Fitzpatrick-Nietschmann J
West J Med. 1983 Dec;139(6):848-53.
Native Hawaiians and peoples from American Samoa, Guam and the Trust Territories of the Pacific Islands are all recipients of US subsidized health care. Categorized as Pacific Islanders they are a heterogeneous group with differences in biology, cultural adaptation to varied ecological settings, historical influences resulting from colonialism and present-day political factionalism. Yet, westernization on home islands and migration to Hawaii and the western United States have created similarities in disease patterns among these culturally diverse peoples. They have high rates of the chronic diseases of civilization: cardiovascular disease, diabetes mellitus and hypertension. Obesity, associated with these ailments, has become a major health problem among Pacific Islanders and may be attributed to changes in local food production and consumption in conjunction with sedentarization. Culturally and linguistically distinct from the American mainstream, these people as migrants or residents are marginal within the US social structure and find if difficult to obtain adequate medical treatment.
夏威夷原住民以及美属萨摩亚、关岛和太平洋岛屿托管地的居民都接受美国政府补贴的医疗保健。他们被归类为太平洋岛民，是一个异质性群体，在生物学、对不同生态环境的文化适应、殖民主义带来的历史影响以及当今的政治派别等方面存在差异。然而，家乡岛屿的西方化以及向夏威夷和美国西部的移民，使得这些文化多样的人群在疾病模式上出现了相似之处。他们患文明病（心血管疾病、糖尿病和高血压）的比例很高。与这些疾病相关的肥胖问题，已成为太平洋岛民中的一个主要健康问题，这可能归因于当地粮食生产和消费的变化以及久坐不动的生活方式。这些人与美国主流群体在文化和语言上存在差异，作为移民或居民，他们在美国社会结构中处于边缘地位，难以获得足够的医疗救治。
