Perceptions of health and well-being held by Native Hawaiian migrants

Wellbeing of Indigenous Peoples in Canada, Aotearoa (New Zealand) and the United States: A Systematic Review

Despite the health improvements afforded to non-Indigenous peoples in Canada, Aotearoa (New Zealand) and the United States, the Indigenous peoples in these countries continue to endure disproportionately high rates of mortality and morbidity. Indigenous peoples' concepts and understanding of health and wellbeing are holistic; however, due to their diverse social, political, cultural, environmental and economic contexts within and across countries, wellbeing is not experienced uniformly across all Indigenous populations. We aim to identify aspects of wellbeing important to the Indigenous people in Canada, Aotearoa and the United States. We searched CINAHL, Embase, PsycINFO and PubMed databases for papers that included key Indigenous and wellbeing search terms from database inception to April 2020. Papers that included a focus on Indigenous adults residing in Canada, Aotearoa and the United States, and that included empirical qualitative data that described at least one aspect of wellbeing were eligible. Data were analysed using the stages of thematic development recommended by Thomas and Harden for thematic synthesis of qualitative research. Our search resulted in 2669 papers being screened for eligibility. Following full-text screening, 100 papers were deemed eligible for inclusion (Aotearoa (New Zealand) n = 16, Canada n = 43, United States n = 41). Themes varied across countries; however, identity, connection, balance and self-determination were common aspects of wellbeing. Having this broader understanding of wellbeing across these cultures can inform decisions made about public health actions and resources.

Nothing Like Living with a Family: A Qualitative Study of Subjective Well-Being and its Determinants among Migrant and Local Elderly in Dongguan, China

Chinese economic development has led to a significant rise in internal migration over the last 20 years, including large numbers of elderly. When elderly Chinese people migrate, they still register their residency to their place of origin and often do not register with the new administrative office at the destination due to the household registration (hukou) system in China. Thus, most of these migrant elderly do not receive full social services, possibly leading to poor subjective well-being. This study aims to qualitatively examine the level of subjective well-being and its determinants among migrants and local elderly in Dongguan City of Guangdong province, one of the most rapid economically developing areas in China. We also present the results of in-depth interviews among 27 elderly, 15 elderly migrants and 12 local elderly living in Dongguan. The results reveal that the overall subjective well-being of the two groups were good. Most migrants believed their well-being had remained stable or even improved over time due to family reunion and a better physical environment. Elderly’s most valuable needs and the main reason of migration is family reunion; however, inadequacy of social support, including community support and government support (e.g., gift during holiday season, free health examination, healthcare expenditure reimbursement), cannot be neglected for maintaining a good level of well-being. The well-being of migrant elderly can be further enhanced by promoting social services and welfare, recreational activities, and enhancing healthcare reimbursement in their new home.

Cancer incidence trends among native Hawaiians and other Pacific Islanders in the United States, 1990-2008

BACKGROUND

Lack of annual population estimates for disaggregated Native Hawaiian and Other Pacific Islander (NHOPI) populations limits the ability to examine cancer incidence rates and trends to understand the cancer burdens among NHOPIs.

METHODS

Utilizing 1990 and 2000 population census data, we estimated the annual populations by age and sex for Native Hawaiians, Samoans, and Guamanians/Chamorros for 1990-2008 in regions covered by 13 of the National Cancer Institute's SEER registries. Cancer diagnoses during 1990-2008 from these registries were used to calculate the age-adjusted (2000 US Standard) incidence rates by sex, calendar year/period, and cancer type for each population. The annual percentage change (APC) in incidence rates was estimated with the 95% confidence intervals (95% CIs) calculated for both the rate and APC estimates.

RESULTS

Statistically significant declining trends were found in Native Hawaiians, in men for lung and stomach cancers (APC = -2.3%; 95% CI = -3.3 to -1.3; and APC = -3.8%; 95% CI = -6.0 to -1.6, respectively), and in women for breast cancer (APC = -4.1%; 95% CI = -5.7 to -2.5) since 1998 and lung cancer (APC = -6.4%; 95% CI = -10.7 to -1.8) since 2001. Rising incidence trends were experienced by Samoans, especially by Samoan women for breast (APC = 2.7%; 95% CI = 0.9 to 4.5) and uterus (APC = 7.3%; 95% CI = 6.2 to 8.4) cancers. With limited data, Guamanians/Chamorros demonstrated lower, but increasing, incidence rates than other NHOPIs.

CONCLUSIONS

Population-based cancer incidence rates for disaggregated NHOPI populations help identify disparities in cancer burden and provide valuable information to improve cancer control efforts among NHOPIs.