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Native Hawaiian Well-Being Statistics -- Suggestions for Improving How Data Are Gathered and Analyzed to Make Them More Useful for Scientific Study and Remedial Programs


by Kenneth R. Conklin, Ph.D. (Philosophy) and M.S. (Mathematics)

[Paper submitted to the Policy Analysis & System Evaluation (PASE) division of Kamehameha Schools on April 21, 2006, for Volume 3 of "Hulili"]

SUMMARY:

We often hear that Native Hawaiians have the worst statistics among Hawai'i's ethnic groups for income, education, incarceration, breast cancer, diabetes, etc. However, little work has been done to look for the causes and cures of alleged deficits. Additional categories should be added to data collection and analysis. For example, the fact that ethnic Hawaiians have a median age of 25, compared with a median age of 39 for all other groups, probably shows that ethnic discrepancies in income, education, and incarceration are normal and to be expected -- the discrepancies are caused by youthfulness and not by race. Most medical data are lacking the very important element of blood quantum. If a woman has a low percentage of Hawaiian native ancestry, it seems unreasonable to allocate one entire tally mark to "Native Hawaiian" for her case of breast cancer -- the tally mark should be allocated to the racial group representing her largest percentage of blood quantum; or perhaps fractional tally marks should be allocated according to the percentages of each group in her ancestry. To claim that merely being Hawaiian is a cause of disease, blood quantum data are needed to prove a correlation between percentage of native blood and percentage of disease incidence. If the claim is that deficits are caused by Hawaiian lifestyle, then the components of Hawaiian lifestyle must be identified and quantified, and it should be studied whether people of native ancestry have deficits at a higher rate than people of non-native ancestry who pursue the same components of lifestyle. Unless there is evidence that Hawaiian ancestry is the cause of medical or social deficits, there is no justification for grants and programs restricted to Native Hawaiians. Study grants, and programs for identification and treatment of medical or social dysfunctions, should be focused on particular diseases and particular social problems rather than being focused on a racial group; unless it can be shown through blood quantum studies or cellular biology that the dysfunctions have a genetic cause. Being left-handed is a far greater risk for breast cancer than being Native Hawaiian. Census data are provided comparing Native Hawaiians with Hawai'i's general population regarding age and income.

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We have all seen reports that Native Hawaiians have the worst statistics among Hawai'i's ethnic groups for income, education, incarceration, heart disease, diabetes, breast cancer, etc.

Such statements might be useful when seeking grants for further studies or for race-specific counseling or treatment programs. Such statements might also elicit sympathy or compassion from the larger community, helping to generate public support for various political initiatives. But the data as currently assembled have very little scientific or programmatic usefulness. What are the causes and cures of the medical or social problems? Indeed, do the alleged ethnic discrepancies truly exist, or are the data somehow skewed?

This essay raises important issues which researchers on Native Hawaiian well-being might find uncomfortable. Since I am not dependent on Native Hawaiian institutions for employment, research grants, or personal services, I feel able to raise these issues in a way "insiders" cannot. I hope insiders will use my analysis to improve the way data are collected and analyzed, rather than reacting defensively to protect turf. The goal should be to identify genuine problems and propose realistic solutions, not merely to keep milking a cash cow.

One issue needing exploration is the nature-nurture controversy. For any particular ethnic discrepancy, the question should be asked whether it is caused by genetics or whether it is caused by social-cultural-environmental factors. Is a particular problem caused merely by BEING genetically Native Hawaiian? Or is that problem caused by living the lifestyle of Native Hawaiians?

As we all know, there are certain diseases which affect one gender or one race exclusively, or which have a genetic marker that causes the disease to be found far more frequently in one race than in others. For example sickle cell anemia affects certain African genealogies; Tay-Sachs disease affects Ashkenazy Jews, and color-blindness affects men more frequently than women. Some diseases have been researched to the point where genetic testing can be done before a man and woman get married, so they can be advised of the likelihood their children will be affected. Such testing might improve the choice one makes in whether to marry a particular individual; or whether to create children at all; or what tests should be done early in a pregnancy to make an informed decision about abortion.

