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CONTACT  Kim Ku'ulei Birnie

MOBILE      808-383-1651





(Kaka‘ako, O‘ahu, Hawai‘i) – [PDF] Papa Ola Lōkahi announced today that $20 million American Rescue Plan funding for the federal Native Hawaiian Health Program will strengthen vaccination efforts, mitigate and respond to the spread of COVID-19, and enhance health care services throughout communities on all islands.

“This funding will relieve the additional burdens placed on systems of care since the pandemic, and be further invested in our communities to strengthen the infrastructure and extend the reach to areas of greatest need,” explained Sheri-Ann Daniels, executive director of Papa Ola Lōkahi. “Like the makawai, which funnels water from the waterway to the lo‘i, resources will be directed into community organizations that enrich the capacity of our workforce and service delivery. What is developed among our partner organizations can sustain the communities they serve long after the initial two-year investment.”

This federal relief funding is intended to serve the health and well-being needs of Native Hawaiians in Hawai‘i over the next 2 years to address the inequities revealed so clearly throughout the COVID-19 pandemic.  The Native Hawaiian Health Care Systems across the state along with community based organizations will increase vaccine capacity, improve COVID-19 response and treatment capacity, increase capacity to sustain accessible and available health care services, and deliver education and services during the ongoing recovery and stabilization of phases.

Papa Ola Lōkahi works toward raising the health status of Native Hawaiians through public health policy, enhancing service delivery capacity, data & information collection and dissemination, and strengthening infrastructure. It has served as the backbone organization for the Native Hawaiian & Pacific Islander Hawai‘i COVID-19 Response, Recovery & Resilience Team (NHPI 3R) since May 2020.

These five Native Hawaiian Health Care Systems will be able to reinforce their primary, dental and mental health services, health education and healthy lifestyle workshops, community outreach and enabling services:

Additionally, Papa Ola Lōkahi is finalizing partnerships with fourteen (14) community-based organizations across five Hawaiian islands to enhance each’s capacity to deliver their unique responses to the COVID-19 pandemic. These include providers of behavioral and mental health services, kupuna care, pregnancy and maternal care, workforce development, broadband access and telehealth, vaccination outreach and delivery, primary care, health education and outreach.

“Papa Ola Lōkahi is uniquely poised to administer American Rescue Plan funds to provide relief and support related to COVID-19,” assured Daniels. “Mahalo nui to Senator Brian Schatz and all who have worked to assure Native Hawaiian communities are equitably included and represented at all levels of decision-making and resource allocation. We are grateful.”



Papa Ola Lōkahi, the Native Hawaiian Health Care Systems and the Native Hawaiian Health Scholarship Program

comprise the Federal Native Hawaiian Health Program

Improving Hawaiian Health and Well-Being for More Than 30 Years

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Kahele and POL haumana 2021 07Policy Assistant Christina Young shares her reflections of her visit to Washington, DC in July.

This trip with Papa Ola Lōkahi was my first visit to Washington D.C. Our main focus was to honor the 100th anniversary of the signing of the Hawaiian Homes Commission Act by Prince Jonah Kūhiō Kalaniana‘ole when he was in Congress.

On Friday, July 9, the actual 100th anniversary, a series of events included office blessings for Congressmen Kai Kahele and Ed Case, paying our respects to the pohaku at the National Museum of the American Indian, and presenting lei and oli to the Father Damien and King Kamehameha statues in the U.S Capitol. To close that special day, we gathered at the Library of Congress where we able to review different historical documents related to Hawai‘i. The highlight was meeting Secretary of Interior Deb Haaland, the first Native American cabinet member.


POL staff at National Archives 2021 0712

In addition to the anniversary events, we attended different Smithsonian National Museums such as the Museum of Natural History, the African American History and Culture, National Archives, the Holocaust Memorial Museum, and the D.C. History Center. My supervisor, Sarah and I also met with the Director of Policy and Advocacy at the Association of Asian Pacific Community Health Organizations (AAPCHO).

