Native Hawaiian Elders’ Experiences with Traditional Health Practices

Background and Purpose: Hawaiian Health Practices are traditional approaches to healing and health promotion that have over 1000 years of use in the Hawaiian archipelago. These practices were outlawed from 1905 - 1973 after the illegal overthrow of the Hawaiian Kingdom government by the United States. During the time that Hawaiian Health Practices were outlawed, however, many healers continued to practice in secret, and Hawaiian Health Practices were passed down through family members across generations. The current study seeks to understand the general experiences of current Native Hawaiian elders with HHP across their lifespans, as well as the impacts of these practices on their health and wellbeing.

Methods: This research project was carried out in the context of a 5-year community-academic research project focused on Native Hawaiian elder health. In coordination with the community partner, Native Hawaiian elders were recruited at elder care meal sites from 2020 to 2024. Recruitment was stratified to ensure participation from elders on all Hawaiian islands. A total of 30 elders participated from the islands of O’ahu, Kaua’i, Mau’i, Moloka’i and Hawai’i. A three-interview, talk story format was used to get to know each elder participant and establish connections with the research team; the interview team also wrote up a life story for each elder that participated, and shared this along with copies of their interview recording and transcript. Interviews were transcribed using Otter.ai software, double-checked, and analyzed using thematic analysis by research team members familiar with Native Hawaiian culture and language.

Results: All 30 interviewees discussed their experiences with traditional Hawaiian Health Practices across the lifespan. These included lāʻau lapaʻau or Hawaiian herbal medicine (25 elders), ʻai pono or Hawaiian diet (21), pule or prayer (14), hoʻoponopono or conflict resolution (12), and lomilomi or massage (10). All but 2 participants specifically discussed use of these practices when they were growing up, usually in the care of parents, grandparents, aunties, or uncles, and 16 specifically emphasized being in good health using only Hawaiian health practices. Additionally, 14 respondents mentioned not having regular access to allopathic or Western medical treatment growing up.

Conclusions and Implications: Hawaiian Health Practices were common in the lives of the Native Hawaiian elders interviewed by this project, despite the historical implementation of policies to outlaw their use. Although health disparities research often emphasizes the lack of access to allopathic or Western medical treatment for Native Hawaiian populations, the results of this study suggest that Native Hawaiian elders recall largely being able to remain in good health using Hawaiian Health Practices. Health disparities frameworks should take into account access to traditional forms of medicine, not only allopathic or Western approaches, and future research should pay particular attention to individuals and communities that are able to remain healthy despite restricted access to allopathic medical care.