Aloha kakou. I am Winona Kealamapuana Ellis Rubin, Director of the Department of Human Services. The State Department of Human Services assists those persons who have special needs through its three divisions Family & Adult Services, Health Care Administration and Vocational Rehabilitation and Services to the Blind, as well as through the administratively attached Hawaii Housing Authority. o The department serves approximately 21,000 Hawaiians O O Data included in Appendices A & B of my testimony or 30% of the approximately 14,000 adults on Aid to Families with Dependent children (AFDC) are There are high concentrations of Hawaiians being served that of Hawaiian homestead communities and which have O The Hawaiian Home Lands waiting list may contain many o The number and concentration of Hawaiians in department AN EQUAL OPPORTUNITY AGENCY The department has been cooperating with agencies such as ALU LIKE on the Native Hawaiian Elderly Needs Assessment and Project Success employment training and placement program. Through native American legislation, under your leadership Mr. Chairman, Congress has acknowledged that Hawaiians, as Native Americans, have significant needs for which federal funds should be made available. Some funds have been designated for Hawaiians in Older American, health and education legislation. FEDERAL ASSISTANCE IS NECESSARY FOR HAWAIIANS IN HUMAN SERVICES We request your favorable consideration of federal funds to provide: (1) (2) (3) A statewide program promoting OUTREACH SOCIAL WORKERS AND CULTURALLY APPROPRIATE HOME BASED INTERVENTION SERVICES as EMERGENCY AND TRANSITIONAL SHELTERS, especially for elders of families with children who are on waitlists for public housing/rental assistance and unable to secure safe shelter. (4) Additional Housing & Urban Development (HUD) SECTION 8 VOUCHERS to meet assistance needs. (5) Addtional federal CHILD ABUSE and neglect demonstration funds for the state to explore innovative and culturally responsive approaches to address family stress violence. (6) STIPENDS to allow those seeking pro and post professional educational field placement expenses to be able to serve in homestead communities. (7) TRAINING FUNDS to encourage low income Hawaiian individuals Federal funds can help to make the difference in addressing the needs of Hawaiians. We would be pleased to work with your staff youred We urge your favorable action in providing these federal the outcom. resources. Mahalo. JOHN WAINEE GOVERNOR OF HA STATE OF HAWAII JOHN C. LEWIN. M.D. In reply, please refer to: OVERSIGHT HEARINGS ON THE HAWAIIAN HOMES COMMISSION ACT OF 1920 TESTIMONY OF DR. JOHN C. LEWIN DIRECTOR DEPARTMENT OF HEALTH August 7, 1989 Mr. Chairman and Members of the Committees: By the time Congress passed the Hawaiian Homes Commission Act in 1921, many profound changes had already negatively influenced the health and integrity of the aboriginal descendants of these islands. The sophisticated civilization which existed in 1778, at the time of the arrival of Captain Cook had a population estimated to be at least 300,000 500,000 people. That number had decreased by over 95% to less than 18,000 people after the overthrow of the Hawaiian monarchy in the late 1800's (Source: State Statistician R. Schmidt). The Hawaiians were immunologically unprepared to cope with the barrage of infectious diseases, plague, and pestilence which came to then with the arrival of the various outside cultures, and this clearly contributed significantly to their drastic reduction in numbers. However, this depopulation could not be attributed solely to the exposure to foreign disease to these people who had been living in complete isolation from the rest of the planet for about 500 years (Kirch, 1984). In fact, acculturation brought drastic changes to their whole way of life: to their diet, to their traditional religious and healing practices, to the economy which they knew and practiced, to the entire Hawaiian way of life. As the Hawaiians gave up their rich culture, many facets of what was highly sophisticated began to diminish and disappear. The response to its loss began to take hold in symptoms of physical and mental collapse. Today, we address the crisis in the health of the Hawaiians of the present and make some suggestions about solutions which are needed. The State of Hawaii today enjoys the highest health status of all the American states. We have the greatest longevity, the lowest incidence of heart attacks, the lowest incidence overall of cancer, emphysema, and obesity. We enjoy the lowest per ACUTE CARE capita rate of hospitalization and utilization of long term care beds. And yet, included among these impressive statistics, one fifth of our population, our Hawaiians, have close to the worst health status of any population group in America. Today, the population of Hawaii is estimated to be 1,022,751, of which 211,189 residents are of Hawaiian ancestry. Thus, the Hawaiians represent 20.7% of our present state population. In terms of their health status, the tragic statistics of Hawaiian health, in relation to those of other population groups in Hawaii, speak for themselves. The Hawaiians experience: the shortest life expectancy of 74.01 years (Chinese in Hawaii have the highest expectancy of 80.24 years) death rate 146% higher than U.S. all race populations death rate 126% higher for all cancers than U.S. all race death rate 588% higher for diabetes mellitus than U.S. all race populations - highest death rate from high blood pressure at 7.5/100,000 for men ages 45-64 in Hawaii-- (1.6/100,000 for all other ethnic groups) - highest death rate from stroke at 73.4/100,000 for men ages 45-64 in Hawaii (42/100,000 for all other ethnic groups) death rates 177% higher for heart disease as compared with U.S. all race populations - highest lung cancer rate in the world at 100.9/100,000 - highest prevalence rate of 86.7/100,000 for diabetes, heart disease and hypertension in women (78/100,000 for all other ethnic groups) |