This trip was a great experience to connect with my POL colleagues and other Hawaiian organization members, to learn more about U.S and Hawaiian history, as well as explore and learn more about DC.

~ Christina Young


 Photo above right:  Congressmember Kaiali‘i Kahele flanked by POL staff Archive Assistant Kahikinaokalā Domingo. Policy Assistant Christina Young, Policy Coordinator Sarah Kamakawiwo‘ole and Archive Assistant Saige Leikuluwaimaka Meleiseā.

Photo above left:  Christina, Leikuluwaimaka, Ha‘aipo, Kalā, Kim, Sarah & Pualani on the steps of the National Archives. Photo by Ho‘oleia.

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Ai Pono Banner 9.58.25 AM

Holoiʻa ka papa, kau ʻia e ka manu. Where there is food, people gather.   

Food is central in every culture, fostering traditions and a sense of community, while also providing us with the nutrients we need to live. In ‘Ai Pono, we will explore the interconnectedness of Native Hawaiian food systems and access, nutrition, and sustainability. Through this series, we will attempt to draw connections between traditional Native Hawaiian food and health/well-being.


There are multiple considerations that go into why we make the food choices we do. While someare based off our preferences, much of what goes into the food choices we makedependon factors that are out of our control.

Kaui Baumhofer

An Assistant Professor of Indigenous Health Sciences at the University of Hawaiʻi West OʻahuKauʻiBaumhofer Merritt spoke about the biggest factors influencing our food choices.

She teaches it within the social ecological model illustrated by multiple layers asto why we eat the way we do. There are individual reasons like personal preferences and ʻohana reasons– eating the food your family and the people you live with like, but there are also larger reasons like physical environments – what grocery stores they live by, if they live by a farmers’ market, or if they have a car. There are also larger social cultural reasons why people eat the way they do.

The United Nations defines food security as when people have physical, social, and economic access to foods that are safe, nutritious, and that meet their dietary needs.¹ Achieving food security can be especially difficult for geographically isolated areas like the Hawaiian Islands, which heavily rely on imported foods. A 2020 study found that 27% of Native Hawaiians living in Hawaiʻi were food insecure.² 

In 2018, some of the biggest barriers people in Hawaiʻi experienced in achieving food access were: housing – being houseless or without the means to store or prepare food; a lack of transportation to access food or difficulty transporting groceries; difficulty finding time to shop for groceries amid busy schedules; not having the skills to prepare food; and being socially isolated.³

“For Native Hawaiians, the main barriers are, what's their physical environment, what's physically available to them, whether they have access issues, whether they have a car, issues of affordability, whether they can afford to get the kind of food that they want, and also time – working two to three jobs or having to commute long distances on the bus, and then having to sit down and cook a full meal,” Merritt said.

Merritt said the biggest barriers for Native Hawaiians are centered around three factors – affordability, accessibility, and acceptability.

Affordability is whether people can afford to get the kind of food that they want. Accessibility is the issue of if people have a car to get to restaurants and grocery stores, but also having the time to prepare that food, she said.

“The other issue is acceptability, … because the first two issues can be applied to really any low socioeconomic group. The last one speaks to more cultural ethnic minorities.Do the stores that you live by have the foods that are acceptable to you that you want to eat?” Merritt said.

As a result of these barriers, many may rely on fast food restaurants for their meals. In 2007, a study found that 56.5% of Native Hawaiian participants ate at a fast food restaurant at least once a week.⁴

“There's a big difference between, you choose to go to Starbucks as a treat once in a while … (and) having to eat at Wendy's or L&L every day, because that's what they can afford and that's what they have time to do.”

A study named Hawaiʻi the “Fast Food Capital of America,” estimating the state has 97.5 fast food restaurants per 100,000 people. For comparison, Alaska had the least amount of fast food restaurants per 100,000 people at 61.9.

In the state of Hawaiʻi, there are 64 7-11 locations,⁶ 74 McDonalds locations, and around 85 Starbucks locations.

