摘要：Cancer mortality is on the decline in the U.S. (Jemal, Siegel, Xu, & Ward, 2010), but like so many other health conditions this is not enjoyed by all Americans. Among the most underserved are Pacific Islanders (PIs), who in 2000 numbered 874,414 (alone or in combination with one or more other races). California is second only to Hawai'i in the number of PIs, with half of the state's 221,458 PIs living in Southern California (APALC, 2005). Pacific Islanders (PIs) represent a wide diversity of ethnic populations, with over 19 census defined groups that each have their own culture, language, traditions, world and health perspectives, and political and migration history. Some of these PI populations have close ties to the U.S. territories and jurisdictions in the Pacific, including American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Commonwealth Nations of the Mariana Islands. Other groups such as Tongans, have migrated from their small island nations in search of higher earnings to support families back home (Small, 1997). Despite their differences in nationalities, PIs generally face high socioeconomic barriers to health and other care (US Census Bureau, 2004). For instance, educational attainment is low: 14-40% of PIs have less than a high school degree compared to the California average of only 10% (APALC, 2005). While only 8% of Californians were at or below the poverty line, this was true for 10-20% of PIs. Compared to nearly all other ethnic groups, PIs suffer from higher prevalence of the leading health disparity indicators, including cigarette smoking, hypertension, obesity, diabetes, infant mortality, tuberculosis, hepatitis B, and asthma (CDC, 2002).
