~~ 4
Both hypertension and diabetes are multifactorial disease complexes,
being dependent on a mixture of heredity, diet, obesity, exercise, etc.
The
primary factors responsible in the Marshalls have not been ascertained.
Even
the exact incidence of each disease is unknown.
An adequate understanding of
the epidemiology of these problems and causative factors in this environment
will
be
an
important
initial
step
in
developing
adequate detection
and
treatment programs.
E.
Social Problems
With
traditional
folk
ways
and
family
relationships
undergoing
dramatic change over the years, kinship lines and responsibilities have been
fragmented for most Marshallese families.
The underlying support system for
all family members has been disintegrating over time and the youth, as well
as the elders, have become disenchanted and alienated.
The Marshallese
perceive the increasing use of alcohol as one of the most serious problems
in
the
Islands
and
identify
fragmentation of kinship ties
it
as
the contributing factor
in further
and in other destructive social
changes.
Arrests for alcoholism (adolescents and adults) have tripled in the past 3
years for adolescents (Wally Wotring, Director of Public Safety) and have
already doubled for adults in 1980 (January through September).
Drunken
behavior has also been involved in the increase of car accidents on Majuro
and the alarming upward trend of suicide throughout the Marshall Islands
(suicide rates for adolescents are considered by some local respondents to
be twice the rate found in the United States).
Other distressing social problems affecting coping abilities and the
mental health of the local people include dislocation and redistribution of
people, increase in crime rates (especially forgery, burglary and assault
and battery), increased prostitution, use of drugs, intrafamily violence,
divorce,
loss
boundaries,
of
understanding
and
neglect of parenting and
communication
parenting
across
skills,
generational
lack
of
family
planning and enhancement of family life; increase in juvenile delinquency,
homosexual relationships, and lack of employment opportunities for all age
groups (adolescence through the aged).
Additional mental health problems are evident in the form of apathy,
alienation, depression, stress syndromes, confusion and ambivalence,
motivation
drives,
self-identity
crises,
role
dysfunction
and
low
role
identification crises (adolescents and adults), and fear of the future and
the unknown (economics, health and basic survival).
14