and drug abuse under the Anti-Drug Abuse Act of 
1986 (21 U.S.C. 801 note; Public Law 99–570); 
‘‘(33) in addition, the United States—
‘‘(A) has recognized that Native Hawai-
ians, as aboriginal, indigenous, native people of 
Hawaii, are a unique population group in Ha-
waii and in the continental United States; and 
‘‘(B) has so declared in Office of Manage-
ment and Budget Circular 15 in 1997 and 
Presidential Executive Order No. 13125, dated 
June 7, 1999; and 
‘‘(34) despite the United States having ex-
pressed in Public Law 103–150 (107 Stat. 1510) its 
commitment to a policy of reconciliation with the 
Native Hawaiian people for past grievances—
‘‘(A) the unmet health needs of the Native 
Hawaiian people remain severe; and 
‘‘(B) the health status of the Native Ha-
waiian people continues to be far below that of 
the general population of the United States. 
‘‘(b) FINDING OF UNMET NEEDS AND HEALTH DIS-
PARITIES.—Congress finds that the unmet needs and seri-
ous health disparities that adversely affect the Native Ha-
waiian people include the following: 
‘‘(1) CHRONIC DISEASE AND ILLNESS.—
‘‘(A) CANCER.—
‘‘(i) IN GENERAL.—With respect to all 
cancer—
‘‘(I) Native Hawaiians have the 
highest cancer mortality rates in the 
State (216.8 out of every 100,000 
male residents and 191.6 out of every 
100,000 female residents), rates that 
are 21 percent higher than the rate 
for the total State male population 
(179.0 out of every 100,000 residents) 
and 64 percent higher than the rate 
for the total State female population 
(117.0 per 100,000); 
‘‘(II) Native Hawaiian males 
have the highest cancer mortality 
rates in the State for cancers of the 
lung, colon, rectum, and colorectum, 
and for all cancers combined; 
‘‘(III) Native Hawaiian females 
have the highest cancer mortality 
rates in the State for cancers of the 
lung, liver, pancreas, breast, corpus 
uteri, stomach, colon, and rectum, and 
for all cancers combined;
‘‘(IV) Native Hawaiian males 
have 8.7 years of productive life lost 
as a result of cancer in the State, the 
highest years of productive life lost in 
that State, as compared with 6.4 
years for all males; and 
‘‘(V) Native Hawaiian females 
have 8.2 years of productive life lost 
as a result of cancer in the State as 
compared with 6.4 years for all fe-
males in the State. 
‘‘(ii) BREAST CANCER.—With respect 
to breast cancer—
‘‘(I) Native Hawaiians have the 
highest mortality rate in the State 
from breast cancer (30.79 out of 
every 100,000 residents), a rate that 
is 33 percent higher than that for 
Caucasian Americans (23.07 out of 
every 100,000 residents) and 106 per-
cent higher than that for Chinese 
Americans 
(14.96 
out 
of 
every 
100,000 residents); and 
‘‘(II) nationally, Native Hawai-
ians have the third highest mortality
rate as a result of breast cancer (25.0 
out of every 100,000 residents), be-
hind African Americans (31.4 out of 
every 100,000 residents) and Cauca-
sian Americans (27.0 out of every 
100,000 residents). 
‘‘(iii) CANCER OF THE CERVIX.—Na-
tive Hawaiians have the highest mortality 
rate as a result of cancer of the cervix in 
the State (3.65 out of every 100,000 resi-
dents), followed by Filipino Americans 
(2.69 out of every 100,000 residents) and 
Caucasian Americans (2.61 out of every 
100,000 residents). 
‘‘(iv) LUNG CANCER.—Native Hawai-
ian males and females have the highest 
mortality rates as a result of lung cancer 
in the State, at 74.79 per 100,000 for 
males and 47.84 per 100,000 females, 
which rates are higher than the rates for 
the total State population by 48 percent 
for males and 93 percent for females. 
‘‘(v) PROSTATE CANCER.—Native Ha-
waiian males have the third highest mor-
tality rate as a result of prostate cancer in
the State (21.48 out of every 100,000 resi-
dents), with Caucasian Americans having 
the highest mortality rate as a result of 
prostate cancer (23.96 out of every 
100,000 residents). 
