A new report shows the state’s Tongan and Samoan communities have more than twice the rate of obesity and nearly double the rate of adult diabetes of other Utahns, and a cultural belief that larger moms and babies are healthier puts infants at risk.
The disparities are even wider than the Utah Department of Health presumed after analyzing death certificates, which showed high rates of diabetes and infant mortality. The new assessment is based on a survey of 605 adult Pacific Islanders in Tongan and Samoan as well as English.
“It was a genius idea,” said Jacob Fitisemanu, an outreach specialist for the Health Department.
Having translators do the questioning helped adapt the use of analytical software geared to English, and made the findings more meaningful to researchers and the Islander community, Fitisemanu said.
The department believes it may be the first study of its kind to examine mainland Pacific Islanders in the United States. Community members were involved throughout, from suggesting questions to promoting the survey, the department said. It hopes to use the results to help guide Utah’s Islanders to better health.
April Young Bennett, spokeswoman for the department’s Health Disparities Reduction office, said the interviews revealed an “extremely high” obesity rate, even after researchers adjusted the body-mass index obesity standard from 30 to 32.
“Some research does suggest that Pacific Islanders can be healthy at a slightly larger size than Caucasians,” Bennett said. “We still found that about half of Utah Pacific Islander adults were obese.”
• Pacific Islanders interviewed in Tongan were particularly likely to have diabetes, with a rate of 44 percent.
• Although only 15 percent of Pacific Islanders were at healthy weight or underweight according to the customized BMI, 33 percent perceived their weight as healthy or underweight.
• Compliance with guidelines about early prenatal care was low, with nearly half of infants born to women without prenatal care, more than half of women not breastfeeding two to six months after their babies were born, and more than a third of women getting pregnant again in fewer than 18 months.
For the past few years, the National Tongan American Society, based in Murray, has been working with the health department to educate the community about the risks a large size may pose. But that awareness has had to fight a cultural bias, said Ivoni Malohifou’ou Nash, the society’s program director.
“We thought big is beautiful. We still are beautiful,” Nash said. “But when you are huge you get diabetes, you get [a] heart attack.”
Pregnant women, she said, “are the princess of the family. You don’t do anything. The whole family feeds you.”
That bias extends to babies, she said. An 8-pound infant is too small. A 10-pound baby is prized.
Women don’t focus on nutrition, Nash said, and are told if they eat pork, salt and taro root, their milk will be better, but if they shower or exercise after giving birth, their milk will go away. Gestational diabetes may be the result of such advice, putting the mom’s and baby’s lives at risk.
Utah Study Results here: http://health.utah.gov/disparities/data/PacificIslanderReport2011.pdf