Introduction and Background


While there is ongoing deliberation as to when the first Native Hawaiians arrived to the shores of the Hawaiian Islands, as well as, the number of Native Hawaiians on the islands at the time of European contact, it is known that the Native Hawaiian people have endured numerous devastating hardships and catastrophic events that have shaped and reshaped Native Hawaiian society and culture. Much has changed over the past two centuries since western culture placed its mark on Hawai‘i and its native people.

Today, Native Hawaiians are perhaps the single racial group with the highest health risk in the State of Hawai‘i. This risk stems from high economic and cultural stress, lifestyle and risk behaviors, and late or lack of access to health care. Accordingly, it is not surprising to find among Native Hawaiians a high incidence of diseases and ailments, early disability, and premature death.

An overall strategy to improve the well-being of Native Hawaiians should focus on two key elements: 1) a systematic identification of health risk factors early in their lives and 2) timely, appropriate and readily accessible health care. Health statistics perform a vital role in this strategy by 1) identifying high-risk segments of the Native Hawaiian population, 2) ascertaining underlying relationships between risk factors and diseases, 3) identifying barriers precluding access to health care, and 4) assessing the adequacy of available health care services.


This report seeks to review a few of the health statistics of Hawai‘i’s native people to identify health status and issues. The report is structured on the “life course model” approach, which provides a deep and layered understanding of how health develops over a lifetime and across generations by combining a focus on health parity and social determinants with an understanding of how they interact. The five sections include:

  1. Infants (hānau)
  2. Children (keiki)
  3. Adolescents (‘ōpio)
  4. Adults (mākua)
  5. Elders (kūpuna)

Through this approach, one can acquire an understanding of how health issues progress from one generation to the next, health issues within each peer group, and address these issues before they progress to the next cohort.