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UH Report: Hawaiian Culture is Just What the Doctor Ordered

Deborah Dimaya
UH Medical School
The traditional cultural practice of hula was used in a five-year study to measure the effectiveness of the practice in reducing hypertension among Native Hawaiians.

A new report by the University of Hawai?i medical school found structural inequities and historical events are partly to blame for continued health disparities among Native Hawaiians. The solution, according to researchers, requires not only systemic change but health interventions rooted in Native Hawaiian culture.

Health inequity for Native Hawaiians began with infectious disease epidemics, intensified with the overthrow of the Hawaiian Kingdom, and persisted through the loss of land and suppression of cultural practices.

That’s according to a report released by the U-H John A. Burns School of Medicine (JABSOM) Keawe?aimoku Kaholokula heads the school’s Native Hawaiian Health Department.

“I think we often focus on the biological and lifestyle issues but neglect the fact that a lot of the structural racism and health inequities that we experience actually stem from this historical past,” says Kaholokula, “So we highlighted that.”

Data in the study also found Native Hawaiians are three-times more likely than other ethnic populations to experience coronary heart disease, stroke, cancer and diabetes. This parallels the first edition of this report released in 2013. Mele Look, the report’s lead author, heads community engagement at the JABSOM Department of Native Hawaiian Health.

“We are beyond looking at the problem but identifying real and sustaining solutions,” says Look, “And it needed a cadre of scientists and providers who are both grounded in their culture as well as grounded in medical and scientific knowledge to create programs that have the best of both.”

Look herself a hula practitioner teamed up with her Kumu Hula Mapuana De Silva of H?lau M?hala ??lima and Kaholokula in creating a six-month hula program highligted in the report that reduced hypertension and lowered the risk of heart disease among Native Hawaiians.

“That’s perhaps the first time a cultural practice has been leveraged for health promotion and tested scientifically,” says Kaholokula.

The report features several other culturally-based health interventions as well as a roadmap for achieving health equity for Native Hawaiians.

The framework developed by Kaholokula is called N? Pou Kihi, meaning “the corner posts” in Hawaiian, and it identifies what needs to be in place or what needs to be strengthened to improve Hawaiian health. This includes social justice, a healthy diet, environmental stewardship, and an indigenous cultural space.

“We can use our cultural practices for health promotion effectively,” says Kaholokula, “In fact, probably do a much better job at it if we do things in a way that is consistent with the values and preferred lifestyle of the people we want to impact in a positive way.”

Assessment & Priorities for the Health and Well-Being in Native Hawaiians and Pacific Islanders by HPR News on Scribd

Kuʻuwehi Hiraishi is a general assignment reporter at Hawaiʻi Public Radio. Her commitment to her Native Hawaiian community and her fluency in ʻōlelo Hawaiʻi has led her to build a de facto ʻōiwi beat at the news station. Send your story ideas to her at
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