Supporting Native Hawaiian Health with Community-Based Social and Biomedical Research

PURPOSE: Research indicates that Native Hawaiians have the highest rates of diabetes and obesity in the state of Hawaiʻi. Understanding the way epigenetics plays a role in Type 2 Diabetes (T2DM) will help us determine how environmental factors play a role in the risk of T2DM in Native Hawaiian populations. Our objectives with this study are:(1) Understand the relationship between social context and health; (2) Learn about the mechanism through which a community-based program impacted health/wellbeing of Native Hawaiians; (3) Consider a new model of community-engaged research that empowers individuals and organizations to address health disparities.

METHODS: The study targeted individuals (16 years or older) in the state of Hawaiʻi affiliated with MAʻO organic farms or connected to their social network. Stool sample kits were distributed to participants with oral and written instructions to collect their own samples at home and store them in a freezer until they can be returned via mail or collected by a community research facilitator for analysis. Stool samples were used to metagenomics analysis. Height, weight, blood pressure, pulse and A1C were measured and recorded.

RESULTS: Results of this study show that main bacteria were dominant in Native Hawaiians (Bacteroidetes, Firmicutes, Proteobacteria, Actinobacteria). Actinobacteria and Proteobacteria were significantly correlated with BMI and A1c in Native Hawaiians. In the overall study population, there is a statistically significant negative correlation between A1c and the abundance of Actinobacteria (ρ= -0.169; CI = 90%) and Proteobacteria (ρ= -0.212; CI=95%). In the same group of participants, BMI is negatively correlated with the abundance of Actinobacteria (ρ= -0.222; CI=95%). The results also show the impact of social networks on the health/wellbeing of the individuals.