Hawaiʻi is the fast food capital of the country. But if you look at places where Native Hawaiians are concentrated, that's even stronger. Those of us in those areas will say that Waiʻanae is the fast food capital of Oʻahu.And so if Hawaiʻi is the fast food capital of the nation and Waianae is the fast food capital of Oʻahu, that means Waianae is probably the fast food capital of the nation,” Merritt said. “The higher the concentration of Native Hawaiians in that population, in that community, the higher the density of fast food outlets, and the lower the density of full-service restaurants and full-service grocery stores.”

This is especially notable considering the high rates of chronic health conditions that Native Hawaiians face.  

In an editorialshe wrote for Honolulu Civil Beat, Merritt brought up the term dietary genocide, which she came across in an article by Rodney Jackson. The idea of dietary genocide refers to how the foods that people eat and have access to can contribute to negative health outcomes, such as the ones that disproportionately impact Native Hawaiians and Pacific Islanders.

“The Western diet is really wiping out Native Hawaiians, Pacific Islanders, and, to a larger extent, other indigenous peoples across the world. … Mainly because of dietary issues and the chronic illnesses related to those dietary issues. … That's the kind of basis of that whole dietary genocide. We're not being killed by infectious diseases like we were ... 150, or 200, or 400 years ago. But we're still dying at just incredibly high rates due to dietary-related diseases.”

Native Hawaiians have the second-highest prevalence of obesity among other race/ethnicity groups in Hawaiʻi at 43%, according to a study done from 2015-2017.¹⁰In 2014, around 12.8% of Native Hawaiians in Hawaiʻi were estimated to have diabetes, compared to 5% of white residents.¹¹

Policy can be another big barrier to achieving food security and access.

“How zoning impacts ... our physical environment, in our neighborhoods, and then if you go even beyond that, there are really big historical factors. And for Native Hawaiians, that goes back to colonization and the … Māhele,” Merritt said.

In 2011, the legislature enacted Senate Bill 101, which allowed producers to sell hand-pounded poi, not requiring that they process poi in a certified food-processing establishment²

“Up until maybe, I think like 10 years ago or 12 years ago, it was illegal to sell hand-pounded poi in a retail setting. The only way to get hand-pounded poi was if you knew someone who pounded for you, and that was not super common. You couldn't even sell it at a farmers market, and it had to do with food safety,” she said. “That's an example of institutional racism. Here's this really nutritional super awesome food, this cultural food, that was illegal for us to sell and make money off of and made it very difficult to get.”

Merritt said there are multiple ways that people can take action and interact with their policymakers. People can go to their neighborhood board meetings or run for neighborhood board.Onopening day at the legislature – which is usually in mid-January – the public see any legislator in charge, introduce themselves, and tell them what they’re interested in. People can also submit online testimony, pick up a phone and call legislators, and even go to testify in person.

“Other ways that you can support Hawai‘i agriculture and food security and food policy if you don't want to interface with the system either in getting involved in the neighborhood board or actually talking to your legislators is just to vote with your dollars. That's probably one of the most immediate and powerful ways that we can support ‘ai pono and local food is voting with your dollars.

 ~ Na Maris Tasaka, Communications Assistant


KauʻiBaumhofer Merritt was born and raised in the ahupuaʻa of ʻAiea. She is an Assistant Professor of Indigenous Health Sciences at the University of Hawaiʻi West Oʻahu. She received her doctorate of science in society, human development, and health from Harvard University, her MPH in health behavior and health education from the University of Michigan Ann Arbor, her master's in Pacific Islands studies from University of Hawaiʻi at Mānoa and her BA in ethnic studies from Mills College. Her research focuses on public health to reduce Native Hawaiian health disparities as they relate to social justice. 

