Pacific peoples fattest in the world: WHO

Pacific peoples are one of the fastest growing communities in New Zealand. But they are also among the fattest, with waistlines bigger than ever. An obesity report by the World Health Organisation (WHO) highlights a wider problem in the Pacific diaspora as PETER REES reports.

The latest obesity report released by the World Health Organisation (WHO) should be of concern not only to the Pacific islands, but the wider Pacific diaspora.
The report passed under the radar while the world’s attention focused on the aftermath of the tsunami that devastated Samoa, American Samoa and Tonga, and the failed Climate Summit in Copenhagen.
But the report’s findings point to a trend that has festered with no signs of abating. Left unchecked, it could have dire consequences on future generations.
The WHO report crowned Pacific peoples as the fattest people in the world with American Samoa on top with 93.5 percent of its residents classified as obese, while Kiribati came in second with 81.5 percent.
In recent years, Tonga, Samoa and Nauru have also featured highly in world obesity statistics.
While obesity and non-communicable diseases (like diabetes) are mainly a problem in the Polynesian and Micronesian islands, it is not for the more populated Melanesian islands. Why is that?
The migratory nature of Polynesians, and to a lesser extent Micronesians, has been sounded out as a key factor.
Looking closer at the WHO report, New Zealand (7th) and the United States (3rd)—the two most common destinations for emigrating islanders—also feature in the world’s top 10 “fattest” nations.
“Islanders were suffering from a drastic change in diet,” the report explains.
“Traditionally, they ate native foods high in complex carbohydrates and low in fat, such as bananas, yams, taro root, coconut and fish.
“But since the Second World War, inhabitants have increasingly migrated to the US, New Zealand, France and Australia, and introduced those back home to fatty Western foods.”
Dependence on imported foods is also to blame.

Interesting Facts • Pacific people have higher rates of chronic diseases than other ethnic group in New Zealand. • Pacific people are two and a half times more likely to be obese than the general population. • Cardiovascular disease is the principal cause of death for Pacific peoples in New Zealand •  The prevalence of diabetes in Pacific populations is three times higher than other New Zealanders. • 27% of Pacific peoples meet the criteria for living in severe hardship compared to 8% of the total population. • Pacific peoples are less likely to own their own homes (26% compared to 55% nationally) and more likely to live in overcrowded households.