The issue of genetics seems to be completely ignored (or perhaps intentionally avoided or suppressed?) in relation to Native Hawaiian discrepancies with other racial groups. The most astonishing feature of research into Native Hawaiian well-being is this: On one hand it is claimed that Native Hawaiians have terrible statistics compared with other racial groups. Such statistics are used to justify grant programs which are racially exclusionary, solely for the benefit of Native Hawaiians. On the other hand there is little effort to explore whether there is any cause-effect relationship between race and the problem being investigated, or how such racial/genetic causes might be treated or managed.

If a problem is not caused by race, then it would seem inappropriate (even counterproductive) to have racial restrictions on either study or treatment.

In some ways the history of Hawai'i would make it understandable -- perhaps even expected -- that Native Hawaiians could have severe deficits compared with other racial groups. Centuries of isolation caused many generations of inbreeding among a genetic pool that may have started with only a few hundred pioneers who themselves came from only a few places. Inbreeding was further amplified by the difficulty for maka'ainana (commoners) to travel between islands. Even on any particular island, ridge-and-stream geography, and a feudal economic system, probably made it difficult to mate outside one's own and neighboring ahupua'a. Historically strong differences in dialect and customs between different islands, and different portions of any individual island, show that most people did not stray far from home. It's well known that multi-generation inbreeding leads to birth defects and heightened susceptibility to various mental and physical diseases. As the number of newcomers increased rapidly after 1778, Native Hawaiians mated outside their own race in ever-larger numbers. Thus the effects of centuries of inbreeding were somewhat mitigated, but have not yet been eliminated.

Native blood quantum is obviously relevant as a measure of inbreeding. It seems reasonable to hypothesize that percentage of native blood quantum would be proportional to severity of impairment. Indeed, the failure to identify blood quantum percentages when describing health and social deficits of Native Hawaiians leads to a (perhaps incorrect) conclusion that there must be something so horribly poisonous about the (probably imaginary) "Hawaiian gene" that even a tiny fractional component of it causes severe biological and social impairments.

One obvious recommendation is that when studies are done, Native Hawaiians should be asked "What is your percentage of native Hawaiian blood quantum?" It would then be easy to analyze the data to discover whether people with a higher native blood quantum also have a higher frequency or greater intensity of the problem, thereby supporting a conclusion that the problem has a racial cause and is deserving of race-based grants and treatment programs. This suggestion to collect blood quantum data is not only in relation to physical diseases that are probably caused by biological factors, but also in relation to economic, social, and psychological issues typically addressed by race-specific grants for study or treatment.

A refinement of that recommendation is that the subject's quantum should be allocated between the mother's quantum and the father's, in case it turns out there is a genetic cause of disease which is transmitted through the X or the Y chromosome.

A further refinement of the blood-quantum recommendation would be to ask each subject for his/her fraction or percentage of each racial/ethnic ancestry: 1/4 Hawaiian, 1/2 Chinese, 1/8 Filipino, 1/8 Irish. It might turn out that the combination of Hawaiian with Irish is more likely to produce children who develop diabetes, or incarceration, than the combination of Hawaiian with Japanese.

Racial blood quanta would also be valuable for allocating a victimhood tally mark (or fractional tally mark) to the appropriate racial group. For example, if the woman whose fractions are described above has breast cancer, then either one full tally mark should be allocated to Chinese (because that is her largest fraction), or else Hawaiian breast cancer gets 1/4 tally mark, Chinese 1/2 tally mark, etc. It is clearly very bad science (and a cause of loss of credibility of the results) to allocate one full tally mark for Native Hawaiian breast cancer to a woman who has only 1/16 or 1/32 Hawaiian native ancestry.