Further Readings/Media



  1. “Water and Food Security.” United Nations, www.un.org/waterforlifedecade/food_security.shtml#:~:text=What%20is%20food%20security%3F,a%20productive%20and%20healthy%20life
  2. Stuplebeen, David A, et al. University of Hawaiʻi Office of Public Health Studies, 2020, pp. 1–22, Food Insecurity in Hawaiʻi Using a Population-Based Sample: A Data Brief.  
  3. “The Fast Food Capitals of America.” NiceRxwww.nicerx.com/fast-food-capitals/.   
  4. Ahedo, A. M., T. W. Lee, J. Pan, K. M. Heinrich, S. Keller, and J. Maddock. “Factors Affecting the Consumption of Away-from-Home Foods in Hawai`i Residents”. Californian Journal of Health Promotion, Vol. 5, no. 2, June 2007, pp. 1-12, doi:10.32398/cjhp.v5i2.1227.
  5. “The Fast Food Capitals of America.” NiceRx, www.nicerx.com/fast-food-capitals/.    
  6. “Locations.” Seven-Eleven Hawaiʻi, 2020, 7elevenhawaii.com/locations/.
  7. Hill, Tiffany. “Talk Story: Brad Miles of McDonald’s Restaurants of Hawaii.” Hawaii Business Magazine, 11 Jan. 2019, www.hawaiibusiness.com/talk-story-brad-miles/
  8. “Starbucks Store Locator.” Starbucks. https://www.starbucks.com/store-locator?map=39.635307,-101.337891,5z.
  9. Baumhofer, N. Kaui. “Hawaii's Moment Of Critical Consciousness Raising.” Honolulu Civil Beat, 18 June 2020, www.civilbeat.org/2020/06/hawaiis-moment-of-critical-consciousness-raising/.
  10. Look, M.A., Soong S., Kaholokula, J.K. (2020). Assessment and Priorities for Health and Well-Being in Native Hawaiians and Pacific Islanders. Honolulu, HI. Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i.https://www2.jabsom.hawaii.edu/native/docs/community/APNHPP/2020_NHOPI_Assessment_and_Priority_Rpt.pdf.
  11. Uchima, Olivia et al. “Disparities in Diabetes Prevalence Among Native Hawaiians/Other Pacific Islanders and Asians in Hawai'i.” Preventing chronic disease vol. 16 E22. 21 Feb. 2019, doi:10.5888/pcd16.180187.
  12. 2011. https://www.capitol.hawaii.gov/session2011/bills/SB101_CD1_.htm.
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Ola HAWAII - This webinar series features emerging research in Hawaiian Health and Well-Being.  This is a partnership among Ola HAWAII, Papa Ola Lōkahi, ‘Ahahui o nā Kauka and others interested in Hawaiian health research.


Ola HAWAII is a specialized center at the University of Hawaii John A. Burns School of Medicine that supports multidisciplinary teams of investigators and community collaborators in basic biomedical, behavioral and clinical research on the causes of health disparities and effective solutions to reduce those disparities among the underserved, multiethic populations of Hawai'i.  

Ola HAWAII is funded by the National Institute on Minority Health and Health Disparities.

More information can be found here.



Ola HAWAII Webinar Series 2 


Keiki Produce Prescription:  Wai'anae Coast Comprehensive Health Center "Makeke Pharmacy" for Food Insecurity and Health Disparity Reduction

These researchers feature their findings and recommendations from their most recent research that impacts  Hawaiian well-being.

June 22, 2021, 1:00 PM









HGenome 4 Webinar 002 thumbnail



"State of the Field" What genetics/genomics looks like for Hawai'i, spotlighting cardiovascular genetics


June 12, 2021, 1:00 PM HST







Ola HAWAII Webinar Series 2 Mini




MALAMA:  Rebuilding Indigenous Food Systems in Rural Native Hawaiian Communities through Backyard Aquaponics


June 1, 2021


Facebook recording







Ola Hawaii 2021 0511 



Two Reports Back to the Community

Exploring Diet Diversity of Native Hawaiian Infants

Ke Ola o ka ‘Āina:  The Role of ‘Āina Connectedness in Health


May 11, 2021


Facebook recording






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Ai Pono Banner 9.58.25 AM

Holo iʻa ka papa, kau ʻia e ka manu. Where there is food, people gather.   

Food is central in every culture, fostering traditions and a sense of community, while also providing us with the nutrients we need to live. In ‘Ai Pono, we will explore the interconnectedness of Native Hawaiian food systems and access, nutrition, and sustainability. Through this series, we will attempt to draw connections between traditional Native Hawaiian food and health/well-being.


