care Theory can be applied to support culturally competent health promotion for Native Hawaiians. It asserts that different cultures have different caring behaviors as well as values on health and illness, beliefs, and behavioral patterns (McFarland & Wehbe-Alamah, 2019). The theory’s primary aim is for nursing care to have beneficial meaning and health outcomes for people from similar or different cultural backgrounds.

Conclusion

Health disparities are apparent among Native Hawaiians and have contributed to a poor health status compared to the general US population. They have high rates of overweight/obesity, hypertension, asthma, and cancer, contributing to poor health outcomes, low quality of life, and reduced life span. Poor diet habits among Hawaiians have contributed to the high obesity and diabetes rates. Primary prevention should aim to increase Hawaiian’s knowledge of lifestyle practices contributing to poor health outcomes to encourage them to modify their behavior.

References

• Kaholokula, J. K., Ing, C. T., Look, M. A., Delafield, R., & Sinclair, K. (2018). Culturally responsive approaches to health promotion for Native Hawaiians and Pacific Islanders. Annals of human biology, 45(3), 249–263. https //doi.org/10.1080/03014460.2018.1465593
• Lee, Y. J., Braun, K. L., Wu, Y. Y., Burrage, R., Muneoka, S., Browne, C., … & Hossain, M. D. (2022). Physical activity and health among Native Hawaiian and Other Pacific Islander older adults. Journal of Aging and Health, 34(1), 120–129. https //doi.org/10.1177/08982643211032468
• Lee, Y. J., Braun, K. L., Wu, Y. Y., Hong, S., Gonzales, E., Wang, Y., … & Browne, C. V. (2022). Neighborhood social cohesion and the health of native Hawaiian and other Pacific Islander older adults. Journal of Gerontological Social Work, 65(1), 3–23. https //doi.org/10.1080/01634372.2021.1917033
• Long, C. R., Narcisse, M. R., Bailey, M. M., Rowland, B., English, E., & McElfish, P. A. (2022). Food insecurity and chronic diseases among Native Hawaiians and Pacific Islanders in the US results of a population-based survey. Journal of Hunger & Environmental Nutrition, 17(1), 53–68. https //doi.org/10.1080/19320248.2021.1873883
• McElfish, P. A., Purvis, R. S., Esquivel, M. K., Sinclair, K. I. A., Townsend, C., Hawley, N. L., … & Kaholokula, J. K. A. (2019). Diabetes disparities and promising interventions to address diabetes in Native Hawaiian and Pacific Islander populations. Current diabetes reports, 19, 1–9. https //doi.org/10.1007/s11892-019-1138-1
• McElfish, P. A., Yeary, K., Sinclair, I. A., Steelman, S., Esquivel, M. K., Aitaoto, N., Kaholokula, K., Purvis, R. S., & Ayers, B. L. (2019). Best Practices for Community-Engaged Research with Pacific Islander Communities in the US and USAPI A Scoping Review. Journal of health care for the poor and underserved, 30(4), 1302–1330. https //doi.org/10.1353/hpu.2019.0101
• McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s Theory of Culture Care Diversity and Universality An Overview With a Historical Retrospective and a View Toward the Future. Journal of transcultural nursing official journal of the Transcultural Nursing Society, 30(6), 540–557. https //doi.org/10.1177/1043659619867134