The issue of social-cultural-environmental factors also needs more study and more quantification. Everyone knows that not all Hawaiians are taro farmers, and not all taro farmers are Hawaiians. The simple concept of "Hawaiian culture" or "Hawaiian lifestyle" is not useful in explaining alleged discrepancies of well-being between ethnic groups.

If it is true that Native Hawaiians are more likely to live in poverty than other ethnic groups, the real question is "Why is that so?" Is poverty caused genetically? That's very doubtful; but the blood quantum analysis described above might shed some light on the issue. Or is poverty caused by lifestyle issues such as absentee father, parental drug addiction, etc.?

To the extent lifestyle factors are important, then studies and rehabilitative programs should be addressed to particular lifestyle factors rather than to the ethnic group; since ethnicity is neither necessary nor sufficient to determine lifestyle. If some researcher is absolutely determined to analyze the relation between "Native Hawaiian lifestyle" and poverty, incarceration, drug abuse, educational attainment, etc.; then it will be necessary for that researcher to make a list of the components of the Hawaiian lifestyle along with a procedure for awarding points to measure the degree of participation in each component, ending with a figure such as "Kimo has a 62% Native Hawaiian lifestyle."

It simply does no good to assemble statistics or make claims that "Native Hawaiians have the worst statistics" without identifying whether all or only some Native Hawaiians are affected, whether race is a causative factor (as shown by high blood quantum individuals suffering greater impact than low-quantum individuals), whether lifestyle issues are causative, whether Native Hawaiians are disproportionally afflicted compared with others who live the same lifestyle; and whether contemplated solutions include genetic counseling, genetic engineering, lifestyle counseling, or lifestyle intervention.

Perhaps the largest single statistical discrepancy between Native Hawaiians and other ethnic groups is age. But age seems to be almost completely ignored in analyzing statistics about ethnic differences. We often hear that Native Hawaiians have the lowest income, lowest educational attainment, and highest incarceration rates among Hawai'i's ethnic groups. But it requires only a moment's glance at the age discrepancies among ethnic groups to understand that it is perfectly normal and expected that Native Hawaiians should have the lowest education, lowest income, and highest incarceration. Those statistics are quite probably explained by the fact that there is a huge age discrepancy.

Native Hawaiians are the youngest ethnic group, having a median age of only 25; compared with about 39 as the median of other ethnic groups! (see footnote #1 for documentation and analysis.) We may never know for sure whether the age discrepancy completely explains the other discrepancies; but the data cry out to receive a correlational analysis. The average household income for Native Hawaiians in Census 2000 was only nine percent lower than the average for the entire population, despite the fact that Native Hawaiians are 14 years younger! It's obvious that people in their mid-twenties have not yet completed advanced degrees, have not yet reached middle-management where the salaries are higher, and have not yet resolved the troubles of youth which people in their late-thirties have outgrown. So let's have some studies comparing 25-year-old Hawaiians with 25-year-old Filipinos and 25-year-old whites, etc. Perhaps the numbers should be "crunched" to compare all the various ethnic groups at 5 year age intervals from age 20 to age 80; and then also to compare each ethnic group in Hawai'i against the same ethnic group on the mainland. And then, when all those numbers have been crunched, if there are still significant ethnic discrepancies then there will still be a need to do the blood quantum and lifestyle analyses to explain the causes and explore the cures. If an incarcerated "Hawaiian" has 75% non-native ancestry, perhaps it is inappropriate to apply racial profiling to claim that his 25% native ancestry (or lifestyle) is somehow responsible for his criminal behavior.

Another issue is mortality from various diseases. Perhaps we need a reminder of two simple facts: (1) Everyone dies; and (2) Nobody dies more than once. So it is impossible for Native Hawaiians to have the worst mortality statistics for all the diseases. If there is one disease for which Hawaiians have the worst mortality, then there must be a different disease for which they have the best mortality. I don't need to rely on my M.S. in Mathematics to know that when it comes to mortality victimhood rates, it all must even out in the end, because: (1) Everyone dies; and (2) Nobody dies more than once. So let's please hear from the number-crunchers some of the good news about diseases from which Native Hawaiians have significantly lower mortality rates than whites and Japanese; and let's have some genealogical, environmental, and lifestyle studies to find out why the good news happens.