Now more than ever, plant-based eating seems to be growing in popularity. 

Jodi Matsuo

More and more people are Googling “plant-based” and the topics related to it. In 2020, plant-based food sales increased by 27%, and more than half of all U.S. households had purchased plant-based foods at some point.¹

The traditional Native Hawaiian diet was largely plant-based. Dr. Kekuni Blaisdell found that the diet consisted of around 78% carbohydrates, 12% protein, and 10% fat, with poi, ʻuala,ʻulu, green leafy vegetables, and seaweed making up most of the carbohydrates

"For Hawaiians, and I guess for a lot of local cultures in general, they think that eating meat was part of the culture.Some people think pork laulau and kalua pig was part of it, and it wasnt. It was a plant-based culture," said registered dietitian and certified diabetes educator Dr. Jodi Leslie Matuso.

Matsuo, who was also a graduate of the Native Hawaiian Health Scholarship Program, talked about eating plant-based and how it is beneficial for both personal health and the health of the environment. 

"You dont have to be vegan to be plant-based. You can allow for the inclusion of fish and some other foods at least part of the time, as long as the majority of your diet is – I usually tell patients 80% to 85% of your diet is plants – then that other 10% to 15% you can use for special occasions – for birthdays, for when you're socializing with friends, or at a party, or eating out, then you can allow some flexibility for that," she said.

Dr. Claire Kuʻuleilani Hughesresearch found that there were also several benefits to the traditional Native Hawaiian plant-based diet. She found that consuming soy products, fiber, fruits, and vegetables daily, along with reducing the consumption of eggs, whole milk, and red and processed meats, was associated with reducing the risk of cancer.²

 "A lot of studies have shown is that a plant-based diet has been helpful in reducing risk of early death, reducing risk of getting heart disease, of cancer, diabetes and a number of other diseases. A plant-based diet has even shown to be helpful in reversing some diseases that people thought were irreversible like MS, lupus, rheumatoid arthritis," Matsuo said.

On top of that, many traditional Native Hawaiian foods were also highly nutritious.

"Taro leaves are really huge. ... If were talking about Hawaiian diet, seaweed was a big source of a lot of different nutrients. Even in the root vegetables itself, like the sweet potato, and the taro root, and the breadfruit, there were a lot of nutrients in there," Matsuo said.

For those looking to begin transitioning into eating plant-based, Matsuo said a good way to start is by using plant-based meats.

"There was a study that was done that compared someone who ate plant-based, veggie meats to people who had eaten regular meat and they actually found that people who had the veggie meats had better health outcomes at the end of the study than the ones who stuck with the chicken and the beef," she said.

In fact, researchers at Stanford Medicine found that switching out red meat for plant-based meats helped lower some risk factors for cardiovascular disease.

While people may choosing to eat plant-based for their health, many also elect to go plant-based for the health of our ʻaina.

"Eating plant-based ... is one of the biggest things that you can do in terms of helping to make an impact on climate change," Matsuo said. "In terms of, say, animal ethics, a plant-based diet is a way to go. … In terms of climate – being good for the environment, good for the planet – its also the way to go. Because it's low of what you call carbon footprint, that it makes a low environmental impact. 

A carbon footprint is the total greenhouse gases that get emitted as a result of a certain activity.

Farms dedicated to raising livestock account for 1/3 of the world’s total land and more than 2/3 of agricultural land. On top of this, around 40% of crops grown globally are used to feed livestock. Scientists estimate that anywhere from 18% to 51% of global greenhouse gas emissions are caused by the livestock industry. Livestock production is also the leading agricultural cause of water pollution.³The Intergovernmental Panel on Climate Change estimated that a global shift toward eating plant-based could help reduce greenhouse emissions bygigatonsannually, which is more greenhouse emissions than the U.S. emits annually. 

"I think plant-based diet can be considered a type of sustainable eating. Theres a lot less environmental impact on the planetfrom growing crops, growing vegetables, versus raising livestock for food," Matsuo said. "Sustainable eating to me, in a nutshell, is eating foods that are good for you and good for the planet. Its beneficial both ways."

