Hawaii typically ranks among the top states when it comes to the health of its residents, but its indigenous population suffers disproportionately from diabetes, cardiovascular disease, obesity and high incarceration rates.
The reasons are complicated, but they are centered on social and cultural factors like lack of access to education and good jobs, and the need for safer communities and health practices that are relevant to Hawaiians.
Those concerns were underscored at a briefing Tuesday at the state Capitol that shared the findings and recommendations of the Native Hawaiian Health Task Force established two years ago at the request of the Legislature.
Keawe‘aimoku Kaholokula, co-chair of a task force on Native Hawaiian health, said there is a crisis that demands immediate attention. At right are Sheri Daniels of Papa Ola Lokahi and Diane Paloma of the Native Hawaiian Health Program, Queen’s Heath Care Systems, who also spoke Tuesday.
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Keawe‘aimoku Kaholokula, a task force co-chair, called the challenges facing Hawaiians “a public health crisis that desperately needs our attention.”
He and others outlined a number of policy recommendations.
They include establishing an online database across state agencies to track Hawaiian health, pushing for median strips and sidewalks in Native Hawaiian neighborhoods, and backing paid family leave that is “culturally relevant” to multigenerational households.
Members of three state Senate committees congratulated the task force on its hard work. But they were not satisfied with its recommendations.
Senate Majority Leader J. Kalani English, a Native Hawaiian, took Kaholokula and others to task for not offering specific details for new legislation. It is something the Senate called for when it authored the resolution creating the task force.
Kaholokula, who works at the Department of Native Hawaiian Health at the University of Hawaii’s John A. Burns School of Medicine, responded that the task force was “a first step” and that it was “too soon” for it to call for specific legislation.
Kamana’opono Crabbe, CEO of the Office of Hawaiian Affairs and the other task force co-chair, agreed, saying the task force felt its work to this point was “preliminary.”
He described the report as a “framework” to build on, one that would be updated with additional task force meetings and aided especially through the creation of a Native Hawaiian Public Policy Advisory Council. It’s one of the task force’s 16 recommendations.
But English still wasn’t hearing what he wanted.
Dr. Noa Emmett Aluli of Molokai General Hospital and a task force member, reminded lawmakers of the need to “close the gap” in health disparities.
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Admitting that he may sound “heavy-handed,” he pointed out that the Legislature is busy crafting bills in advance of a Friday deadline for nonadministrative legislation.
English also pointed out that a report on the dire status of Native Hawaiian health is nothing new.
Indeed, Crabbe himself called attention to a 1985 Native Hawaiian Health Needs Study Group that highlighted health disparities. And Noa Emmett Aluli, a doctor at Molokai General Hospital and a member of a hui of Hawaiian physicians called Ahahui o Nā Kauka, said the health problems existed when he started medical school in the 1970s.
While again complimenting the task force on its “great work,” English’s main point was that the Legislature needs to move quickly on translating recommendations to help Hawaiians into actionable legislation.
It was a point echoed by Sen. Brickwood Galuteria, a Hawaiian who described what he called a “disconnect” between what the task force wants and what the Legislature must do. The time to act, Galuteria said, was now, and he offered up his own staff to help write legislation.
The task force is calling for some policy changes that are already in the works at the Legislature, including an increase in the minimum wage. A “livable” wage of $15 an hour is sought, as compared to the $10.10 that is set to go into effect next January.
State senators praised the task force’s work but expressed concern that it had not developed more concrete legislative proposals to help Hawaiians.
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The task force may also be helped by the fact that the Senate has as one of its four main priorities this session ola lehulehu — helping people and communities. English said that the Senate’s thematic approach, one launched three years ago, could lead to legislative priorities from the task force that comport with plans to support health care for Hawaiians and Pacific Islanders already agreed on in his chamber.
There is also a concern about how to fund the task force’s work, something raised by Sen. Roz Baker. OHA and the medical school have funded the work thus far, but with a new presidential administration and uncertainty about the Affordable Care Act, there are worries of losing federal funding.
As Baker explained, the Legislature will receive requests for money from a variety of sources. Crabbe said that helping improve the health of Hawaiians is one of OHA’s six priorities, and it would fund what it could.
Kaholokula reminded lawmakers that Hawaiians represent 25 percent of the state’s population and the Hawaiian population may double by 2050. The responsibility for helping Hawaiians “is a responsibility for all of us,” he said, because lifting Hawaiians is in everyone’s best interest.
The briefing was coordinated in part by Big Island Sen. Kai Kahele, whose late father, Sen. Gil Kahele, requested the task force report.