For many years the media and public have been bombarded with Hawaiian victimhood statistics which sometimes seem strange, exaggerated, and useless. How are we to understand and take action on a claim that Native Hawaiian women have the highest rate of breast cancer of all the ethnic groups in Hawai'i? Where exactly did that statistic come from? Should we also note more detail, that white women have a higher rate of breast cancer being diagnosed (but a lower mortality rate) than Native Hawaiians? Will there be a struggle as large institutions seeking government and philanthropic grants try to protect their "turf" by citing statistics to prove that Native Hawaiians are really the worst victims, while suppressing statistics that prove otherwise? Does the racial stereotyping of Native Hawaiians by KSBE/PASE victimhood statistics have a bad effect on their self-esteem and social status?

What should we do with the fact that being left-handed doubles a woman's risk of getting breast cancer? Being left-handed is a far greater risk for getting breast cancer than being Native Hawaiian (see footnote #2 for two scientific studies). Therefore, according to the sort of reasoning used by PASE, government and philanthropic grants for study and treatment of breast cancer should be directed toward the race-neutral category of left-handed women through their (imagined) organization 'Ahahui Wahine Hana Lima Hema rather than toward Native Hawaiians through Papa Ola Lokahi. Left-handed-ness as a more significant risk factor for breast cancer than Native-Hawaiian-ness is mentioned here as only one small example illustrating the importance of placing Native Hawaiian victimhood statistics into a larger context. There are probably thousands of similar examples.

It is understandable that Native Hawaiian institutions are eager to accumulate statistics providing documentation for claims of Native Hawaiian victimhood. Such claims provide an important basis for seeking financial and political support enabling those institutions to thrive. But ultimately the thriving of "real people" is more important than the thriving of the institutions created in their name. Scientific studies should focus on causes and cures. If it is claimed that Native Hawaiians have race-based difficulties needing race-based remediation, then there must be statistical analysis of race-based factors such as blood quantum to determine the true relationships among race, lifestyle, medical problems, and social dysfunctions. A victimhood tally mark should be awarded to the racial group that has the largest component of a victim's ancestry; or fractional tally marks should be divided among racial groups in proportion to their percentages of the victim's ancestry. The fact that Native Hawaiians have a median age of only 25 compared with a median age of 39 for all other ethnic groups is an extremely important factor that may provide a benign explanation why Native Hawaiians have lower income, lower education, and higher incarceration rates than other ethnic groups. Favorable statistics should be studied as extensively as unfavorable ones to identify positive factors. Claims of Native Hawaiian victimhood may sometimes be unaccountable or of no practical use, as illustrated by the data that being left-handed is a far greater risk for breast cancer than being Native Hawaiian.

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NOTES

(1) Additional information and analysis of age, income, and ethnicity.

The following material is written by one unpaid individual assembling a small amount of publicly available data on a few simple topics, and providing a tentative analysis of their significance. Surely a large organization with numerous staffers and great wealth should be aware of these issues and should be able to gather large amounts of data and analyze them professionally.

The median age of ethnic Hawaiians is 11 years younger than the median age for the State of Hawai'i as a whole. Ethnic Hawaiians' median age is only 25. The general population (including ethnic Hawaiians) has a median age of 36. So excluding the Hawaiians, the median age of the other groups is substantially older than 36. Let's do the math. The documentation (sources of data to verify the accuracy of the numbers) is provided after the math.

Assuming that ethnic Hawaiians are about 20% of the population of Hawai'i, then here's the arithmetic of weighted averages. Median age of general population is 36, and that's 100% of the population. 36 x 100 = 3600. Median age of Hawaiians is 25, and they are 20% of the population. 25 x 20 = 500. Removing the Hawaiians, 3600 - 500 = 3100. That 3100 represents 80% of the population. 3100 divided by 80 = 38.8 which rounds off to 39 as the median age of the non-Hawaiian population.

