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• Accidents—death rates did not differ significantly between part-Hawaiians and the "all races" group, but f u l l - Hawaiians' rates were two times higher; this may be due to type of occupation. Probable factors 74/ that may be associated with high mortality rates of full-Hawaiians: • Income level; • Inadequate understanding of Western health care and a formal education; • High content of salt in Hawaiian foods; • Cultural concepts of health and illness that may affect selfdiagnosis and willingness to seek treatment; • Genetic factors; the ability to resist diseases may be associated with ethnicity. Incidence of Cancer 75/ Cancer is the second leading cause of death in Hawaii and during 1980, there were 2,769 new cases of cancer diagnosed. The incidence of cancer varies markedly in the various racial groups in the State. Table 34 compares the "age standardized" incidence rates of selected cancers for five groups (Caucasian, Chinese, Filipino, native Hawaiian, and Japanese) for the period 1973 through 1980. Since the incidence varies by age, the rates are "standardized" to show what the rates in the various racial groups would be, if all groups had the same age composition. The table shows that of the five ethnic groups, native Hawaiian men had by far the highest incidence of stomach and lung cancer. They had the second highest incidence of prostate cancer, after Caucasian men. For women, the incidence of cancer of the lung and breast was highest for native Hawaiians. Native Hawaiian women were second to Caucasian women in the incidence of cancer of the cervix. Acute and Chronic Conditions 76/ The State of Hawaii collects data on the presence and prevalence of acute and chronic conditions. As seen in Table 35, the Hawaiian and part- Hawaiian group reports the highest overall level of acute conditions among the major ethnic groups in Hawaii. They have particularly high rates for respiratory conditions. The Hawaiian and part-Hawaiian group fares better when compared to other ethnic groups on the prevalence of chronic conditions (see Table 36). Of the twenty chronic conditions reported, the native Hawaiian group scored highest in only one (not counting the "other" group), asthma with or without hayfever. The Hawaiian group reported the second highest prevalence in two categories: mental and nervous condition and bronchitis/emphysema. The Hawaiian group also reported the lowest prevalence of malignant neoplasms (cancer). A few cautionary notes should be added to this discussion. As reported in the mortality study above, combining full- and part-Hawaiians may be misleading, given the significantly higher mortality rate of full- Hawaiians for some of these diseases. The method of collecting the data must also be considered. The data in these tables was gathered by the Hawaii Health Surveillance Program via a statewide household survey. During 1980, 14,407 persons were interviewed to obtain these statistics. Those excluded from the sample were: