Beyond the Ability to Pay: The Health Status of Native Hawaiians and Other Pacific Islanders in Relationship to Health Insurance.

Native Hawaiians and Other Pacific Islanders (NHOPI) suffer from a number of poor health outcomes, such as high rates of overweight status, obesity, hypertension, and high rates of asthma and cancer mortality. In addition to a disproportionate burden of illness, barriers to health care access and utilization also exist. This study examines the effect of health insurance coverage on the health status of NHOPI in comparison to Asians. To analyze this relationship, the study uses the Behavioral Risk Factor Surveillance System (BRFSS) 2012 data and logistic regression. Findings show insured NHOPI were significantly more likely than insured Asian Americans to report poor or fair health after sequential cumulative adjustments of socioeconomic, lifestyle and behavioral factors, history of diagnosed diseases, and access to care (OR: 1.66, 95% CI:[1.34, 2.05]). Health insurance alone will not eliminate the present disparities experienced by NHOPI. Other barriers prohibit health care access for NHOPI that should be considered in the investigation and development of strategies to increase healthcare access and eliminate health disparities for NHOPI.

Native Hawaiian views on biobanking.

Genomic science represents a new frontier for health research and will provide important tools for personalizing health care. Biospecimen-based research is an important mechanism for expanding the genomic research capacity, and indigenous peoples are a target of biospecimen-based research due to their relative isolation and the potential to discover rare or unique genotypes. This study explored Native Hawaiian perceptions of and expectations for biobanking. Ten discussion groups were conducted with Native Hawaiians (N = 92), who first heard a presentation on biobanking. Six themes emerged: (1) biobank governance by the Native Hawaiian community, (2) research transparency, (3) priority of Native Hawaiian health concerns, (4) leadership by Native Hawaiian scientists accountable to community, (5) re-consenting each time specimen is used, and (6) education of Native Hawaiian communities. Considered together, these findings suggest that biobanking should be guided by six principles that comprise "G.R.E.A.T. Research" (Governance, Re-consent, Education, Accountability, Transparency, Research priorities). These recommendations are being shared with biobanking facilities in Hawai'i as they develop protocols for biobanking participation, governance, and education. These findings also inform researchers and indigenous peoples throughout the world who are working on biobanking and genomic research initiatives in their nations.