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Survey finds health disparities in two Pacific Islander populations

ANN ARBOR—A survey of two groups of Pacific Islanders draws comparisons between the health of two populations of Pacific Islanders residing in California, revealing they lag behind the state in several key areas of health.

Led by Sela Panapasa, a scientist at the University of Michigan Institute for Social Research, a group of researchers administered surveys to 240 Samoan and Tongan households in California. They included a companion survey for adolescents, ages 13 to 17, living in the home.

The survey found that both Samoans and Tongans had higher rates of hypertension than Californians at large, smoked at about four times the rate of Californians, were less likely to have health insurance, and used available health care services at lower rates, relying heavily on emergency room care.

Panapasa is presenting these results as part the U.S. Department of Health and Human Service's Office of Minority Health's kickoff to April's National Minority Health Month. The theme for the National Minority Health Month is "Bridging Health Equity Across Communities."

The researchers found that about 61 percent of Samoans and nearly 53 percent of Tongans reported having health insurance compared to 79 percent of Californians. Both groups also tended to delay medical care—likely because the groups were underinsured. At 36 percent for Samoans and 26.5 percent for Tongans, both groups were highly likely to visit the emergency room for health care.

The report also provided a more nuanced view of high blood pressure among Pacific Islanders. Previously, research showed low rates of hypertension among Pacific Islanders—much lower than the United States as a whole, and on par with rates in California. But these lower rates among Pacific Islanders may be because of underdiagnosis rather than good health, according to Panapasa.

Thirty-one percent of Samoans reported high rates of hypertension compared to 27 percent of Californians, while Tongans were slightly lower at 22 percent. But researchers found slightly different rates during the preliminary analysis of resting blood pressure collected when the survey was administered. They found that of the people who had reported no history of hypertension, 30 percent had blood pressure readings that suggested high blood pressure, and almost 50 percent had pre-hypertensive readings.

The gap between reported hypertension and the new findings from the survey may be caused by the practice of aggregating the health information collected across more than 20 Pacific Islanders ethnicities into a single measure, according to Panapasa. In fact, until 1997, the federal Office of Management and Budget grouped data collection such as health statistics for Asian-Americans and Pacific Islanders under the same category.

"These are very distinct groups. Each has its own culture, language and unique history," Panapasa said. "Going in with this one-size-fits-all attitude is not going to work."

Panapasa hopes the report will allow health care providers to develop more targeted approaches to help improve health behaviors among these underserved populations.

"This survey highlights the heterogeneity within the Pacific Islander community," she said. "This work needs to be expanded so that we would have similar information on other Pacific Islander groups in California, as well as across other states with large Pacific Islander populations."

Other results include:

  • Sixty percent of adult Samoans and 50 percent of Tongans reported smoking compared to only 13 percent of Californians.
  • Just 20 percent of women reported seeing an obstetrician-gynecologist in the last 12 months.
  • Twenty-five percent of Pacific Islanders reported seeing a natural healer in the past year and 14 percent reported seeking health care advice from their church pastor.
  • Only 13 percent of Samoan men and 19 percent of Tongan men report having a prostate screening compared to 43.5 percent of Californian men.
  • Less than 40 percent of Samoan and Tongan adults in California report their health as very good or excellent, compared to 60 percent of the U.S. population.
  • Fifteen percent of Pacific Islander adults report having had asthma compared to 13 percent of the U.S. population and 14 percent of Californians.
  • Forty percent of Pacific Islander women over age 50 report having had a mammogram compared to 46 percent of the U.S. population and 77 percent of Californians.
  • Just 9 percent of the Pacific Islander adult population reported having a colonoscopy.

The HHS Office of Minority Health will host an event featuring Panapasa, among other speakers, 1-2:30 p.m. Wednesday, April 13. The event will be streamed live through the Office of Minority Health's Twitter handle, @MinorityHealth and can be viewed at the office's website. Follow along using the hashtag #Bridge2Health.

The report was produced in collaboration with the U.S. Department of Health and Human Services Office of Minority Health and the Asian & Pacific Islander American Health Forum, the W.K. Kellogg Foundation.

 

More information:

Report is available upon request.