Search

Native Hawaiians constitute 401,000 or 0.1 percent of the total U.S. population, with approximately 60 percent residing in the state of Hawai'i. In Hawai'i, Native Hawaiian elders ("na kupuna") face a number of social and health disparities when compared with their non-Native Hawaiian counterparts: higher rates of poverty, greater disability rates, higher rates of specific life-threatening diseases, shorter life expectancies, and lower utilization rates of some services. Integrating life course literature and resiliency theory, the authors propose a model that provides a context from which to analyze and understand social and health disparities found among older Native Hawaiians. The authors introduce a historical timeline that identifies key cultural and historical markers in the lives of "na kupuna" and then link this timeline to health and social-health delivery strategies. This model offers a rationale for the development and implementation of culturally based solutions for "na kupuna" and underscores the need for social workers to intervene at the micro, meso, and macro levels to affect the well-being for this and other ethnic populations.

The escalating demand for trained direct long-term care (DLTC) workers, those individuals with the most sustained direct contact with vulnerable older adults in homes and facilities, is a consequence of our rapidly aging population. Research documents the present and projected shortages of DLTC workers, and developed nations are increasingly turning to immigrant women to fulfill these workforce needs. The authors identify international trends that influence the availability of these workers. Following a broad overview of the DLTC workforce, they turn to a specific examination of immigrants working in long-term care settings in the United States. The authors raise a number of questions about this changing workforce profile. They outline four ways that institutes of higher education can help improve the DLTC workforce in the United States and suggest that colleges and universities work in partnership with policy makers and the long-term care industry to this end.

The increase in the nation's present and projected multicultural aged population is both dramatic and well documented. One result of this growth is a sharpened focus on racial and ethnic disparities in health, health care access, and utilization of services that impact aging adults. This paper presents work conducted by a university-community collaborative project in gerontology. The thrust of the project is that cultural competency is a key ingredient for preparing social work students for work with ethnic minority elders and for potentially improving services to older minority populations. A brief description of the project is presented with highlights of the standards of cultural competencies that were developed for three specific populations: Japanese, Filipino, and Native Hawaiians. In general, standards organized around knowledge, values and skills consistently reflect the importance of the family system in caring for older adults. (Contains 1 table.)

With the aging of the world's population comes the rising need for qualified direct long-term-care (DLTC) workers (i.e., those who provide personal care to frail and disabled older adults). Developed nations are increasingly turning to immigrant women to fill these needs. In this article, we examine the impact of three global trends--population aging, globalization, and women's migration--on the supply and demand for DLTC workers in the United States. Following an overview of these trends, we identify three areas with embedded social justice issues that are shaping the DLTC workforce in the United States, with a specific focus on immigrant workers in these settings. These include world poverty and economic inequalities, the feminization and colorization of labor (especially in long-term care), and empowerment and women's rights. We conclude with a discussion of the contradictory effects that both population aging and globalization have on immigrant women, source countries, and the long-term-care workforce in the United States. We raise a number of policy, practice, and research implications and questions. For policy makers and long-term-care administrators in receiver nations such as the United States, the meeting of DLTC worker needs with immigrants may result in greater access to needed employees but also in the continued devaluation of eldercare as a profession. Source (supply) nations must balance the real and potential economic benefits of remittances from women who migrate for labor with the negative consequences of disrupting family care traditions and draining the long-term-care workforce of those countries.

Describes a two-year, multisite, curriculum-development project aimed to increase the pool of professionals trained in geriatric and/or gerontological social work. Methods included providing advanced training in aging, cultural competence, and interdisciplinary practice; developing, implementing, and testing an innovative student curriculum based on standardized learning competencies; revising the university curriculum to support such competencies; and producing a practical handbook. (Contains 21 references and 2 tables.) (GCP)

Describes a model for social work educators and social work school officials who are building academic-field linkages. Survey of social workers on the knowledge and skills they need to respond to new directions in these linkages identified a number of themes for staff development and research. (RJM)

