Both hypertension and diabetes are multifactorial] disekse complexes,
being dependent on a mixture of heredity, diet, obesity, exerdise, etc.
The
primary factors responsible in the Marshalls have not been ascartained.
the exact incidence of each disease is unknown.
Even
An adequate unflerstanding of
the epidemiology of these problems and causative factors in thlis environment
will
be
an
important
initial
step
in developing
adequate [detection
and
treatment programs.
E.
Social Problems
With
traditional
folk
ways
and
family
relationshipB
undergoing
dramatic change over the years, kinship lines and responsibilities have been
fragmented for most Marshallese families.
The underlying supp
t system for
all family members has been disintegrating over time and the y@uth, as well
as the elders, have become disenchanted and alienated.
Tha
Marshallese
perceive the increasing use of alcohol as one of the most serfous problems
in the Islands and
identify it as the contributing factof
in further
fragmentation of kinship ties and in other destructive sodial
Arrests for alcoholism (adolescents and adults) have tripled
changes.
Jn the past 3
years for adolescents (Wally Wotring, Director of Public Safdty) and have
already doubled for adults in 1980 (January through Septembar).
Drunken
behavior has also been involved in the increase of car accidegts on Majuro
and the alarming upward trend of suicide throughout the Marghall Islands
(suicide rates for adolescents are considered by some local réspondents to
be twice the rate found in the United States).
Other distressing social problems affecting coping abilfties and the
mental health of the local people include dislocation and redigtribution of
people, increase in crime rates (especially forgery, burglary
and assault
and battery), increased prostitution, use of drugs, intrafam#ly violence,
divorce,
loss
boundaries,
of
understanding
and
neglect of parenting and
communication
parenting
across
skills,
[generational
laqgk
of
family
planning and enhancement of family life; increase in juvenile|delinquency,
homosexual relationships, and lack of employment opportunitieq
for al? age
groups (adolescence through the aged).
Additional mental health problems are evident in the form
of apathy,
alienation, depression, stress syndromes, confusion and amb@valence,
motivation
drives,
self-identity
crises,
role
dysfuncti
and
low
role
identification crises (adolescents and adults), and fear of tMe future and
the unknown (economics, health and basic survival).
14