How do current U.S. Government healthcare policies affect Micronesians? As legal "aliens," indicated in the Compact of Free Association (COFA), what challenges do Micronesians experience while navigating the healthcare system in Washington State? Our research demonstrates that for 30 years Micronesian families migrating to the U.S. in search of beneficial opportunities experience great amount of difficulty when accessing healthcare in Washington State. Current U.S. policies towards migrants from the Freely Associated States perpetuate Dr. Paul Farmer's theory of structural violence by failing to acknowledge the United States Government's role in the healthcare burdens residing in the bodies of COFA citizens, due to U.S. colonialism within the region. Preliminary results indicate that different subgroups have distinct experiences in comparison to others. Methods of research include interviews with Micronesian students and community members, specifically from March 1st, 2016, A Day of Remembrance --solidarity event with the Marshallese community at the Burke Museum on the anniversary of the largest nuclear weapon ever tested by the U.S. Government.

Despite the various health and wellness interventions available to Mãori and Pasifik peoples, their health outcomes tend to be worse off than the Pakhea (White majority) living in Aotearoa (New Zealand). As a part of the Māhina: International Indigenous Health Research Training Fellowship, Solana Rollolazo, Rachael Tamngin and I engaged in health research internships with Māori and Pasifik communities and participated in the Digital Storytelling process that aided us in developing the qualitative research lens required to engage in community based and community informed research with Indigenous peoples. In a word, we “indigenized” our research approaches in order to support communities in bettering their own health on their own terms. Interning within the Epidemiology department at the University of Auckland my research dissected the ways that “fizzy,” sugary-filled drinks are disproportionately advertised to children in low socio-economic communities of Auckland—demographically including a majority of children of Pasifik and Māori descent. To understand the origins of the elevating health disparities plaguing Pasifik and Māori communities of Aotearoa, particularly that of obesity and diabetes, my intern supervisor, Gerhard Sundborn, shared with me the histories of unjust deportations of Pasifik immigrants known as the “Dawn Raids,” and the Māori’s ongoing struggle for sovereignty of their lands and resources. Culminating the knowledge amassed throughout my internship my digital story speaks the quieted histories of Pasifik people. It tells the story of how structural racism and systemic inequities plague the health of Pasifika and how before we reach medical diagnoses and population health disparities, before prescriptions and medication are given, we must first disseminate a wellness in honoring culture, family, and spirituality in order to guarantee health. We must honor histories that have passed.

In Filipino culture, family is arguably the most important and emphasized value. When Filipino parents or elders require care, it is customary in the Filipino culture to assume the role of a caretaker, often times until they pass. However, this traditional family structure and system of care can be compromised when practiced in the United States. Since 1990, the Philippines has been consistently among the top five countries of origin, accounting for 4.5% of the 41.3 million total immigrant population in the United States. As of the 2010 Census, Washington is home to the fifth largest Filipino American population of any single state in the nation, with an estimated 137,083 Filipinos in the region. Among this large Filipino immigrant and Filipino American population, a high proportion are nurses and health care workers. Despite the large population of immigrant Filipinos in the U.S., many elders experience isolation, acculturation stress and depression due to the cultural disconnection and shift of family structure. Considering the high volume of Filipino elders and health care workers, it is important to investigate the relationship between Filipino elders and health care workers. Cultural concordance plays a large role in developing trust and allowing for effective health treatment. Through the qualitative methods of interviews, participant observation and spatial analysis, I have explored the different elements of health and wellness that effect Filipino elders. I delved into the experiences of Filipino elders who are cared for by their families as well as those who receive end-of-life care. More generally, I aim to identify the key aspects of holistic health among elderly Filipinos through their communal involvement and wellbeing. Through this research, I aim to emphasize the importance of cultural relationality and concordance in health care and in the broader community for Filipino elders in Seattle.

Through my internships at Toi Tangata and Hapai Te Hauora, two Maori health care providers in New Zealand, I sought to understand the methods in which health services can successfully integrate cultural understanding into health promotion in order to create better health outcomes for indigenous peoples. With Toi Tangata, I worked alongside specialists in positive health, fitness and nutrition who understand the unique relationship between our culture and the way we move, eat, drink, think and behave. Toi Tangata's youth physical education curriculum founded in Maori legends and traditions like haka and mau rakau (Maori martial arts) is one example of a successful culturally-based and community-driven health program. I also learned about the structural interventions of health advocacy through Hapai Te Hauora, a health provider that utilizes multi-tiered health research initiatives to advocate for Maori health via workforce development, public health planning, information technology solutions and policy development. Through participant observation and informal interviews with health care providers, community members receiving care and Maori academics researching indigenous health, I was able to able to learn about the implementation of effective, ethnic specific approaches to health care. My findings were summarized in a digital story, a digital narrative of my personal experience paired with academic findings, which was presented back to the Maori community. My digital story shares my personal devotion to indigenous health to honor the hardships, and more importantly the resilience, of my ancestors.This research could be valuable informing local health policy about effective cultural health approaches that can and should be employed to improve the health and wellbeing of underserved, marginalized communities.

How has colonization affected Samoan culinary traditions, identity, and health? What is the process of reclaiming culture, health, and identity through food sovereignty for Samoan communities in the United States (King County)? For centuries, the effects of Western colonialism in the Pacific has left scars on both indigenous lands and the wellbeing of indigenous peoples. What once was a sustainable food system has transformed to a system reliant on commodified and imported foods. I argue that a shift in diet from a traditional to Western contribute to a high prevalence of obesity, type 2 diabetes, and other chronic illnesses among the Samoan population. This study critically examines Samoan food practices, colonial history in the South Pacific, and current health challenges for Samoan communities. Methods of research include oral and written interviews by Samoan students and community members, discourse analysis, and participant-observation. The aim of this project is to inform the general public of the importance of revitalizing and sustaining indigenous food traditions for the health and overall well-being of our indigenous communities.

While rheumatic fever has been eradicated throughout majority of developed countries in the world, it continues to be a health disparity in the developed country of Aotearoa. Why is this relatively preventative illness and disease virulent in Aotearoa? In Aotearoa (New Zealand), health and wellness conditions among the Maori and Pasifika populations are similar to that of citizens from underdeveloped countries. In order to find out the causes of the disparities within these communities, interviews were conducted in both individual and group settings. Physicians, nurses and public healthcare workers were interviewed individually while families, Maori and Pasifika, were interviewed in multi-person settings. In addition, district health boards were contacted to insure that the research conducted within each region of Aotearoa was appropriate and within official guidelines. Poor housing conditions and limited access to healthcare among these populations have led to excessive exposure to group A streptococcus bacterium. When not treated, this illness develops into acute rheumatic fever (ARF), rheumatic heart disease (RHD), and eventually results in either cardiac failure, stroke or endocarditis, and/or death; although this strain of strep can be easily treated with Penicillin V or Amoxicillin. This disease has been observed mainly in young children and young adults. The health disparities occurring in this age group can be attributed to the close contact they experience within the schooling system, which results in high transmission rates. Findings reveal that the best medicine for this disease is prevention.