Template:Nhsc-v1-99

Health And Social Services A. INTRODUCTION S i n c e a wide v a r i e t y of h e a l th s t a t i s t i c s for n a t i v e H a w a i i a n s and f o r the S t a t e of Hawaii were p r e s e n t ed i n the p r e v i o u s c h a p t e r , they w i l l not b e r e p e a t e d h e r e . I n s t e a d , t h is c h a p t e r w i l l focus on the h i s t o r i c a l and c u l t u r a l background of n a t i ve Hawaiian h e a l t h ; and the S t a t e and f e d e r a l p r o g r a n s t h a t e x i s t to a d d r e ss t h e h e a l t h needs of a l l r e s i d e n t s of t h e S t a t e , as well as programs s p e c i f i c a l l y for n a t i v e H a w a i i a n s, The Hawaii S t a t e H e a l t h D e p a r t m e nt a d m i n i s t e r s a wide range of programs e m p h a s i z i n g h e a l t h m a i n t e n a n c e and p r o n o t i o n , r i s k r e d u c t i o n , and p r e v e n t i v e s e r v i c e s . 1/ Total e x p e n d i t u r e s by t h e D e p a r t m e n t for the f i s c a l year e n d i n g June 30, 1980, were $ 1 1 6 , 3 6 8 , 5 7 6 . The F e d e r a l Government .-jrovided 1 2 . 1 p e r c e n t cf t h i s amount, o r 5 1 4 , 0 5 5 , 5 2 6 . The v a r i o u s programs a v a i l a b l e to a d d r e s s h e a l t h needs a re d e s c r i b e d below. D e s c r i p t i o n s i n c l u de the s e r v i c e s p r o v i d e d , the community s e r v e d , and the problems e n c o u n t e r e d. B. HISTORICAL AND CULTURAL BACKGROUND r i t i c a l h i s t o r i c a l e v e n t s and u n i q u e c u l t u r a l f e a t u r e s i n f l u e n c i ng

• / The f o l l o w i n o s e c t i o n on

h i s t o r i c a l and c u l t u r a l background is a complete r e p r o d u c t i o n of a s e c t i on of the paper p r e p a r e d by R i c h a rd Kekuni B l a i s d e l i , M.D., e n t i t l e d: " H e a l t h S e c t i o n of N a t i v e Hawaiians S t ' i d y Commission R e p o r t " (pages 1 t h r o u g h 18, F e b r u a r y , 1983), w r i t t en a t the d i r e c t i o n of and funded by t he O f f i c e of Hawaiian A f f a i r s . Dr. B l a i s d e l i is a P r o f e s s o r in the U n i v e r s i t y of H a w a i i ' s Medical S c h o o l. Minor e d i t o r i a l ~hangps have been made t o cor.lorrr to t h e F i r : a l R e p o r t 's f o r m a t , and the f o o t n o t e s have been r e d e s i g n a t e d for the c o n v e n i e n c e of t h e h e a l t h a:id i l l n e s s of n a t i ve H a w a i i a n s are c o n v e n i e n t l y c o n s i d e r ed i n t h r e e p e r i o d s : before c o n t a c t with t h e n o n - P o l y n e s i a n w o r l d ; c o n t a c t, b e g i n n i n g w i t h C a p t a i n James Cook in 1778 to t h e o v e r t h r o w of the monarchy i n 1893; and the end of the kinqdom to t h e p r e s e n t, P r e - c o n t a c t ( A n c i e n t to 17 78) H e a l t h and I l l n e ss P r i o r to and at the same time of t h e a r r i v a l of C a p t a i n Cook in J a n u a ry 1778, the H a w a i i a n s of old wer>- g e n e r a l l y h e a l t h y b e c a u s e they had a d a p t e d e f f e c t i v e l y to i s l a nd e c o s y s t e m s about them, and they had l i v e d in i s o l a t i o n from the r e s t of t h e p l a n e t for over 500 y e a r s . 2/ Gene s t r e n q t l i was e v i d e n t in a f l o u r i s h i n g p o p u l a t i o n of an e s t i m a t ed 3 0 0 , 0 0 0 at the time of C a p t a i n Cook. _3_/ These were d e s c e n d a n t s of p e r h a ps one hundred h a r d y , f i r s t s e t t l e r s who had a r r i v e d more than 1,000 y e a rs p r e v i o u s l y from the South P a c i f i c, a f t e r b r a v i n g over 2,000 m i l e s cf open s e a in d o u b i e - h u l i e d c a n o e s . Some g e n e weakness was p o s s i b l e b e c a u s e of ( c o n t ' d ) the r e a d e r . Except fgr t h e s e c h a n g e s , the s e c t i o n of Or. B l a i s d e l l ' s p a p e r a p p e a r s as s u b m i t t ed by OHA and is o t h e r w i s e u n c h a n g e d. The second p a r t of Dr. B l a i s d e l l 's p a p e r , " H e a l t h P r o f i l e , " is not i n c l u d e d h e r e - - i t i s c o n s i s t e n t with t h e h e a l t h d a t a p r e s e n t e d in the " D e m o g r a p h i c s " c h a p t e r of t h i s Report which i n c o r p o r a t e s p r e v i o u s comments s u b m i t t e d to the Commission by "T . B l a i s d e l i . Dr. b l a i s d e l l ' s e n t i re ed in the Appendix of

he r e f e r e n c e s he used

p a p e r is reprodu t h i s Report and a r e marked w i t h " [ 1 ) " in the "Li' R e f e r e n c e s . "t

-p99-