Native Hawaiian adults face mobility challenges earlier in life

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Native Hawaiian adults experience mobility limitations--including challenges with agility, gait, balance and fall risk-at significantly higher rates and at younger ages than other major racial and ethnic groups in Hawaiʻi, according to new research from the University of Hawai'i at Mānoa's Hā Kūpuna National Resource Center for Native Hawaiian Elders.

The study, published in the Centers for Disease Control and Prevention's Preventing Chronic Disease, analyzed mobility and functional limitations among adults aged 55 and older using data from the Hawaiʻi Behavioral Risk Factor Surveillance System collected between 2019 and 2021.

Led by Miquela Ibrao, associate director of Hā Kūpuna and assistant professor in the Thompson School of Social Work and Public Health, the study found that 28% of Native Hawaiian adults ages 55 and older reported mobility limitations. In contrast, rates for White, Filipino and Japanese adults ranged from 17% to 19%. These disparities were evident even among those aged 55 to 64, suggesting that mobility challenges begin earlier than typically expected for Native Hawaiians.

"This study points to the need to assess mobility changes earlier than age 65," said Ibrao. "Staying mobile is critical to living independently and maintaining social connections."

Addressing health equity

The research team, which included Hā Kūpuna researchers Yan Yan Wu and Kathryn Braun, investigated how social determinants of health-such as income, education, health insurance access and neighborhood walkability-influence mobility.

For both Native Hawaiian and White adults, higher income was linked to lower rates of mobility limitations, underscoring the critical role economic factors play in healthy aging.

"We need more culturally grounded, community-based programs for Native Hawaiian adults," added Ibrao. "These initiatives are essential to address social determinants of health and help kūpuna age with dignity, connection and independence in the communities they call home."

Hā Kūpuna researchers hope the findings will inform policies and programs aimed at reducing health disparities and improving quality of life for Native Hawaiian older adults across the state.