Cultivating Pacific Leaders for the Journey to Wellness Nia Aitaoto, MPH MS Principal Investigator, Faith in Action Research Alliance Advisor, Pacific Chronic Disease Coalition Advisor, Pacific Partnership for Tobacco Free Islands O le ala i le pule o le tautua Samoan Proverb The path to leadership is through service to others Sense of Place: Oceania Sense of Belonging: Race & Ethnicity Polynesians ◦ Hawaiians, Samoans, Tongans, Maori, Tahitians, Cook Islanders, etc. Micronesians ◦ Chamorros, Carolinians, Chuukese, Pohnpeians, Yapese, Marshallese, Palauans, Kosraeans, etc. Melanesians ◦ Papuans, Solomon Islanders, Fijians, Vanuatu Islanders, etc. Sense of Connection: U.S Pacific Territories (Guam & A.S) Commonwealth (CNMI) Freely Associated States (Republic of Belau, Republic of the Marshall Islands and the Federated States of Micronesia) Relationship with U.S The U.S Promise The Pacific Promise ◦ Health ◦ Military Support ◦ Education ◦ Resource Utilization ◦ Protection ◦ UN support The Reality • High Poverty • Disparity in Health Spending • Migration to the United States Per Capita Health Spending United States $5,274 Republic of Palau $730 Republic of the Marshall Islands $415 Federated States of Micronesia $311 Source: WHO 2002 Data Diabetes Prevalence Jurisdiction Year Prevalence Guam 2002-2003 11% FSM 2002 24% RMI 2002 30% Palau 2006 39% American Samoa 2004 47% United States 2007 8% Source: Hosey G, Aitaoto N, Satterfield D, Kelly J, Apaisam CJ, Belyeu-Camacho T,deBrum I, Luces PS, Rengiil A, Turituri P. The culture, community, and science oftype 2 diabetes prevention in the US Associated Pacific Islands. Prev ChronicDis. 2009 Jul;6(3):A104. Epub 2009 Jun 15. Diabetes and Smoking The prevalence of smoking among Native Hawaiian or Other Pacific Islander adults is 16.5%. Among Native Hawaiian and Pacific Islanders, there are no gender differences in smoking rates. “Smokers with diabetes are eleven times more likely to have a heart attack or stroke than people who don't have diabetes and don't smoke.” (Source: Diabetes Health, http://www.diabeteshealth.com/read/2009/05/05/6186/diabetes-and-smoking/?isComment=1#comments) Smoking effects insulin activity and can contribute to the development of diabetes. (Source: Haire-Joshu, D., Glasgow, R., Tibbs, L. (1999). Technical Review - Smoking and Diabetes. Diabetes Care. Volume 22, Number 11. 1887 – 1898.) SOURCE: Legacy Foundation Research Team That was not always the case… 1940’s U.S Navy health survey ◦ Found: intestinal parasites, yaws, tuberculosis and skin diseases ◦ Complete absence of malnutrition or obesity ◦ No indication of diabetes ◦ Almost no hypertension Taeao a fua In this new day we have the opportunity to re-examine the visions of old to re-assess our direction and to realign our strengths and weaknesses. Case Studies Pacific Partnership for Tobacco Free Islands (PPTFI) & Legacy For Health Pacific Chronic Disease Coalition (PCDC) & `Imi Hale/Papa Ola Lokahi Faith in Action Research Alliance (FARA) & University of Iowa Pacific Partnership for Tobacco Free Islands & (PPTFI) Smoking rates among adults and youth in the Pacific are higher than U.S. National averages for any racial or ethnic group. PPTFI Goal: Creating a powerful, collective voice for the Pacific Island Jurisdictions in addressing tobacco control and prevention and advocating for resources and recognition. Efforts were aimed at developing comprehensive programs focused on decreasing smoking rates and shifting social norms around tobacco use. Lifestyle Tips Diet Exercise Quitting Smoking Reduced Alcohol Consumption Vitamins and Supplements Source: http://www.tobaccofreemontana.org/a-lifestyle-control/ Key Components Understand Cultural Context Respect Existing Leaderships Engage in Participatory Practices Pacific Mentorship ◦ Knowledge ◦ Wisdom ◦ Mana - Spirit What is Lacking from health/academic institutions? Recruitment and Retention Initiatives Culturally Competent Mentorship Programs Multi-dimensional approach Measuring Impact Increased the number of NHPI leadership positions Increased number of students enrolling in and graduating from college Improved health outcomes Recommendation Liaison between NHPI communities and the federal government ◦ Provide training on special needs of NHPI ◦ Evaluate past and current programs funded by HHS targeting NHPI Kinnisow – Kommol – Kulo Contact Information: Nia Aitaoto Principal Investigator Faith in Action Research Alliance University of Iowa [email protected].