H.R. NO.













Urging the DEPARTMENT OF health to endorse the "screen at 23" campaign that screens adult asian americans for type 2 diabetes at a body mass index of 23.



     WHEREAS, approximately 130,000 people, or 9.1 percent of the population, in Hawaii have diabetes, 442,000 or 30.9 percent have pre-diabetes, and residents of Asian American heritage comprise 56.2 percent of the population of Hawaii; and


     WHEREAS, diabetes is the fifth leading cause of death among Asian Americans; and


     WHEREAS, Asian Americans are 30 percent more likely to have diabetes than White Americans and are also at greater risk of developing pre-diabetes, diabetes, and associated risks at a lower body mass index than White, Hispanic, Black, or Native Americans; and


     WHEREAS, Asian Americans face a health care disparity in type 2 diabetes detection and diagnosis, as the current guidelines for screening Asian Americans at a body mass index of 25 not only miss 32 percent of diabetes diagnoses in Hawaii, but also underestimate the prevalence of pre-diabetes among Asian Americans; and


     WHEREAS, two out of three persons with type 2 diabetes die from heart attack or stroke, and adults with diabetes are at risk for developing end stage renal disease and kidney failure, blindness, and lower limb loss; and


     WHEREAS, the per capita health care cost of diabetes in the State is $14,377 per year, while the annual cost for diabetes in the State is $1,500,000,000 in medical costs and $400,000,000 in indirect costs and productivity loss; and


     WHEREAS, early detection and treatment can mitigate diabetes-related complications, risks, and costs; and


     WHEREAS, interventions focusing on nutrition, physical activity, and healthy weight loss have been shown to reverse pre-diabetes, improve glucose function in people with diabetes, and reduce the need for multiple medications; and


     WHEREAS, screening Asian American patients at a body mass index of 23 instead of 25 would unmask thousands of new diabetes cases and more than three times that amount of new pre-diabetes cases in the State, thereby initiating treatment or early interventions to reduce negative co-morbidities like heart diseases, kidney diseases, and limb amputation; and


     WHEREAS, the National Institutes of Health recently found that more than half of Asian Americans with diabetes are undiagnosed, and community based participatory research and studies on Asian American subpopulations have shown that Asian Americans develop diabetes at a lower body mass index; and


     WHEREAS, the World Health Organization recommends screening Asian patients at a lower body mass index than non-Hispanic Whites, and the 2015 official guidelines of the American Diabetes Association recommend that Asian Americans should be tested for type 2 diabetes at a body mass index of 23; and


     WHEREAS, the Asian American, Native Hawaiian, and Pacific Islander Diabetes Coalition has coordinated the "Asian BMI" efforts of over 15 national and regional organizations, culminating in the launch of the "Screen at 23" campaign; and


     WHEREAS, Hawaii has the opportunity to be one of the first states to formally recognize and recommend screening adult Asian Americans for type 2 diabetes at a body mass index of 23, enabling thousands of individuals to get the early care and treatment needed to live healthier and happier lives; now, therefore,


     BE IT RESOLVED by the House of Representatives of the Twenty-eighth Legislature of the State of Hawaii, Regular Session of 2016, that the Department of Health is urged to endorse the "Screen at 23" campaign's efforts to increase awareness of diabetes among Asian American communities and to eliminate disparities; and


     BE IT FURTHER RESOLVED that the Department of Health is also urged to encourage all public and private health care providers and facilities to participate in these efforts; and


     BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Governor and Director of Health.









Report Title: 

Body Mass Index; Asian American Residents; Diabetes