Pacific Islanders

According to the 2000 Census, there were 874,414 Native Hawaiian and other Pacific Islanders (NHOPIs) living in the U.S. (alone or in combination with one or more other races). California is second only to Hawaii in the number of NHOPIs, with half of the state’s 221,458 NHOPIs living in Southern California. PIs generally face high socioeconomic barriers to health and other care. Educational attainment is low, with only 16.3% of PIs as high school graduates compared to the national average of 28.3%. While only 12.4% of people in the U.S. were at or below the poverty line in 1999, this was true for 17.7% of PIs (U.S. Census, 2001).

Between 1992-2002, while breast cancer incidence rates decreased or remained the same for all other racial/ethnic groups, they increased for Asian Pacific Islanders (Edwards et al., 2005). Compared to nearly all other ethnic groups, PIs suffer from higher prevalence’s of the leading health disparity indicators, including hypertension, obesity, diabetes, infant mortality, tuberculosis, hepatitis B, asthma, and cigarette smoking.While data on the cancer needs of Pacific Islanders in the U.S. is sparse, available evidence universally point to critical needs and high barriers to care for this diverse group. Among the primary factors associated with cancer onset, several are of particular concern for Pacific Islanders (CDC, 2002). First, obesity has been implicated as a causal factor in the onset of several cancers (including breast, colon, endometrium, esophagus, and kidney cancers), and rates of obesity are high in all Pacific Islander populations. In California, data from the 2001 California Health Interview Survey (CHIS) indicate that 19.4% of Pacific Islanders in Southern California (defined as the six counties of Imperial, Los Angeles, Orange, Riverside, San Bernadino and San Diego) were obese (with a body mass index equal to or greater than 30) compared to only 17.9% of the non-PI population.

Studies have also documented the high rates of tobacco use among Pacific Islanders. In a review of tobacco use behaviors among Asian Americans and Pacific Islanders (AAPIs), Lew and Tanjasiri (2003) reported that Native Hawaiians, American Samoans, Chuukese and Palauans had rates of use between 42-58% among men, and between 11-67% among women. These smoking rates (with the exception of the Palauan data, which was betel nut use) were among the highest for both genders of all AAPIs. Data from the 2000 National Youth Tobacco Survey indicated that by high school 32% of Hawaiian/Pacific youth were smokers. While smoking among Asian Americans tends to be a male behavior, that is not the case for Pacific Islanders. Nearly one quarter (24.4%) of Hawaiian/Pacific Islander females reported current smoking.

Finally, little to nothing is known about the cancer survivor needs and experiences of Pacific Islanders . For instance, despite the fact that breast cancer is the most common cancer for Pacific Islander women, information on ways to ameliorate the significant mental, social and physical health impacts are nearly non-existent. In two studies of differences in breast cancer treatment modalities, AAPI women were found to be less likely to receive radiation or hormonal therapy compared to white women, and more likely to receive a mastectomy rather than breast conserving surgery (Chui & Lyerly, 2002; Prehn et al., 2002). . It’s unclear to what extent this reflects Pacific Islander women’s experiences, and further research must be done into treatment and quality of life experiences with the many PI subgroups.

Appleyard J, Messeri P, Haviland ML. Smoking among Asian American and Hawaiian/Pacific Islander youth: new data from the 2000 National Youth Tobacco Survey. As Am Pac Isl J of Health, 2001, 8(1): 6-14.

Asian Pacific American Legal Center. The Diverse Face of Asians and Pacific Islanders in California. Los Angeles, CA: APALC. 2005

Asian Pacific American Legal Center . (2005). The Diverse Face of Asians and Pacific Islanders in California. Los Angeles: APALC.

Asian Pacific American Legal Center. The Diverse Face of Asians and Pacific Islanders in California. Los Angeles, CA: APALC. 2005

Centers for Disease Control and Prevention (CDC). (2002). Health disparities among Native Hawai’ians and other PIs garner little attention. Chronic Disease Notes & Reports, 15.

Chui SY, &Lyerly HK. Disparities in breast carcinoma treatment in Asian/Pacific Islander women: a challenge to the provider. Cancer, 2002; 95: 2257-9.

Edwards BK, Brown ML, Wingo PA, Howe HL, Ward E, Ries LAG, Schrag D, Jamison PM, Jemal A, Wu XC, Friedman C, Harlan L, Warren J, Anderson RN, Pickle LW. (2005). Annual report to the nation on the status of cancer, 1975-2002, featuring population-based trends in cancer treatment. J Nat Cancer Inst, 97(19): 1407-27.

Lew R, Tanjasiri SP. Slowing the epidemic of tobacco use among Asian Americans and Pacific Islanders. American Journal of Public Health, 2003, 93(5): 764-768.

Prehn AW, Topol B, Stewart S, Glaser SL, O’Conner L, 7 West DW. (2002). Differences in treatment patterns for localized breast carcinoma among Asian/Pacific Islander women. Cancer, 95:2268-75. U.S. Department of Commerce. The Native Hawaiian and Other Pacific Islander Population: 2000. U.S. Department of Commerce, U.S. Census Bureau, 2001.

UCLA Center for Health Policy Research. California Health Interview Survey. Los Angeles, CA: UCLA.

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