Exploring Challenges and Health Disparities Among Aging Asian Americans and Native Hawaiians

Exploring Challenges and Health Disparities Among Aging Asian Americans and Native Hawaiians and Other Pacific Islanders

Listening to the voices of native hawaiian elders and 'ohana caregivers: discussions on aging, health, and care preferences. Browne and colleagues (2014) conducted a qualitative study that was involved in a larger 6 year mixed-method study carried out by Hā Kūpuna. The authors’ purpose for this study was to gain a clear understanding of social and health disparities among nā kūpuna (elderly).

Six focus groups were interviewed, each of which were recruited from community-based programs in rural islands of the state which include Hawaiʻi, Molokaʻi and Kauaʻi. Researchers stressed the importance for understanding cultural outlooks, values, and beliefs affecting the health and well being of Native Hawaiian kupuna.

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The article is relevant to my research topic because it dives into the lived experiences of Native Hawaiians and explains the importance of community-based programs and its impact on aging in Hawaii for both elders and caregivers. This study is useful for analysing programs and interventions and addressing health disparities among Native Hawaiian elders. Best-practice physical activity programs for older adults: findings from the national impact study.

Hughes and colleagues (2009) evaluated existing physical activity programs for older adults. Specifically, they conducted a randomized trial to assess the impact of a multiple-component physical activity program for older adults. The programs were offered in community settings where they could target older adult participants. The authors focused on exercise adherence self-efficacy among the participants in the program.

Hughes and colleagues provided strong evidence that community providers can provide a multiple-component physical activity program that provides measurable benefits and outcomes of participant progress. Researchers measured participant progress in physical strength and consistent exercise participation. This study showed the importance that physical activity programs have on adults and why U.S. public policies should encourage these types of health promotion programs, being that they are inexpensive and effective at improving the quality of health among older adults.

This empirical study is useful in supporting the effectiveness and success of community-based program intervention for elderly populations.  Kaʻopua, L. S., Braun, K. L., Browne, C. V., Mokuau, N., & Park, C.-B. (2011). Why Are Native Hawaiians Underrepresented in Hawaii's Older Adult Population? Exploring Social and Behavioral Factors of Longevity. Journal of Aging Research, 1-8. https://doi:10.4061/2011/701232

Kaʻopua and colleagues (2011) describes the influences of the health and longevity of Native Hawaiian elders. The authors explored the causes for premature mortality among the aging population in Hawaii and identified different ways on how sociodemographics and behavior factors vary by ethnicity among Hawaiiʻs aging population. Ethnicities involved in data collection included Native Hawaiian, Caucasian, Filipino and Japanese people, all ages 60 and older.

In order to explain the ethnic differences in life expectancy among these individuals, Kaʻopua and colleagues highlighted the differences in cause of death, health and behavior indicators. Findings compared Native Hawaiian elders with other major ethnic groups in Hawaii which displayed that Native Hawaiian elderly have the highest prevalence of chronic diseases such as asthma and diabetes. Along with chronic diseases, heart disease seemed to be the leading cause of premature death, resulting in loss of years of life. Results were consistent with prior research on the Hawaiian population documenting health and social disparities they face.

Kanti and Falconier (2017) conducted a qualitative study examining the experience of second generation Asian Americans who provide housing and financial support for first generation parents. Semi-structured interviews collected responses from individuals stating their responsibility for care giving out of love and not obligation. American and Asian cultural values are completely different in the way they view elder care. Asian views typically shift the responsibility of care to children, meaning they are expected to take care of their parents as they age. Kanti and Falconier point out how Asian adults are more likely to live with their elderly parents and financially support them due to cultural expectation.

Findings indicated that the majority of participants reported positive impacts, yet they all agreed caring for their parents limited their independence. Overall, the study identified challenges among Asian Americans due to a mix of asian cultural values transmitted by parents, combined with the cultural values of the individualistic society Lee, J. H., Heo, N., Lu, J., & Portman, T. A. A. (2013). Qualitative exploration of acculturation and life-p issues of elderly asian americans. Adultp Journal, 12(1), 4–23. https://doi: 10.1002/j.2161-0029.2013.00012.

This qualitative research study explored the life-p process of elderly Asian Americans. Lee and colleagues (2013) explored the cultural identity, social relationships and perceptions of aging among Asian American individuals.the results of the study provided insightful information that has implications for the counseling profession... The authors acknowledge how Confucian values influenced the views of a family oriented asian american lifestyle……. Moreover, the acculturation process that Asian Americans experience……

Maskarinec, G. G., Look, M., Tolentino, K., Trask-Batti, M., Seto, T., de Silva, M., & Kaholokula, J. K. (2015). Patient perspectives on the hula empowering lifestyle adaptation study: benefits of dancing hula for cardiac rehabilitation. Health Promotion Practice, 16(1), 109–114. https://doi.org/10.1177/1524839914527451

In this article, Maskarinec and colleagues (2015) describes the benefits of hulan as dance therapy and how it benefits individuals going through cardiac rehabilitation.patients enrolled were between 50-81 years of age.Ethnicity was not limited to pacific islanders but also included asain americans.Hula is a safe activity, also considered a dance therapy, that improved the functional capacity of the participants. The authors stress how a culturally effective cardiac rehabilitation program promotes integrated wellness and enduring cultural values… culturally resonant interventions have a much stronger impact than traditional forms of CR. Challenges and promises of health equity for native hawaiians. National Academy of Medicine, https://doi: 10.31478/201610d

This article describes the challenges Native Hawaiians face when it comes to health equity. Mokuau and colleage (2016) identify health and social disparities among native hawaiians while presenting programs that promise health equity for this population. Historical trauma caused by the United States is what caused health disparities among NH because of discrimmination and oppression.....

