As the program progressed, her physical stamina increased and her attitude toward life improved. Every day presents a challenge, but when one has learned the right tools to meet these challenges, you can be successful at anything. There is no single cause of diabetes, so combating the disease requires multiple strategies, says Dr.
Kevin Lum. Specialists in the year-old program include registered dietitians, a medical social worker, behavioral health specialist, pharmacist and nurse practitioner, as well as an exercise physiologist, stress management specialist and mental health experts. Eating habits are one of them, but there are also a lot of psychosocial barriers to success. As well, stress is also a big contributor to diabetes. Any kind of stressor can increase your cortisone, and when that goes up, it increases your sugar. So we incorporate stress management to learn what is causing those stresses and how to decrease them.
Is it your job?
Your home life? Do you stress eat? So how can you learn to manage those things? Treatment at the Ekahi center begins with a care navigator who looks at the reasons that may keep a person from successfully managing the disease. We have had so much success at the clinic with the Ornish diet that we want to incorporate it into a wellness diet. The Ekahi clinic also builds resilience in participants with group classes that address diet, stress management and exercise. Becoming friends with others who also want to get better can help people with their own care. The facility includes a small gym where participants learn to exercise safely.
The exercise program includes aerobic activity along with strength training and weightlifting. So our behavioral specialist will work in some of the tools to manage time better. For instance, meal prepping, or planning your day is important. Book 15 minutes to prepare a lunch or on Sunday night make sure you have lunch for the week. When participants adopt a plant-based diet, says Lum, they tend to see changes in their blood sugar in the first two to three weeks.
What is health?
We see people coming off medications as well. Lum says Type 2 diabetes is generally considered to be reversible. When people are highly motivated, we can see changes within the first month or so. While the program is typically nine weeks, it can last longer. It can also lead to lifelong friendships among people who now have a common commitment to themselves and their health. Learn More : For further information about the program or to register, call , ext. An estimated 2, children in Hawaii deal with serious emotional problems. Some are as young as 4. Mental illness is rarely their only problem.
Many are homeless, or have been physically or sexually abused. Often they are poor or come from fractured families or chaotic homes or all of the above. And far too often, there is no adult at home they can talk with. Stanton Michels. So we need to get into the picture earlier, when kids are more malleable. As they get older, they can end up behind closed doors, in residential programs, in juvenile justice courtrooms, sometimes in locked hospital units. The picture is especially bleak for Native Hawaiian youth. In , the latest year for which data was available, 32 percent of Native Hawaiian high school students surveyed said they experienced depression; one-fifth said they had suicidal thoughts within the past year.
In addition to the 2, young people with severe issues, many of whom get help from the Child and Adolescent Mental Health Division, another 4, receive specialized services from therapists in their schools. And overall, 12, Hawaii children and adolescents receive some level of services for non-academic issues through their schools, according to data from the state departments of Health and Education.
He says that no longer happens. The focus has been to reduce the time children spend in institutional therapy in favor of treatment in their homes whenever possible. Keeping them in an institutional setting means just spending money without seeing advances, he says. You have to make sure your money is doing something.
When possible, children are increasingly being served in their homes — or in a safe alternative environment — by telemedicine, often using Skype or FaceTime.
Understanding Health Literacy
The technology is especially useful if they live in rural or other difficult to reach areas, helping stretch limited mental health resources a bit further. The next step is the cellphone. Therapeutic care from private institutions is needed to supplement state resources, but residential treatment programs at Castle Medical Center and Leahi Hospital on Oahu have closed in recent years.
Sutter Health Kahi Mohala has stepped into the breach with its 88 licensed beds and a staff of about ; about half of the patients under its care are young people. Forty percent are from Neighbor Islands, up from 27 percent in The proposed Hawaii Island treatment program would have onsite schooling; the Oahu program would be a day short-term crisis center that could accept eight young people at a time for up to a month of intervention and services. The common denominator among these children is they need a safe place to be.
