(Re)constructing Conceptualizations of Health and Resilience among Native Hawaiians

Abstract

Biomedical definitions of health have conventionally taken problem-based approaches to health, which may disregard indigenous perspectives of health that take a holistic approach and emphasize the importance of maintaining balance between physical, mental, and spiritual health and relationships maintained with others, the land, and the spiritual realm. Resilience-based approaches to health have been shown to foster strengths in indigenous communities, including the Native Hawaiian community, which leads to more positive health outcomes. The research questions of this paper asked, “how do Native Hawaiians conceptualize health and the concept of resilience specific to health?”. Qualitative methods were employed to explore the concept of resilience from the perspective of 12 Native Hawaiian adults. Community leaders and key stakeholders aided in the purposive recruitment process. The themes of this study include: (1) health maintained through balance, (2) being unhealthy vs. being ill, (3) the concept of colonialism and resulting adversities, and (4) protective and resilience factors that foster health. Cultural values and cultural practices may address concerns related to health disparities that stem from cultural and historical trauma, determinants of health, and environmental changes. Health interventions that are culturally-, family-, spiritually-, and land-based may particularly aid in responsiveness to health programs.

Reclaiming ʻĀina Health in Waimānalo

“…Findings align with previous research that emphasize the importance of ʻāina as an indicator of health [ 28 , 39 , 40 ]. In particular, ʻāina and a connection to ʻāina is a key solution to health and addressing health concerns that have stemmed from colonization and social injustices [ 41 ].…”

“…This study expands on our previous research, which explored the concept of health as being holistic and the concept of resilience as a multi-dimensional construct [ 28 ]. In our previous study, we qualitatively explored conceptualizations of health and resilience among Kānaka Maoli based on 12 residents of Hawaiian Homestead Lands throughout Hawaiʻi (i.e., on the islands of Oʻahu, Molokaʻi, and Hawaiʻi Island) in 2016–2017.…”

A Scoping Review of Nature, Land, and Environmental Connectedness and Relatedness

“…In particular, a connection with land, and thus a connection with culture and cultural connectedness, plays an important role in mitigating the negative effects of social and cultural determinants of health experienced by Indigenous peoples. This is not surprising given the growing research that supports the importance of land as a reflection of health amongst Indigenous peoples and thus a relationship with land serving as an indicator of resilience [ 97 , 98 , 99 , 100 , 101 ] despite the large amount of trauma inflicted upon Indigenous peoples due to the ill effects of land displacement. In other cases, these scales were developed with an effort to better understand the general psychometric properties of these scales as well as with the intention of exploring the relationship between cultural connectedness and health in future research.…”

The case of Kahewai: Indigenous ways of knowing and Kānaka ‘Ōiwi well-being.

“…Kanaka 'Ōiwi Health and Epistemology Antonio et al (2020) conducted a study interviewing twelve Native Hawaiians on urban and rural Hawaiian homesteads (e.g., Hawaiian Homelands) across the seven islands focusing on the narrative of health and resilience grounded in the perspective of Native Hawaiians. Four themes (Antonio et al, 2020) emerged from the interviews: Health is maintained through lōkahi (balance) and Native Hawaiian values; being unhealthy is characterized as being a This glossary provides basic translations however words in the Hawaiian language can have multiple meanings and thus may make these translations incomplete. For complete translations check the following resource: Pukui and Elbert (1971).…”

“…Antonio et al (2020) conducted a study interviewing twelve Native Hawaiians on urban and rural Hawaiian homesteads (e.g., Hawaiian Homelands) across the seven islands focusing on the narrative of health and resilience grounded in the perspective of Native Hawaiians. Four themes (Antonio et al, 2020) emerged from the interviews: Health is maintained through lōkahi (balance) and Native Hawaiian values; being unhealthy is characterized as being out of balance whereas illness is when someone experiences a chronic health condition; negative consequences of colonialism and poverty and their impact on health; and protective and resilience factors that foster health and well-being. Protective factors were being pono (righteous/good/moral), maintaining lōkahi, and increasing one’s sense of physical, spiritual, social, and emotional well-being.…”