Nguyen D. (2010). Physician contact by older Asian Americans: the effects of perceived mental health need. Clinical interventions in aging, 5, 333–336. https://doi.org/10.2147/CIA.S14273
In this article, Nguyen (2010) examines the perception of mental health needs in older Asian American adults. The author associated the perception of mental health needs with a decreased number of physician contacts for Filipino and Korean Americans.

This study reveals the interethnic differences among older Asian Americans and their experience with contacting physicians. Nguyen stresses how crucial it is to correctly identify mental health needs of older Asian Americans in the healthcare system. This study encourages mental health professionals to work on reducing mental health disparities among older AA, designing culturally appropriate evidence-based interventions. This study contributes to the contribution of the identification and treatment of mental health concerns that need to be adapted/tailored to meet the needs of specific groups.

By tailoring intervention efforts to the help-seeking patterns of Asian American groups, mental health professionals can work toward reducing mental health disparities
Nishita, C., & Browne, C. (2013). Advancing Research in Transitional Care: Challenges of Culture, Language and Health Literacy in Asian American and Native Hawaiian Elders. Journal of Health Care for the Poor and Underserved 24(1), 404-418.

This peer-reviewed article describes a conceptual framework and proposes a research agenda that assess family health literacy ability, explores relationships between culture, decision making, and the development and adaptation of planning tools. Nishita and Browne (2013) examined the cultural values of the four major ethinic groups in Hawaii which include Chinese, Filipino, Japanese and Native Hawaiian older adults. Moreover, with Hawaii having a high percentage of Asain American (AA) and Native Hawaiians and Other Pacific Islanders (NHOPI) as a whole in the U.S, the authors identified the additional demands that multicultural adults will need in the future.

This article is useful for addressing the expectations for caregiving at home by extended family. The authors indicated how each ethnicity is unique in the way they define health , healthcare needs, health problems, healing illnesses and managing disabilities. Overall, findings show the intersectionality that cultural values have on an individuals health profile and itʻs influence for settings and delivery of long term care for the aging AA and NHOPI population in Hawaii Nishita, C. M., Hayashida, C., & Kim, E. (2014). Better care for complex, challenging clients: hawaii's training program to improve residential long-term care.

This empirical study describes an innovative program to train caregivers and improve the skills of home and foster care facilities in Hawaii. The program is called the Kupuna Adult Care Home Project, which uses culturally relevant training modules that incorporates a combination of practical knowledge and active learning strategies to help participants work through real-life scenarios.The authors evaluated a total of 787 participants by measures of improved knowledge and satisfaction of the training.

Nashita and colleagues (2014) stress the importance of continuous education and training for personal and home care aids to improve quality and satisfaction of care for elderly patients. Findings from this program indicated high levels of satisfaction and gained knowledge. The limitation of this study is due to the access of the training program one one island, Oahu. For improvements, the authors recommend testing an online format to make the training modules more accessible to neighboring islands in the state of Hawaii, thus allowing caregivers to take the training classes at their convenience and at a reasonable price to sustain the program.

Reflection: Relevance to Topic: At the end, reflect and explain how all these articles are relevant to your research question and why it is important and how it expresses intersectionality
The purpose of my research is to examine the intersectionality of age and ethnicity among Asian Americans (AA) and Native Hawaiians and Other Pacific Islanders (NHOPI) populations in the state of Hawaii. Using an intersectionality lens, I wanted to examine the difficulties and challenges that arise among the aging population in Hawaii. Hawaii is a mixing pot of Polynesian and Asian ethinic groups with a rich cultural background. With such a diverse community comes differences for individual life experiences.

Hawaii is a multi-cultural place, which is why I chose to examine the impacts that intersectionality has as the community I grew up in ages.

Some articles are mainly focused on asian americans, while others are focused in native hawaiians and other pacfic islanders. I chose to break down my target population separately when looking into research articles because it allowed me to see the differences these populations face. Being that I focused on aging in Hawaii, it was important to break apart asians and polynesians as I found research articles, and allow them to collectively intersect to bring upon the broader issues of aging in Hawaii with the intersectionality of ethnicity, age and cultural backgrounds.
The 10 scholarly articles that I have selected embodies the intersectionality that the aging asian and pacific islander population encounters.

A few are specifically targeted at strictly Asian Americans, while ## articles focus on Native Hawaiians and other major ethnic groups which include filipino, chinese and japanese. For the six empirical articles I examined, I decided to focus on the importance of community based programs to gain a better understanding of the effectiveness and ability to be tailored to fit the specific needs of this diverse population. Physical activity programs were also a trend, and a reasonable one to assist and influence the aging population to be more physically active to maintain their health.

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