Sentell, Tetine PhD

Pilot Project PI
Associate Professor
Office of Public Health Studies
University of Hawai’i at Manoa

(808) 956-5781

Research Overview

2014-2015 RMATRIX Collaboration Pilot Projects Program Awards

Project Description

Title: Racial Discrimination, Health, and Healthcare for Hawaii’s Chuukese Population
Principal Investigator: Tetine Sentell, PhD
RMATRIX HEALTH Initiative(s): Nutrition & Metabolic
RMATRIX Core Support: Biostatistics & Health Sciences Data Analytics, Regulatory Knowledge and Support


A growing body of research supports the theory that an increase in perceived racial discrimination can lead to negative health outcomes and decrease access to appropriate healthcare. Despite supportive evidence that discrimination and health inequity are important issues for the Chuukese community living in Hawaii, very little research has been published regarding associations between racism and health in this population. (Chuukese are decedents from Chuuk, a state within the Federated States of Micronesia. Chuukese are often times aggregated into the broad category of Micronesians.) Despite a dearth of population based health statistics on Hawaii’s Chuukese population, some studies show they have a high burden of some types of cancers, and chronic and infectious disease. An assessment conducted in Hawaii with 454 Micronesian households found 35% of Micronesian adults over the age of 40 reported having diabetes, compared to only 12% of the state as reported by the Behavioral Risk Factor Surveillance System. This study concluded that diabetes was a main health concern for COFA migrants and that Hawaii should prioritize addressing this health issue. The aim of this study is to help close this research gap and address health inequities in this population, including diabetes and obesity. We propose to do this by investigating how racial discrimination in Hawaii’s healthcare system is experienced, perceived, and discussed by Chuukese community members. A literature review on measuring racial discrimination concludes that there is still no consensus on the most appropriate or valid method to measure racial discrimination. An added complication for accurate measurement is the fact that an individual’s interpretations of racial discrimination may be affected by their cultural background and beliefs. Therefore, we propose that before we can study racial discrimination with the COFA migrant community, it is imperative to create a culturally appropriate measurement tool. To do this we will utilize an interdisciplinary approach to collect a more comprehensive perspective from both academia and the community.

Selected Publications

  • Guo MW, Ahn HJ, Juarez DT, Miyamura J, Sentell TL.
    Length of Stay and Deaths in Diabetes-Related Preventable Hospitalizations Among Asian American, Pacific Islander, and White Older Adults on Medicare, Hawai'i, December 2006-December 2010.
    Prev Chronic Dis 2015 [more...]

  • Heo HH, Sentell TL, Li D, Ahn HJ, Miyamura J, Braun K.
    Disparities in Potentially Preventable Hospitalizations for Chronic Conditions Among Korean Americans, Hawaii, 2010-2012.
    Prev Chronic Dis 2015 [more...]

  • Sentell T, Braun KL, Davis J, Davis T.
    Health literacy and meeting breast and cervical cancer screening guidelines among Asians and whites in California.
    Springerplus 2015 [more...]

  • Sentell T, Miyamura J, Ahn HJ, Chen JJ, Seto T, Juarez D.
    Potentially Preventable Hospitalizations for Congestive Heart Failure Among Asian Americans and Pacific Islanders in Hawai'i.
    J Immigr Minor Health 2015 [more...]

  • Sentell TL, Ahn HJ, Miyamura J, Juarez DT.
    Cost Burden of Potentially Preventable Hospitalizations for Cardiovascular Disease and Diabetes for Asian Americans, Pacific Islanders, and Whites in Hawai'i.
    J Health Care Poor Underserved 2015 [more...]

  • Sentell TL, Tsoh JY, Davis T, Davis J, Braun KL.
    Low health literacy and cancer screening among Chinese Americans in California: a cross-sectional analysis.
    BMJ Open 2015 [more...]

  • Sentell TL, Valcour N, Ahn HJ, Miyamura J, Nakamoto B, Chow D, Masaki K, Seto TB, Chen JJ, Shikuma C.
    High rates of Native Hawaiian and older Japanese adults hospitalized with dementia in Hawai'i.
    J Am Geriatr Soc 2015 [more...]

  • Sentell T, Chang A, Cheng Y, Miyamura J.
    Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawai'i: an observational study from five years of statewide data.
    BMC Pregnancy Childbirth 2014 [more...]

  • Sentell T, Marten L, Ahn HJ, Qui Y, Chen JJ, Miyamura J, Chow D, Shikuma C.
    Disparities in hospitalizations among HIV positive individuals for Native Hawaiians and Asians compared to Whites in Hawai'i.
    Hawaii J Med Public Health 2014 [more...]

  • Sentell T, Zhang W, Davis J, Baker KK, Braun KL.
    The influence of community and individual health literacy on self-reported health status.
    J Gen Intern Med 2014 [more...]

  • Sentell TL, Juarez DT, Ahn HJ, Tseng CW, Chen JJ, Salvail FR, Miyamura J, Mau MK.
    Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
    Hawaii J Med Public Health 2014 [more...]

  • Sentell T, Braun KL, Davis J, Davis T.
    Colorectal cancer screening: low health literacy and limited English proficiency among Asians and Whites in California.
    J Health Commun 2013 [more...]

  • Sentell T, Dela Cruz MR, Heo HH, Braun KL.
    Health literacy, health communication challenges, and cancer screening among rural native Hawaiian and Filipino women.
    J Cancer Educ 2013 [more...]

  • Sentell T, Unick GJ, Ahn HJ, Braun KL, Miyamura J, Shumway M.
    Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.
    Psychiatr Serv 2013 [more...]

  • Sentell TL, Ahn HJ, Juarez DT, Tseng CW, Chen JJ, Salvail FR, Miyamura J, Mau ML.
    Comparison of potentially preventable hospitalizations related to diabetes among Native Hawaiian, Chinese, Filipino, and Japanese elderly compared with whites, Hawai'i, December 2006-December 2010.
    Prev Chronic Dis 2013 [more...]

  • Sentell T, Braun KL.
    Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California.
    J Health Commun 2012 [more...]

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