Posted on: Saturday, September 18, 2004

Women's health risks get closer look

By Robbie Dingeman
Advertiser Health Writer

The new Hawai'i women's health data book is the first compilation on health issues specific to various ethnic groups and on trends on different islands.

JoAnn Tsark serves as project director for 'Imi Hale-Native Hawaiian Cancer Network, one of the partners in producing the just-released Hawai'i Women's Health Status report.

Tsark said sharpening the focus reveals some significant health concerns unique to certain groups.

For example, Hawai'i has an overall reputation of low rates of breast cancer when all ethnic groups are lumped together. But Tsark said a closer look at the data reveal Hawaiians have a much higher rate of breast cancer — 31 fatal cases per 100,000 people, compared to rates of 25.4 for Caucasian women, 14.9 for women of Chinese ancestry, 14.2 percent for women of Filipino ancestry and 12.2 percent for women of Japanese ancestry.

"For native Hawaiians, they're dying at almost twice the rate of the other ethnic groups," she said.

Including Japanese and Chinese women with lower risks and rates masks some of the reality, she said. "It just looked like there was no problem, and that was not the case," Tsark said.

The report will be valuable in making the pitch for federal grants and for putting the focus on some of the more pressing issues. Tsark also serves as research director for Papa Ola Lokahi, a Native Hawaiian health group working to improve health and wellness of Native Hawaiians.

The main backer of the book is Kap'iolani Health Systems. Dr. Ginny Pressler, vice president for Kapi'olani Health Systems, said some of the data has never been published before including the county-by-county breakdowns.

Pressler said the report gathered information from the state, U.S. Census, the Hawai'i tumor registry as well as hospital discharge data. "It's the first time we've put in one place the Hawai'i-specific data," she said.

Having that kind of detail "allows us to focus our public health and policy decisions to address needs of particular populations."

As an example of how the report can shed new light on specific problems, Pressler said the report shows that Filipino women have the highest rate of stroke death at 78 deaths per 100,000. She said that runs counter to the general notion that the rates would be higher in Japanese and Chinese women, who have a reputation for high blood pressure, an important contributing factor to stroke.

Pressler also noted regional differences and poorer health overall for women on the more rural Neighbor Islands. "I'm assuming part of that has to do with access to healthcare."

For example, on the Big Island, the data revealed that more than half the births — 51.7 percent — are to unmarried women, while the statewide rate is 34 percent and O'ahu's rate was just under 30 percent.

Pressler said she doesn't know why one island would show a higher rate than others. "But it raises a lot of questions. What's going on here? What can we do to address this?"

The health concern with single mothers is that they tend to be younger, less educated and poorer, she said. For example, 25 percent of single women head of households are living below the poverty level compared to only 10 percent of married mothers.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.