Focus group research on elderly Filipino women living in the United States yields preliminary findings regarding their attitudes toward caregiving and formal service use. Filipino cultural values and the economic challenges attributed to their immigration status were perceived to be the greatest strengths and challenges in caring for the aged. Results identify generally positive attitudes toward formal service use and governmental assistance. Together, these findings shed light on Filipinos' acceptance and use of formal services. Further research to confirm and explore these findings can guide the design of the nation's practice and policy interventions for an increasingly ethnic and cultural diverse older population. KEYWORDS Filipinas, utilization of services, elderly adults, diversity, qualitative research

Similar to the nation's majority and racial/ethnic minority populations, Native Hawaiian families provide the bulk of care to loved ones with dementia. Limited research has focused on youth caregivers, who are largely invisible to the eldercare service system. This knowledge gap is especially critical for Native Hawaiians who place a high value on eldercare, often provided in multigenerational homes. To address this gap, we describe the process by which a university-community center developed a culturally responsive storybook on dementia targeted to Native Hawaiian youth. The development process honored community-based participatory research principles grounded in the cultural values and practices of Native Hawaiians, active collaboration of an advisory council, and face-to-face engagement with Native Hawaiian youth. Future directions are shared about culture-based programming and evaluation in dementia care that may be useful in work with other racial/ethnic youth and families. [ABSTRACT FROM AUTHOR]

This exploratory study investigated reasons why Filipinas in Hawai'i have become the primary caregivers of elders in residential care homes and if they thought their children would follow them in this profession. A random sample of 173 Filipina care home operators (CHO), of which 95% were first-generation immigrants, was interviewed using telephone survey methods. Data were collected: to profile caregivers; to identify motivations for becoming a care home operator; and to gauge if they or their children would continue in this line of work. The sample was composed of middle-aged Filipina CHO with training and experience in elder care who concurred that the job fit their cultural values. About a third also felt that this job was open to immigrants and helped them buy a house. Twenty percent or less felt discriminated against because of this work. Although half the sample felt that women were better caregivers than men, only 38% felt that caregiving was primarily the responsibility of women. Almost 90% planned to continue with this work, but only 12% said it was likely that their children or grandchildren would become CHO, supporting the notion that choosing this profession had less to do with cultural values and gender expectations than with economic opportunities available to the current cohort of CHO. Given these findings, Hawai'i's capacity to meet future residential long- term care needs is discussed. doi: 10.1300/J083v48n03_10 KEYWORDS. Filipino Americans, geriatric foster care, elderly, long-term care, workforce development

We draw from a number of theoretical perspectives and frameworks on the life course, age and gender scholarship to argue their value in furthering critical discussions on work-life balance policies and their contributions to women's employment and economic security in later life. Using OECD and other big data sets, we examine the patterns of women's employment over the life course in Japan, Sweden and the United States, as three illustrated cases of welfare states with different nation's work-life balance policies. We summarize findings before offering concluding thoughts to advocate for women's security in later life. [ABSTRACT FROM AUTHOR]

Native Hawaiian and other Pacific Islander (NHPI) older adults experience various social and health challenges. There is a growing literature linking neighborhood conditions with health, yet few have focused on NHPI older adults. This study examines associations between neighborhood social cohesion and health outcomes (i.e., self-rated health, psychological distress, and memory) in this population. Data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n=1,045 with respondents aged 50+) were analyzed with logistic regression models. The level of neighborhood social cohesion was determined by responses to items on perceptions of mutual help, dependability, trust, and close relationships within the neighborhood. Higher perceived neighborhood social cohesion was associated with lower odds of having serious psychological distress or memory problems. There was no statistical association of social cohesion with self-rated health. Socially cohesive neighborhoods are important to the health of NHPI. We discuss methods to improve neighborhood social cohesion as a way to promote health equity for NHPI older adults in the United States (U.S.). [ABSTRACT FROM AUTHOR]

Using focused ethnography, Native Hawaiian elders living away from Hawai'i for 30+ years were recruited through Hawaiian organizations and word-of-mouth and interviewed by teleconferencing on reasons for migrating, experiences on the Continent, and resilience. The 18 participants in 13 states left for college, work, and family. Many experienced racism, but all created community and cultivated aloha in their new homes. Most planned to stay on the Continent, although two-thirds wanted remains/cremains returned to Hawai'i. Family, culture, and financial well-being were sources of resilience. Social workers should advocate for improved socioeconomic and deracialized conditions for all people, and base interventions on cultural strengths. [ABSTRACT FROM AUTHOR]

