An unequal distribution of the human right to health: assessing ethnic health disparities in cardiometabolic disease prevalence among Hawaii’s houseless population
International Journal of Human Rights in Healthcare
ISSN: 2056-4902
Article publication date: 4 April 2024
Abstract
Purpose
In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.
Design/methodology/approach
A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.
Findings
Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.
Originality/value
To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.
Keywords
Acknowledgements
The authors would like to thank the Hawaii Homeless Outreach and Medical Education Project as well as the John A. Burns School of Medicine for making this study possible.
Research funding details: No funding was received for this study.
Declaration of interest statement: The authors have no conflicts of interest to declare.
Data availability statement: The full de-identified data sets that support the findings of this study are available from the corresponding author, Nicholas Fancher, upon reasonable request.
Statement of ethics: This study was performed with the approval of the University of Hawaii at Manoa’s Institutional Review Board, protocol ID 2019-00823. Our study was granted a waiver of the informed consent requirement by the Institutional Review Board on the basis that the data was gathered in a de-identified manner and posed minimal risk to subjects. Access to the Houseless Outreach and Medical Education Project clinic patient records was also authorized by organization leaders Dr. Teresa Schiff-Elfalan and Dr. Jill Omori.
Citation
Fancher, N., Saha, B., Young, K., Corpuz, A., Cheng, S., Fontaine, A., Schiff-Elfalan, T. and Omori, J. (2024), "An unequal distribution of the human right to health: assessing ethnic health disparities in cardiometabolic disease prevalence among Hawaii’s houseless population", International Journal of Human Rights in Healthcare, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJHRH-09-2023-0077
Publisher
:Emerald Publishing Limited
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