‘‘(B) DIABETES.—With respect to diabe-
tes, in 2000—
‘‘(i) Native Hawaiians had the highest 
mortality rate as a result of diabetes 
mellitis (38.8 out of every 100,000 resi-
dents) in the State, which rate is 138 per-
cent higher than the statewide rate for all 
racial groups (16.3 out of every 100,000 
residents); and 
‘‘(ii) full-blood Hawaiians had a mor-
tality as a result of diabetes mellitis of 
93.3 out of every 100,000 residents, which 
is 518 percent higher than the rate for the 
statewide population of all other racial 
groups. 
‘‘(C) ASTHMA.—With respect to asthma—
‘‘(i) in 1990, Native Hawaiians com-
prised 44 percent of all asthma cases in 
the State for those 18 years of age and
younger, and 35 percent of all asthma 
cases reported; and 
‘‘(ii) in 1999, the Native Hawaiian 
prevalence rate for asthma was 129.6 out 
of every 1,000 residents, which was 69 per-
cent higher than the rate for all others 
combined in the State (76.7 out of every 
1,000 residents). 
‘‘(D) CIRCULATORY DISEASES.—
‘‘(i) HEART
DISEASE.—With respect 
to heart disease—
‘‘(I) the mortality rate for Native 
Hawaiians as a result of heart disease 
(372.3 out of every 100,000 residents) 
is 68 percent higher than the rate for 
the entire State (221.9 out of every 
100,000 residents); and 
‘‘(II) Native Hawaiian males 
have the greatest years of productive 
life lost in the State, because Native 
Hawaiian males lose an average of 
15.5 years and Native Hawaiian fe-
males lose an average of 8.2 years as 
a result of heart disease, as compared
with 7.5 years for all males, and 6.4 
years for all females, in the State. 
‘‘(ii) HYPERTENSION.—With respect 
to hypertension—
‘‘(I) the mortality rate for Native 
Hawaiians as a result of hypertension 
(3.5 out of every 100,000 residents) is 
84 percent higher than that for the 
entire State (1.9 out of every 100,000 
residents); 
‘‘(II) Native Hawaiians have sub-
stantially higher prevalence rates of 
hypertension than—
‘‘(aa) those observed state-
wide; and 
‘‘(bb) those of any other eth-
nic group in Hawaii; and 
‘‘(III) the prevalence rate of hy-
pertension for Native Hawaiians is 
37.9 percent, 11 percent higher than 
that for all others in the State (34.1 
percent). 
‘‘(iii) STROKE.—The mortality rate 
for Native Hawaiians as a result of stroke 
(72.0 out of every 100,000 residents) is 20
percent higher than that for the entire 
State (60 out of every 100,000 residents). 
‘‘(2) INFECTIOUS
DISEASE
AND
ILLNESS.—
With respect to infectious disease and illness—
‘‘(A) in 1998, Native Hawaiians comprised 
20 percent of all deaths resulting from infec-
tious diseases in the State for all ages; and 
‘‘(B) the incidence of acquired immune de-
ficiency syndrome for Native Hawaiians is at 
least twice as high per 100,000 residents (10.5 
percent) than that for any other non-Caucasian 
group in the State. 
‘‘(3) INJURIES.—With respect to injuries—
‘‘(A) the mortality rate for Native Hawai-
ians as a result of injuries (32.0 out of every 
100,000 residents) is 16 percent higher than 
that for the entire State (27.5 out of every 
100,000 residents); 
‘‘(B) 32 percent of all deaths of individuals 
between the ages of 18 and 24 years of age re-
sulting from injuries were Native Hawaiian; 
and 
‘‘(C) the 2 primary causes of Native Ha-
waiian deaths in that age group were motor ve-
cent higher than that for the total popu-
lation in the State; 
‘‘(iv) the chronic alcohol drinking rate 
among Native Hawaiians is 54 percent 
higher than that for all other racial groups 
in the State; 
‘‘(v) in 1991, 40 percent of Native 
Hawaiian adults surveyed reported having 
used marijuana, as compared with 30 per-
cent for all other racial groups in the 
State; and 
‘‘(vi) 9 percent of the Native Hawai-
ian adults surveyed reported that they use 
or have used marijuana within the year 
preceding the survey, as compared with 6 
percent for all other racial groups in the 
State. 
‘‘(B) CRIME.—With respect to crime—
‘‘(i) in 1998, of the 7,789 arrests that 
were made for property crimes in the 
State, arrests of Native Hawaiians com-
prised 23 percent; 
‘‘(ii) Native Hawaiians comprised 40 
percent of juvenile arrests in 1998, the