There is a growing recognition of the link between poverty and poor health — particularly long-range physical health and mental health. UH Public Health Professor Kathryn Braun, who has studied disease and disability in minority populations for more than 40 years, agrees that geographic zip codes are a closer match to determine health and longevity than cultural or racial backgrounds.
The zip codes with the worst outcomes are on Molokai, and what is that but Native Hawaiian and Filipino, very high poverty, low household incomes, and very high Medicaid for the blind and disabled. So you have a population with a lot of poverty, and with that come diseases and disability and lower life expectancy.
And poverty is due in many cases to underlying racism in our system. And that spells doom for our healthcare system. Poverty often leads to depression. The MHA report, as well as other findings, shows Hawaii lagging far behind other states. Hawaii was:.
The most recent Hawaii Youth Risk Behavior Survey by the Department of Health in cooperation with the Department of Education, also gives a telling glimpse into the lives of young teens. Data from the report shows that from to marijuana use increased almost two percentage points among middle school students, going from That amounts to 3, middle schoolers who have used pot. The Behavior Risk Survey also shows that use of all illegal drugs among middle schoolers — with drugs offered at school, sold at school or received at school — increased from 8. Even with that increase, the numbers are lower than they were in when 9.
Michels says the way forward is for state departments and agencies to collaborate — both in their work with patients and through changes in funding — to increase their effectiveness for their patients. This could be through earmarking special funds for these specific purposes, or by other means. Secondly, do something about housing.
Increase property taxes so the government has enough money to create low and moderate-income housing that they control, not developers. Healthy foods are more expensive. If we can do those things, we can see reductions in healthcare costs. And an increase in overall community health. One-fifth of all Native Hawaiian students surveyed said they had suicidal thoughts within the past year.
Mental health services are increasingly difficult to access, especially for low-income people with Medicaid coverage. On average in Hawaii, someone commits suicide every two days. Suicide is the second-leading cause of death among people aged 15 to But there is also hope that the next generation of Micronesians will rise up and take their place as other immigrant groups to Hawaii have done. But other Micronesians without U.
As a result, only 1 in 4 Micronesian households has health insurance, according to data collected by Michael Levin, a consultant with PacificWeb LLC, whose career as a demographer has taken him to the U. Levin tracked the Micronesian experience in Hawaii through surveys in , , and Even Howard is fearful, though she has worked in Hawaii for 30 years and has medical coverage through her job.
With the Compact of Free Association created in , the U. COFA allowed Micronesians easy immigration to America and included eligibility for Medicaid or low-income health care benefits in the U. That placed an enormous burden on the more than 15, Micronesians in Hawaii and on the state health care system, as uninsured Micronesians often use hospital emergency rooms for their health care needs.
And some tried to come to We Are Oceania to apply for any health coverage available to them, but most of the times there was none. We established partnerships with Hoola Health and Urgent Care Clinic, and have been referring people without health coverage there for medical treatment. He cites the example of a Micronesian woman who gave birth to a healthy daughter 10 years ago while studying at UH Hilo. She had pregnancy related diabetes, which was measured several times a day and precautions taken.
And she was on bed rest for the last month of her pregnancy. She had a very healthy daughter who is now 3 years old. Obviously each pregnancy is different, but it is unlikely that the result would have been the same in Micronesia. Their move from a traditional diet and lifestyle to Western food and a more sedentary life has led to conditions like hypertension, diabetes and high cholesterol. The U. Department of Education published the only national data on health literacy skills in The study found that adults who self-report the worst health also have the most limited literacy, numeracy, and health literacy skills.
European Union countries have found similar health literacy skill issues in the European Health Literacy Survey Cdc-pdf [2. No, but they are related. People do need strong literacy and numeracy skills to make it easier to understand and use health information and services.
But, research shows that many health and healthcare activities are unfamiliar, complicated, and technical to most people. Listen to health literacy leaders describe their research and practice in podcasts External Source: Helen Osborne Choose a computer screensaver that makes you laugh. Frame photos of you and your family or friends having fun. Remember funny things that happen.