Caught Between “The Rock” and a Hard Place: The Native Hawaiian and Pacific Islander Struggle for Identity in Public Health

Abstract

DURING THE CONGRESSIONAL debate over health care reform in the fall of 2009, Saturday Night Live opened a show with a parody of President Barack Obama trying to persuade reluctant senators to endorse an overhaul of the nation's health care system. His best sales pitch was that each of the senators would have a voice in the process, but his overtures fail to win their support.1 The president becomes so frustrated by the politicians’ steadfast opposition to reform that he transforms into “The Rock Obama,” a Hulk-like character played by Dwayne “The Rock” Johnson. FAR LEFT: Murina Sony and her baby, Ketsen. Printed with permission. The skit evoked a mixed response from Dorothy E. Schmidt-Vaivao of the Samoa National Nurses Association (SNNA). “It made me laugh but it also made me think,” she says. “There is profound irony in The Rock Obama—with his commanding voice—being played by a Samoan American at a time when Pacific Islanders are among the faintest voices in our country's health care dialogue.” SNNA and a growing number of other health advocacy groups believe that giving Native Hawaiians and Pacific Islanders parity in health research and services should be a priority for health care reform but is not because most people assume that they are in large part a healthy group. As Schmidt-Vaivao put it, There is a false perception out there that the highly conditioned Pacific Islander athletes who thrill sports fans on Monday Night Football or Saturday night wrestling are the norm. We are very proud of people like Dwayne Johnson and Troy Polamalu but unfortunately they do not represent the health status of most Pacific Islanders. Taunuu Ve'e-Remmers, Native Hawaiian and Pacific Islanders Affairs Manager of the Asian & Pacific Islander American Health Forum (APIAHF) agrees that Native Hawaiians and Pacific Islanders are at risk for negative health outcomes because of these assumptions. “The scant public health data collected about Native Hawaiians and Pacific Islanders have traditionally been overshadowed because they were combined with much larger data sets about Asian Americans,” she points out, “but the socio-cultural context of Pacific Islanders is different from Asian Americans and as a result their health issues are different.” Historically, there are pros and cons regarding why Asian American, Native Hawaiian, and Pacific Islander census and health data were aggregated. Now, however, most progressive health researchers recognize that aggregating such data distorts the true picture of Native Hawaiian and Pacific Islander health and have begun collecting separate data sets on these distinctly different groups. “Because of their relatively small population sizes, Pacific Islanders have tragically been almost invisible to public health, and as a result resources have not been made available to assess and respond to their particular health needs,” says Ve'e-Remmers. APIAHF and other Native Hawaiian and Pacific Islander advocacy groups have been pushing hard for more disaggregated health data to quantify the health issues facing these groups in an effort to teach others about the disparities and needs that are in plain view within their communities. Armed with data, these groups hope to marshal the support and resources needed to improve Native Hawaiian and Pacific Islander health.