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Contents
Health And Social Services
A. INTRODUCTION
Since a wide variety of health statistics for native Hawaiians and for the State of Hawaii were presented in the previous chapter, they will not be repeated here. Instead, this chapter will focus on the historical and cultural background of native Hawaiian health; and the State and federal programs that exist to address the health needs of all residents of the State, as well as programs specifically for native Hawaiians.
The Hawaii State Health Department administers a wide range of programs emphasizing health maintenance and promotion, risk reduction, and preventive services. 1/ Total expenditures by the Department for the fiscal year ending June 30, 1980, were $116,368,576. The Federal Government provided 12.1 percent of this amount, or $14,055,526. The various programs available to address health needs are described below. Descriptions include the services provided, the community served, and the problems encountered.
B. HISTORICAL AND CULTURAL BACKGROUND
Critical historical events and unique cultural features influencing the health and illness of native Hawaiians are conveniently considered in three periods: before contact with the non-Polynesian world; contact, beginning with Captain James Cook in 1778 to the overthrow of the monarchy in 1893; and the end of the kinqdom to the present.
Pre-contact (Ancient to 1778)
Health and Illness
Prior to and at the same time of the arrival of Captain Cook in January 1778, the Hawaiians of old were generally healthy because they had adapted effectively to island ecosystems about them, and they had lived in isolation from the rest of the planet for over 500 years. 2/ Gene strength was evident in a flourishing population of an estimated 300,000 at the time of Captain Cook. 3/ These were descendants of perhaps one hundred hardy, first settlers who had arrived more than 1,000 years previously from the South Pacific, after braving over 2,000 miles of open sea in double-hulled canoes. Some gene weakness was possible because of
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*/ The following section on historical and cultural background is a complete reproduction of a section of the paper prepared by Richard Kekuni Blaisdell, M.D., entitled: "Health Section of Native Hawaiians Study Commission Report" (pages 1 through 18, February , 1983), written at the direction of and funded by the Office of Hawaiian Affairs. Dr. Blaisdell is a Professor in the University of Hawaii's Medical School. 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 ( 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
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