So OF COURSE ethnic Hawaiians have lower average income -- they're just kids -- just getting started in their jobs or professions; while at age 39, the typical non-ethnic-Hawaiian (AND ETHNIC HAWAIIAN TOO) is in middle management, or watching his company or medical practice start to boom. Of course people with average age of 25 have high unemployment and incarceration and drug abuse etc. compared to people with average age of 39. The sins of youth.

This illustrates that many "Native Hawaiian" victimhood claims are not really about "Native Hawaiians" at all -- they are about youthfulness.

Furthermore, while it is true that the average income of "Native Hawaiians" is somewhat lower than the state average, the difference is only about nine per cent, which seems entirely reasonable in view of the fact that "Native Hawaiians" have an average age of only 25, compared with 36 for the state as a whole.

In Census 2000, the median household income for "Native Hawaiians" was $45,381, and their median age was 25.3. In Census 2000, the median household income for the population of Hawai'i as a whole was $49,820, and the median age was 36.2.

Also in Census 2000, 12% of all "Native Hawaiians" had household income ABOVE $100,000 (and that was back when a hundred grand was real money!). Surely those wealthy people should not be eligible for government handouts based on the racial profiling of "Native Hawaiians" as poor and downtrodden.

Here are the sources to back up the facts about median age and median income.

For "Native Hawaiians" separately (race alone[i.e., "pure"], or in combination with one or more other races -- i.e., the "one drop" definition as used in the Akaka bill) all the statistics are on:

http://www.hawaii.gov/dbedt/census2k/sf4profiles/xnhstate.pdf

"Native Hawaiian" median household income $45,381 on page 5 at 3/4 way down; median age 25.3, middle of page 1, median household income above $100,000 is 11.9% (add up the bottom 3 rows of income table on page 5).

OVERALL STATE OF HAWAI'I, ALL FROM CENSUS 2000 (including ethnic Hawaiians along with everyone else):

Average age 36.2 from middle of page 1 of

http://www.hawaii.gov/dbedt/census2k/h90_00_state.pdf

Median household income is $49,820 from middle of table at

http://tinyurl.com/na53j

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(2) Reductio-ad-absurdum showing that PASE-style statistical "studies" of Native Hawaiian victimhood need to be placed into a broader context.

It turns out that being left-handed is a far greater predictor of breast cancer than being Native Hawaiian. So according to the logic used by "studies" done by KSBE/PASE, money spent to study and treat breast cancer in Native Hawaiians should instead be spent to study and treat left-handedness in women regardless of race.

Two medical studies reported in 2005 prove that left-handedness modestly increases the risk of breast cancer in post-menopausal women, and that left-handedness more than DOUBLES the risk of breast cancer in pre-menopausal women.

(a)

http://today.reuters.com/News

Reuters, Sunday September 25, 2005

Left-handed women's risk of breast cancer higher -- study

By Patricia Reaney

LONDON (Reuters) - Left-handed women are more than twice as likely as right-handers to suffer from breast cancer before reaching menopause, Dutch scientists said on Monday.

More than a million women are diagnosed with breast cancer worldwide each year. Three-quarters of cases occur after menopause, which usually begins around the age of 50.

Researchers at the University Medical Center in Utrecht in the Netherlands speculate that there is a shared origin early in life for both left handedness and developing breast cancer, possibly exposure to hormones in the womb.

"Left handedness is associated with breast cancer, most specifically pre-menopausal breast cancer," said Cuno Uiterwaal, an assistant professor of clinical epidemiology at the university, in an interview.

He and his colleagues studied 12,000 healthy, middle-aged women born between 1932-1941 who were part of a breast screening program. The scientists determined their hand preference and followed up their medical history to see which women developed breast cancer.