It is not surprising to see the US mentioned as being the undisputed fast food capital of the world.
Some might find comparison with its tiny American territory in the Pacific, which arguably has more foreign-inspired fast food franchises (i.e McDonalds, KFC, Pizza Hutt) per head of population, than anywhere else in the Pacific.
Obesity epidemic: But in New Zealand, where the term takeaways is preferred to fast food, health authorities have shown concern at the rise in obesity figures there. And they are pointing the finger at the country’s growing Pacific islands community which numbers around 270,000 people (or seven percent of New Zealand’s population). Nearly half of that number is Samoan with the next largest groups being Tongan, Cook Islands, Niuean, Fijian, Tokelauan and Tuvaluan, in that order.
Two-thirds of the Pasifika population is concentrated in Auckland, New Zealand’s biggest city of 1.4 million people, a fact which has prompted locals to proudly proclaim the City of Sails as the Polynesian capital of the world.
By 2026, Pacific peoples are predicted to comprise 10 percent of the total population, which currently sits at 4.2 million.
With figures pointing to an obesity epidemic explosion, it is a worry for New Zealand taxpayers who are footing that health bill.
Leading health experts blame poor health for Pacific peoples dangling at the bottom of most social indicators. They argue that poor nutrition leads to a flow-on effect, especially on education achievement where Pacific and Maori youth form a long brown tail that trails behind other ethnic groups.
Making the health system more responsive to Pacific communities is one of the aims, according to the government’s Chief Advisor for Pacific Health, Dr Api Talemaitoga.
“Eighty percent of hospital admissions (Pacific peoples) are due to chronic conditions, such as complications from diabetes or heart conditions.
“If we learn how to manage chronic conditions more effectively, it will have a huge positive impact on the health system,” he says.
Poor health and other social disparities often relate to environment and the stark reality is, the majority of Pacific and Maori live in low income poverty-stricken areas.
The past decade is perceived as a golden period, where Pacific peoples emerged from its shell of being a migrant working class community to being leaders in sport, the arts, music and politics.
New tact: Pacific peoples celebrated their cultures and government got behind efforts to maintain that vital link to the islands with state-funded language retention programmes and supporting iconic events such as the Pasifika Festival, the world’s biggest free community event.
Nine years of a Labour-led government under former prime minister Helen Clark led many New Zealanders to embrace its multiculturalism. But underneath the achievement, Pacific peoples were struggling.
The current government led by John Key has changed tact from Clark’s regime. He has brought in a more streamlined approach to addressing issues in the Pacific community; particularly in health, education, crime and employment.
The global recession provided an extra challenge with Pacific unemployment doubling over the past year to over 11,000.
There was some outcry in the Pacific community as government departed from the wider consultation process they were used to under Labour. But there was a determination that government services would cease to be ‘ambulances at the bottom of the cliff’ and become more policy setters.
There has been some continuation of initiatives started by the previous government. A big push in recruitment campaigns targeting Pacific peoples has happened in recent months. That push is seeking to put more Pacific islander police officers, teachers and nurses into the workforce in a response to worsening figures in crime, education and health.
Millions has also been spent on media campaigns to create more awareness on health and social issues. Campaigns have largely focussed on areas where Pacific peoples are one of the worst represented ethnic groups, such as smoking and alcohol consumption, poor nutrition, cervical and breast cancer screening, and educational achievement.
But facing up to New Zealand’s obesity epidemic presents a significant challenge for Key’s government.
It is the lead cause of diabetes, where the prevalence is three times higher for Pacific people than other New Zealanders.
Diabetes New Zealand has shown concern at an Obesity Action Coalition report that says only 46.6 percent of Pacific households with children stated that they could always afford to eat properly, compared to 86.1 percent of European households.
The report says that Pacific people are two and a half times more likely to be obese than the general population.
The Pacific demographic had significantly higher age-standardised obesity rates than the total population with 65 percent of Pacific peoples 15 years and over found to be obese in a 2006/2007 Ministry of Health report, compared to Maori (43 percent), Europeans (23 percent) and Asians (12 percent). The pattern was similar for children 5-14 years of age. Pacific children had the highest rate at 26 percent compared to 5 percent of European children.
Obesity levels have increased simultaneously with the increase in cases of Type 2 diabetes in the Pacific community.
“In the face of these alarming statistics, action must be taken to prevent the onslaught of diabetes in the Pacific community,” says the organisation’s president Mike Smith.
Recent health cuts to diabetes services has some worried.
Labour MP for Mangere in south Auckland, Su’a William Sio, accused the government of failing to address the threat of obesity in the Pacific community when he criticised the slashing of NZ$4.8 million for a major diabetes project in the 2009 Health Budget.
“To find that there is a complete absence of consultation is beyond belief. I cannot imagine how either of these politicians can look Pacific people in the eye,” he said last September, referring to Health Minister Tony Ryall and Pacific Affairs Minister, Georgina Te Heuheu.
Diabetes New Zealand advocates portion control and the healthy plate, with half in vegetables, as a key to reversing that trend.
Simple as it sounds, Pacific people are slow to buy into the idea. People’s attitudes have largely remained unchanged, due in part to the mentality that big is still better.
The Pacific islander stereotype has changed dramatically since the first major migratory wave from the Pacific islands took place almost 50 years ago. To outsiders, Pacific islanders were dusky maidens and well-built seafaring men. That mindset has shifted to one of a people, who are overweight, uneducated, lazy and prone to violence. Even the exploits of globally recognised sportsmen and entertainers like boxer David Tua, Hollywood actor Dwayne ‘The Rock’ Johnson and the biggest name in rugby, Jonah Lomu, has failed to change that mentality.
When it is said often enough, stereotypes find a way of embedding itself in the subconscious, eventually becoming socially accepted.
“Food is central to all Pacific cultures,” says Diabetes New Zealand nurse Lesieli O’Brien. “It is the culture and without the food there is no social involvement. My message is ‘cut down the fat and the sugar content in the food’, but put in a way that people can accept it.”
Pacific islanders have learnt to laugh at their size and love of food, in part due to the proliferation of stereotypes.
Many remember one of the first references to the size of Pacific islanders on the big screen in the acclaimed 1994 film Pulp Fiction where Samuel L. Jackson’s character Jules Winnfield quips: “I wouldn’t go so far as to call the brother fat, I mean he got a weight problem. What’s the nigger gonna do? He’s Samoan.”
Numerous songs sung by Pacific islands musicians glorify their love of food. Soul Food, released by well-known South Auckland based hip-hop music label Dawn Raid in 2007, describes Pacific islanders as being able to “eat more rice than all the Asians put together”.
Pacific mindset: New Zealand-based Pacific comedy acts, The Laughing Samoans and the Kila Kokonut Krew, regularly parody Pacific eating behaviour and the respective front men of those collectives are known to their fans for their size.
There has been some progress since the Ministry of Health established a Pacific health branch—a team of analysts dedicated to improving the health of Pacific peoples in New Zealand—in 2000.
Heathier eating and more active lifestyles have been preached widely in the community. Schools have adopted breakfast programmes and healthier lunch options. Pacific islands churches—the most common meeting place of Pacific families—have increasingly become the focal point for government and district health board initiatives.
Church and community groups are now encouraged to cook traditional islands food using alternative, healthier ingredients or providing healthier options at functions and meetings.
Still, the price of food and increasing work pressures, is forcing families to opt for cheaper takeaway food options.
The economic recession has seen a rise in takeaway sales in New Zealand over the past year. Children are leading more sedentary lifestyles as well with the proliferation of video games and television entertainment. Policymakers, in the end, have only so much influence.
Many agree that curbing obesity levels lies not just in the halls of power, but at home where the message of policymakers is often missed.
What that ultimately means is more direct intervention and Pacific communities taking more ownership of their health, if attitudes towards food is to change. Maybe then, will the Pacific mindset change from living to eat to eating to live.