At the Kukui Lifestyle Medicine clinic, which Matsuo and her husband Dr. Leon Matsuo founded, she runs a nine-week program called the Pono Program, in which she offers cooking demonstrations and health education. Through her classes, Matsuo shows that eating plant-based does not have to be restrictive. 

When selecting recipes for the program, there are several factors she takes into consideration. 

"It had to be simple, it had to be liked by local people. So it has to suit local people's tastes, and, of course, it had to be healthy and plant-based. So, with that in mind, I would choose simple recipes," she said. "Ingredients-wise, because it can be expensive, ... it has to be affordable as well."

Matsuo said she has three tips for those looking to eat plant-based. The first is tothink of what people can add to theidiet – the ways they can add more fruits and vegetables.

"I think just start by thinking about what foods you can add to your diet. People think that when you hear the word diet, you think of being so limited and taking away from what you normally eat, but maybe looking at it from the opposite way and saying, 'What can I add to my diet to become more plant-based?'"

Her second tip is to gradually build up to including more fruits and vegetables so that 50% of your meal is fruits and vegetables. This could be in the form of a stir fry or something distinct like having a vegetable soup or salad.

Her last tip is to take recipes people already use and substitute the meat with either tofu, beans, or more vegetables. 

"You can use the same spices, you can use the same flavorings, but just switch out the meat for tofu, or for beans, or just more vegetables. So, start off with dishes that are easy," she said. "If there's familiar dishes, then they’re probably more likely tstick to it," she said. "Ill make a veggie luʻau, like how they have chicken luʻau or squid. ... For the meat replacement, Ill use either veggie chicken, or taro, or sweet potato. Sometimes I do like a tofu poke, instead of regular poke."

Despite getting comments about people never having seen a Hawaiian vegetarian before, she said plant-based eating is part of the Native Hawaiian culture. 

"Its not going against your cultural norm to go plant-based; its actually going back. Itactually what would be the opposite, in a sense. Youre actually reverting back to your cultural ways by going plant-based."

Na Maris Tasaka, Communications Assistant


Dr. Jodi Leslie Matsuo was born and raised in Kona. She graduated from Konawaena High School and attended the University of Hawaiʻi at Mānoa where she received a masters and a doctorate in public health. She is a registered dietitian and certified diabetes educator, with training in integrative and functional nutrition, and alumna of the Native Hawaiian Health Scholarship Program. Along with her husband, Dr. Leon Matsuo, she founded and runs the Kukui Lifestyle Medicine clinic in Kailua-Kona. She also writes the Mālama I Kou Kino column for Ka Wai Ola.


Further Readings/Media



  1. Orlando, Brian. “Retail Sales Data.” Plant Based Foods Association, 7 Apr. 2021, www.plantbasedfoods.org/retail-sales-data/
  2. Hughes, Claire  Ku'uleilani. “Culturally Appropriate Health Intervention Programs for Native Hawaiians.” Asian American and Pacific Islander Journal of Health, vol. 6, no. 2, 1998, pp. 174–179.
  3. Dopelt, Keren et al. “Environmental Effects of the Livestock Industry: The Relationship between Knowledge, Attitudes, and Behavior among Students in Israel.” International journal of environmental research and public health vol. 16,8 1359. 16 Apr. 2019, doi:10.3390/ijerph16081359.
  4. Worland, Justin. “If We Want to Stop Climate Change, Now Is a Moment of Reckoning for How We Use the Planet, Warns U.N. Report.” TIME, TIME USA, 8 Aug. 2019, time.com/5646787/ipcc-climate-change-land-report/.
  5. Armitage, Hanae. “Plant-Based Meat Lowers Some Cardiovascular Risk Factors Compared with Red Meat, Study Finds.” Stanford Medicine News Center, Stanford Medicine, 11 Aug. 2020, med.stanford.edu/news/all-news/2020/08/plant-based-meat-versus-animal-meat.html.
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