"If we take pre-menopausal and post-menopausal breast cancer then there was a 40 percent increased risk," Uiterwaal said of left-handed women.

But when they spilled it further the scientists found most of the excess risk was in breast cancer before the menopause.

"We found that left-handed women are more than twice as likely to develop pre-menopausal breast cancer as non-left handed women," the researchers said in the report published online by the British Medical Journal.

Other risk factors such as family history of breast cancer, numbers of pregnancies, smoking habits, and social and economic status were considered.

About 8 percent to 9 percent of women are left-handed. But the scientists said the findings should not alarm them.

"What our study intends to do is focus on this area. We do not know all the causes of breast cancer, that is why we should continue. This may be one new factor that leads us to a better understanding of the aetiology (cause of the illness)," Uiterwaal added.

About 5 percent to 10 percent of breast cancers are hereditary. Most are due to mutations in the BRCA1 or BRCA2 genes. The earlier the illness is diagnosed and treated, the better the prognosis is for the woman.

"Although the underlying mechanisms remain elusive, our results support the hypothesis that left handedness is related to increased risk of breast cancer," the researchers added.

(b)

http://www.cancerpage.com/news/article.asp?id=483

Left-Handed Women At Greater Risk Of Breast Cancer After Menopause

Left-handedness, a marker of intrauterine steroid hormone exposure, modestly increases the risk of breast cancer in postmenopausal women, according to a report in the March issue of the journal Epidemiology.

The finding contrasts with the results of prior studies that either failed to identify a link between left-handedness and breast cancer, or revealed the inverse relationship, Dr. Linda Titus-Ernstoff, of Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and a multicenter team explain in the journal.

The team conducted a case-control study to examine the association. The cases were women ages 50 to 79 years living in Wisconsin, Massachusetts or New Hampshire with a first diagnosis of invasive breast cancer. Controls were women of similar age living in the same states.

Left-handedness was modestly associated with breast cancer risk, with an odds ratio of 1.42. This association was modified by age, with the greatest risk ratio observed in the oldest age group.

The contrast between this and prior studies may reflect an "age-related bias," the investigators say. They note that left-handedness is likely to be less common in older women, who were raised in a period when right-handedness tended to be enforced.

Thus, Dr. Titus-Ernstoff and colleagues speculate "that older left-handed women represent those who were unable, despite social pressure, to convert to right-handedness. These women may have a stronger predisposition to left-handedness, perhaps reflecting causes of left-handedness that are associated with breast cancer risk."

The team concludes that the new findings support the hypothesis that intrauterine exposure to steroid hormones may play a role in the development of breast cancer.

SOURCES:

Reuters Health, March 9, 2000

The journal Epidemiology, March 2000; 11:181-184

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(3) A more detailed commentary and analysis of Native Hawaiian victimhood claims can be found at

http://www.angelfire.com/hi5/bigfiles3/victimhoodclaims.html

One interesting concept explored on that webpage is the question what might be done to produce a long-term solution to the alleged pervasiveness of Native Hawaiian victimhood. Science fiction novels have identified two different ways humans can survive on a planet whose environment is hostile to human survival: (a) Terraform the planet (make it more like Earth), or (b) Biomorph the humans (remake the human genome so it is adapted to that planet's environment). If Native Hawaiians have wide-ranging intractable medical and social difficulties in modern Hawai'i, as the PASE studies seem intended to prove, then there may be two conflicting ways of dealing with the problem, both of which are unacceptable: (a) Radically change the physical and cultural environment of Hawai'i to restore it to how it was before 1778, when Native Hawaiians were thriving in the place they had adapted to during many centuries of isolation and inbreeding; or (b) Change the Native Hawaiian genome and lifestyle by deleting genetic and cultural characteristics that cause incompatibility with the environment of modern Hawai'i. Again I emphasize that both of these options are unacceptable, although some groups seem to be headed in the direction indicated by (a).


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Ken_Conklin@yahoo.com

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