[Congressional Record Volume 147, Number 20 (Tuesday, February 13, 2001)]
[Extensions of Remarks]
[Pages E170-E171]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


    INTRODUCTION OF A BILL TO AMEND THE NATIVE HAWAIIAN HEALTH CARE 
             IMPROVEMENT ACT TO REVISE AND EXTEND SUCH ACT

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                         HON. NEIL ABERCROMBIE

                               of hawaii

                    in the house of representatives

                       Tuesday, February 13, 2001

  Mr. ABERCROMBIE. Mr. Speaker, I rise today with my colleague, 
Representative Patsy Mink, to introduce a bill to reauthorize the 
Native Hawaiian Health Care Improvement Act. The purpose of this 
legislation is to improve the health status of Native Hawaiians through 
the continuation of comprehensive health promotion and disease 
prevention. IT is intended to provide health education in Native 
Hawaiian communities and primary care health care services using 
traditional Native Hawaiian healers and health care providers trained 
in Western medicine. In areas where there is an underutilization of 
existing health care delivery systems that can provide culturally 
relevant health care services, this bill authorizes the Secretary of 
the Department of Health and Human Services to contract with Native 
Hawaiian health care systems to provide care referral services to 
Native Hawaiian patients. This reauthorization is intended to assure 
the continuity of health care programs for Native Hawaiians under the 
authority of Public Law 100-579.
  As enacted in 1988, the Native Hawaiian Health Care Improvement Act 
is premised upon the findings and recommendations of the Native 
Hawaiian Health Research Consortium report of December 1985 to the 
Secretary of the Department of Health and Human Services. The report 
clearly indicates that the underutilization of existing health care 
services by Native Hawaiian can be traced to the absence of culturally-
relevant services. Additionally, the report reveals a general 
perception in the Native Hawaiian community that health care services 
based on concepts of Western medicine will not cure diseases afflicting 
Native Hawaiian people.
  The bill contains extensive findings on the current health status of 
Native Hawaiians including the incidence and mortality rates associated 
with various forms of cancer, diabetes, asthma, circulatory diseases, 
infectious disease and illness, and injuries. It also includes 
statistics on life expectancy, maternal and child health, births, teen 
pregnancies, fetal mortality, mental health, and education and training 
in the health professions.
  The Native Hawaiian population living in Hawaii consists of two 
groups: Hawaiians and part-Hawaiians, which are distinct in both age 
distributions and mortality rates. Hawaiians comprise less than 5 
percent of the total Native Hawaiian population and are much older than 
the growing part-Hawaiian population.
  Overall, the Native Hawaiian death rate is 34 percent higher than the 
death rate for all races in the United States, but this composite masks 
great differences that exist between Hawaiians and part-Hawaiians. 
Hawaiians have a death rate 146 percent higher than the U.S. all-races 
rate. Part-Hawaiians also have a higher death rate, but only 17 percent 
greater than the U.S. as a whole. A comparison of age-adjusted death 
rates for Hawaiians and part-Hawaiians reveals that Hawaiians die at a

[[Page E171]]

rate 110 percent higher than part-Hawaiians, and this pattern is found 
in all but one of the 13 leading causes of deaths common to both 
groups.
  The health status of Native Hawaiians is far below that of other U.S. 
population groups. In a number of areas, the evidence is compelling 
that Native Hawaiians constitute a population group for which the 
morality rates associated with certain disease exceed that for other 
U.S. populations in alarming proportions.
  Native Hawaiians premise their high morality rates and incidence of 
disease upon the breakdown of the Hawaiian culture and belief systems, 
including traditional healing practices. That breakdown resulted from 
western settlement and the influx of western diseases to which the 
native people of the Hawaiian Islands lacked immunity. Further, Native 
Hawaiians perceive the high incidence of mental illness and emotional 
disorders in the Native Hawaiians population as evidence of the 
cultural isolation and alienation of the native peoples in a statewide 
population of which they now constitute only 20 percent. Settlement 
from both the east and the west brought new diseases which decimated 
the Native Hawaiian population, and it devalued their customs and 
traditions to the point of prohibiting their native tongue in schools 
and other public venues.
  The concepts embodied in this bill are the result of extensive work 
of Native Hawaiian health care professionals and others dedicated to 
improving the health of Native Hawaiians. Its purpose is to enable 
Native Hawaiians to achieve the healthful harmony of the self, or 
lokahi, with others and all of nature. For Native Hawaiians to function 
effectively as citizens and leaders in their own homeland, there must 
be a restoration of cultural traditions, integration of traditional 
healing methods in the health care delivery system, and a collective 
effort to restore to Native Hawaiians a sense of self esteem and self 
worth. The ultimate goal is to have this Native Hawaiian way of dealing 
with health eventually become an integral part of the State's health 
policy for both Native Hawaiian and Non-Hawaiians.

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