The Hōkūleʽa Worldwide Voyage Comes Full Circle: The NLM Connection

Guest post by Dr. Fred Wood, Outreach and Evaluation Scientist in the Office of Health Information Programs Development.

On June 17, the ocean-going, double-hulled canoe Hōkūleʽa (named for Arcturus, the Star of Gladness) successfully completed its historic Worldwide Voyage.  The Hōkūleʽa departed Honolulu, Hawaiʽi, on May 18, 2014 and over the last three years traveled more than 60,000 nautical miles, stopping at 150 ports in 27 nations, while completing its circumnavigation of the globe.

Launched in 1975, the Hōkūleʽa recreates the type of ocean-going canoes used by Polynesians for thousands of years to traverse the Pacific Ocean and to discover other Pacific islands, including Hawaiʽi.  Hōkūleʽa’s original mission was to prove that traditional double-hulled canoes “powered” only by native knowledge of the wind and swells, as well as the sun, moon, stars, and ocean wildlife, could voyage across the 2,500 miles each way between Hawaiʽi and Tahiti. Once accomplished, this initial mission expanded to include voyages to other islands throughout the Pacific, west to Asia, and east to the US mainland.

Building on this voyaging success, the Hōkūleʽa transformed into a symbol for a broader revitalization of Native Hawaiian culture, pride, ecological sustainability, and health, messages that remain at the heart of its global voyage.

When that voyage reached Washington, DC in May 2016, NLM hosted Nainoa Thompson, one of only a handful of Native Hawaiians trained in the traditional navigation methods referred to as wayfinding. Thompson spoke passionately about the history and role of the Hōkūleʽa in promoting Hawaiian culture and health, and in advocating for environmental protection, sustainability of the oceans, and world peace.

Even before the Worldwide Voyage and Thompson’s lecture, NLM had closely followed the Hōkūleʽa and honored its importance in NLM exhibitions and associated websites and apps.

model of a double-hulled sailing canoe
A scale model of the Hōkūleʻa graced the entrance to the Library from 2011-2015.

For the NLM exhibition Native Voices: Native Peoples Concepts of Health and Illness, the Library commissioned a one-sixth scale model of the Hōkūleʽa built by Hawaiian artisans to the exact specifications of the full-sized canoe. The model was on display for several years in the NLM rotunda. In addition, Native Voices included interviews with Thompson, and with several of Hōkūleʽa medical officers, including Drs. Ben Young, Ben Tamura, and Marjorie Mau, who served on various legs of the Hōkūleʽa’s 40+ years of ocean voyaging.

The Hōkūleʽa and the ancient arts of navigation and voyaging were also at the center of the NLM exhibition A Voyage to Health, which looked at how the resurgence of Native Hawaiian culture helped heal the soul of the community. When the canoe and her crew returned to Honolulu last week, A Voyage to Health was there as part of the welcoming celebration.

Both traveling exhibitions have visited dozens of venues across Hawaiʽi and the rest of the US. And NLM’s scale-model Hōkūleʽa is now on display at the Disney Aulani Resort, in West Oahu, under auspices of the Friends of the Hōkūleʽa and Hawaiʽiloa.

NLM celebrates the accomplishments of the Hōkūleʻa and the entire Hawaiian voyaging community that participated in the Mālama Honua (“Care for the Earth”) Worldwide Voyage.  As that voyage comes to a close, NLM acknowledges once again its significance as an icon of Hawaiian culture, values, and health.

More Information
Native Voices Exhibition: NLM Hōkūleʽa microsite
Video: Nainoa Thompson’s Special Lecture on the Hōkūle’a and Native Hawaiian Health (May 23, 2016)
NIH Record: “For Native Hawaiians, Canoe Instills Pride, Healing”

Health Disparities: Big Data to the Rescue?

Guest post by Dr. Fred Wood, Outreach and Evaluation Scientist in the Office of Health Information Programs Development.

Socially disadvantaged populations have fewer opportunities to achieve optimal health. They also experience preventable differences when facing disease or injury. These inequities, known collectively as health disparities, significantly impact personal and public health.

Despite decades of research on health disparities, researchers, clinicians, and public health specialists have not seen the changes we were hoping for. Instead many health disparities are proving difficult to reduce or eliminate.

With that in mind the National Institutes of Health (NIH) National Institute on Minority Health and Health Disparities (NIMHD) launched a Science Visioning Process in 2015 with the goal of producing a scientific research plan that would spark major breakthroughs in addressing disparities in health and health care. NIMHD defines health disparities populations as including racial or ethnic minorities, gender or sexual minorities, those with low socioeconomic status, and underserved rural populations.

Through a mix of staff research and trans-NIH work groups—of which the National Library of Medicine is a part—NIMHD is gathering input on the current state of the science on minority health and health disparities.

Prompted in part by the NIH All of Us precision medicine initiative, one key visioning area—methods and measures for studying health disparities—includes big data.

We expect big data to bring significant benefits and changes to health care, but can it also play a part in reducing health disparities?

Last month the journal Ethnicity & Disease published a special issue focused on big data and its applications to health disparities research (Vol. 27, No. 2).

The issue includes a paper co-authored by the current NIMHD director, several NIH researchers (including me), and several academic partners. Titled “Big Data Science: Opportunities and Challenges to Address Minority Health and Health Disparities in the 21st Century,” (PDF | 436 KB) the paper identified three major opportunities for big data to reduce health disparities:

  1. Incorporate social determinants of health disparities information—such as race/ethnicity, socioeconomic status, and genomics—in electronic health records (EHRs) to facilitate research into the underlying causes of health disparities.
  2. Include in public health surveillance systems environmental, economic, health services, and geographic data on targeted populations to help focus public health interventions.
  3. Expand data-driven research to include genetic, exposure, health history, and other information, to better understand the etiology of health disparities and guide effective interventions.

But using big data for health disparities research has its challenges, including ethics and privacy issues, inadequate data, data access, and a skilled, diverse workforce.

The paper offered eight recommendations to counteract those challenges:

  1. Incorporate standardized collection and input of race/ethnicity, socioeconomic status, and other social determinants of health measures in all systems that collect health data.
  2. Enhance public health surveillance by incorporating geographic variables and social determinants of health for geographically defined populations.
  3. Advance simulation modeling and systems science using big data to understand the etiology of health disparities and guide intervention development.
  4. Build trust to avoid historical concerns and current fears of privacy loss and “big brother surveillance” through sustainable long-term community relationships.
  5. Invest in data collection on area-relevant small sample populations to address incompleteness of big data.
  6. Encourage data sharing to benefit under-resourced minority-serving institutions and underrepresented minority researchers in research intensive institutions.
  7. Promote data science in training programs for underrepresented minority scientists.
  8. Assure active efforts are made up front during both the planning and implementing stages of new big data resources to address disparities reduction.

Big data, it seems, is the classic double-edged sword. It offers tremendous opportunities to understand and reduce health disparities, but without deliberate and concerted action to address its inherent challenges and without the active engagement of minority communities in that process, those disparities could widen, keeping the benefits of precision medicine—including improved diagnosis, treatment, and prevention—from millions of those who need them.

How do you think big data will inform health disparities research? And what else might we do to ensure the disparities gap continues to close?