In Utah, where the per-capita share of Pacific Islanders is the highest in the continental U.S., they have the highest incidence of stroke, the lowest rate of prenatal care and the highest prevalence of diabetes (twice that of the state average).
These figures are why Jake Fitisemanu, an outreach coordinator for the Office of Health Disparities at the state health department, started Pacific Islander Health Week four years ago.
"The statistics are terrible, but that's how the statistics change," said Fitisemanu. "I'm a Type II diabetic. I look at my kids, I need to be walking that walk. … We have to go one person by one person."
At the Monday health expo, the Pacific Islander community kicked off the week with determination and a lot of Zumba, munching on bagels and carrots and getting BMI, blood pressure and bone density screenings.
It's all too common, said Fahina Pasi, to see obesity and other health problems among Pacific Islander adults and youth. Pasi, who is Tongan, serves as the executive director of the National Tongan American Society.
"If you look at our dialysis places, a lot of our folks end up in dialysis," Pasi said. "Every Pacific Islander probably has a family member or two or three or four with diabetes."
She said problems such as poverty and unemployment add to health issues, especially when combined with language and cultural barriers.
Ivoni Malohifo'ou-Nash, who was diagnosed with diabetes years ago, along with her three siblings, said she took it upon herself to learn how to take care of her condition, reading a Tongan book on diabetes and going to a diabetes center to get tips.
"I'm Pacific Islander, but I'm trying to be a vegetarian," Malohifo'ou-Nash said, adding that she already gave up soda. "But it's hard!"
She now runs a diabetes support group for Pacific Islanders, which is conducted in Tongan. In a culture that loves to eat, she said, many people know they are diabetic but struggle to change their diet or exercise habits. They also face language barriers with their doctors and health care providers and often don't fully understand their condition, Malohifo'ou-Nash said.
"They don't know what the low is and what the high is," she said. "To a Pacific Islander, 300, 400 blood glucose is normal."
Even in her own family it can be a battle. Malohifo'ou-Nash said one of her sisters still struggles to change her diet and exercise habits and may very well be headed toward dialysis.
The Pacific Islander community in Utah — made up of Tongans, Samoans, native Hawaiians and more — is becoming increasingly tight-knit over these issues, said Charles Ah You, the president of the Queen Center, a Pacific Islander community health organization.
"It wasn't like this before, way back," Ah You said. "Now, the community is all one."
From early morning fitness classes to mental health panels, Pacific Islander Health Week events are taking place in Salt Lake City, St. George and Spanish Fork. Among the additions to this year's event are several new activities in Provo and a panel for Pacific Islander veterans.
The week will culminate with a walk from 100 South to the Capitol building in honor of World Diabetes Day.
When he thinks about the numbers, Fitisemanu said, it's hard not to get discouraged. Then he remembers the history and culture he was taught as a kid with mixed Samoan, Chinese and Korean heritage growing up in Hawaii and Utah.
"To exist on these remote, tiny islands and not to survive but to thrive, to build these beautiful cultures and the sailing technology and explore the world's largest ocean before Christopher Columbus was even born — this is amazing, amazing ancestry we have," Fitisemanu said. "And that was done because people were fit, mentally strong, and physically strong."
"Our people were always that way before," he added. "Thanks to sedentary lifestyles and Westernization and industrialization, we've changed, but that's still our history. That's still in us."