interventions, however, and more health professionals
need to be recruited from this population into health
and medical fields in specific geographic areas. Profes-
sionals from the dominant (white) culture also need to
become more culturally competent.RisksNutrition and Health Status
Accurate mortality and morbidity statistics for
this population are limited, mainly because data on
Pacific Islander Americans were classified with Asian
Americans until a few years ago. Pacific Islander
Americans have a high rate ofobesity, and Native
Hawaiians and Samoans are among the most obese
people in the world. Dietary and lifestyle changes, as
well as a likely genetic predisposition to store fat, are
possible causes for this high rate. Lifestyles have
changed from an active farming- and fishing-basedsubsistence economy to a more sendentary lifestyle.
Pacific Islanders may be genetically predisposed to
store fat for times of scarcity (the ‘‘thrifty gene’’ phe-
notype), and there is evidence that prenatal undernutri-
tionmodifiesfetaldevelopment,predisposingindividuals
to adult obesity and chronic diseases.
Besides obesity, Pacific Islander Americans have
high rate of diabetes,hypertension, cardiovascular
disease, and stroke. Data collected from 1996 to 2000
suggest that Native Hawaiians are 2.5 times more
likely to have diagnosed diabetes than white residents
of Hawaii of similar age. Guam’s death rate from
diabetes is five times higher than that of the U.S.
mainland, and diabetes is one of the leading causes
of death in American Samoa. Overall, Pacific Islander
Americans have much lower rates of heart diseasethan
other minority groups in the United States, but it is
still the leading cause of death within this population.
Risk factors for and mortality from heart disease are
high partly because of higher rates of obesity, diabetes,
and high blood pressure. The poor health status of
Pacific Islander Americans is also linked to socioeco-
nomic indicators—Native Hawaiians have the worst
socioeconomic indicators, the lowest health status,
and the most diet-related maladies of all American
minorities.Resources
PERIODICALS
Galanis D. J.; McGarvey, S. T.; Quested, C.; Sio, B.; and
Afele-Fa’amuli, S. A. (1999). ‘‘Dietary Intake of Mod-
ernizing Samoans: Implications for Risk of Cardiovas-
cular Disease.’’Journal of the American Dietetic
Association99(2):184–90.
Kittler, P. G., and Sucher, K. P. (2001).Food and Culture,
3rd edition. Stamford, CT: Wadsworth.
Wang, C. Y.; Abbot, L.; Goodbody, A. K.; and Hui, W. T.
(2002). ‘‘Ideal Body Image and Health Status in Low-
Income Pacific Islanders.’’Journal of Cultural Diversity
9(1):12–22.OTHER
National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK). ‘‘Diabetes in Asian and Pacific
Islander Americans.’’ Available from<http://diabetes
.niddk.nih.gov/.
U.S. Geological Survey, Biological Resources Division.
‘‘The Status and Trends of the Nation’s Biological
Resources: Hawaii and the Pacific Islands.’’ Available
from http://biology.usgs.gov/.Ranjita Misra
Delores C. S. JamesSOURCE: U.S. Census Bureau, Census 2000Native Hawaiian and other U.S. Pacific Islander
population, 2000National origin Population Percent
Total 874,414 100.0%
Polynesian
Native Hawaiian 401,162 45.9
Samoan 133,281 15.2
Tongan 36,840 4.2
Tahitian 3,313 0.4
Tokelauan 574 0.1
Polynesian, not specified 8,796 1.0
Micronesian
Guamanian or Chamorro 92,611 10.6
Mariana Islander 141 *
Saipanese 475 0.1
Palauan 3,469 0.4
Carolinian 173 *
Kosraean 226 *
Pohnpeian 700 0.1%
Chuukese 654 0.1
Yapese 368 *
Marshallese 6,650 0.8
I-Kiribati 175 *
Micronesian, not specified 9,940 1.1
Melanesian
Fijian 13,581 1.6
Papua New Guinean 224 *
Solomon Islander 25 *
Ni-Vanuatu 18 *
Melanesian, not specified 315 *
Other Pacific Islander 174,912 20.0
*Less than 0.1%.(Illustration by GGS Information Services/Thomson Gale.)Pacific Islander American diet