Objective: The Native Hawaiian population experiences numerous disparities in health and income. Using a mixed-method research (MMR) design, we summarize findings from three phases of an MMR approach used to uncover kūpuna (elder) long-term service and support (LTSS) needs and care preferences. Methods: Key informants in Hawaiian health were interviewed, secondary analyses of large state data sets were conducted, and kūpuna and "ohana (family) caregivers were engaged in listening sessions. Results: Quantitative data confirmed numerous health disparities experienced by older Native Hawaiians, whereas qualitative data exposed their limited knowledge of this poor health profile and revealed their historical and contemporary experiences with discrimination in education, employment, and health care. Hawaiian culture was identified as a continued source of resilience in support of elders and family caregiving regardless of geographic setting. Discussion: We suggest three practice, policy, and research directions that offer the potential to respond to and improve kūpuna health and service use. [ABSTRACT FROM AUTHOR]

Background: Increasingly, U.S. grandparents are raising their grandchildren. In Hawai'i, 12% of Native Hawaiian grandparents live with grandchildren, compared to 7% of grandparents in all races combined in the state, and to 3.6% of grandparents in the total U.S. Although strong family-centric cultural values may provide Native Hawaiian grandparents with caregiving benefits, a generally poor health profile suggests they may also face challenges in this role. In this study, we talked to Native Hawaiian grandparents raising grandchildren (GRG) about the benefits and challenges of their caregiving experiences. Method: Three focus groups were conducted with Native Hawaiian grandparents (n=33) in Hawai'i who were 55 years of age or older and caregivers to their grandchildren. Findings: The most prevalent themes voiced by grandparents spoke of the benefits of being a grandparent caregiver (the greatest being the experience of mutual, unconditional love) and the enjoyment of passing on "life lessons" to their grandchildren. Grandparents identified concrete examples of what they provided to grandchildren and also spoke of their role in transmission of Native Hawaiian cultural values, practices, and stories to their grandchildren. A number of challenges pertaining to grandparent caregiving were identified along with needed services--respite care, financial assistance, children's programs, and information on grandparent legal rights. Despite these challenges, grandparents preferred to seek help from extended family rather than from formal supports. Our results support previous research on a number of universal GRG needs and services (i.e., legal rights of GRG) but also suggest potential directions to meeting the needs of Native Hawaiian GRG that are responsive to indigenous cultural values and preferences. Given the number of unmet needs expressed, further research is needed to design interventions for this population of grandparents raising grandchildren. [ABSTRACT FROM AUTHOR]

The United States is becoming more ethnically diverse, and Asian and Pacific Islanders (APIs) are one of the most rapidly growing ethnic minority groups. Of interest to social workers is how the traditional values and practices of these cultures affect their perceptions of disease and use of health services. This article presents information on perceptions of dementia, caregiving, and help seeking for the API group as a whole, with additional information on five of the major API subgroups - Chinese, Japanese, Filipino, Vietnamese, and Hawaiian. Implications for practice, policy, and research are discussed. Key words Asian Americans dementia caregiving help seeking Pacific Islander Americans, Alzheimer's disease, which causes progressive memory loss and dependence, is estimated to affect 4 million Americans (Yeo & Gallagher-Thompson, 1996). Social workers, regardless of setting in which they work, will [...]

Native Hawaiians comprise 24.3% of Hawai'i's population, but only 12.6% of the state's older adults. Few published studies have compared health indicators across ethnicities for the state's older adult population or focused on disparities of Native Hawaiian elders. The current study examines data from two state surveillance programs, with attention to cause of death and socialbehavioral factors relevant to elders. Findings reveal that Native Hawaiians have the largest years of productive life lost and the lowest life expectancy, when compared to the state's other major ethnic groups. Heart disease and cancer are leading causes of premature mortality. Native Hawaiian elders are more likely to report behavioral health risks such as smoking and obesity, live within/below 100-199% of the poverty level, and find cost a barrier to seeking care. Indicated is the need for affordable care across the lifespan and health services continuum. Future research might explain behavioral factors as influenced by social determinants, including historical trauma on Native Hawaiian longevity. [ABSTRACT FROM AUTHOR]