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Examining the Social and Economic Impacts on the Health of Native Hawaiians and Pacific Islanders

Posted: February 13, 2018

Alika Maunakea is leading a study to scientifically prove what seems apparent to many: Social and economic forces in a community can impact health.  Maunakea, assistant professor at the John A. Burns School of Medicine at the University of Hawaiʻi at Mānoa, is conducting the study in a place he knows well: Waiʻanae, where he was born and raised.

The community, situated on a beautiful stretch of the Leeward Oʻahu Coast, also has its challenges. Maunakea’s hometown has the largest proportion of health disparities in the state.

The study aims to scientifically prove what seems apparent to many: that social and economic forces in a community can impact health. Obesity, diabetes, smoking and alcoholism are all more prevalent within places like Waiʻanae, with high populations of Native Hawaiians or Pacific Islanders. Incomes there are below the median and the way of life (which generations ago centered on harvesting food from the land and the sea) has been disrupted by rapid change and urbanization.

Dr. Maunakea’s specialty is Epigenetics. He is seeking to understand the molecular interaction between the environment and genes, and how changes in this interaction are involved in diseases which are disproportionately prevalent in Native Hawaiian and Pacific Island populations–changes which are not due to differences in DNA sequence (i.e. genetics).

Maunakea’s colleague in the study is Ruben Juarez, an associate professor in the UH Mānoa Department of Economics and UH Economic Research Organization. He is a mathematical economist researcher with expertise in social networks and behavior.

Maunakea and Juarez believe social and economic forces can push people toward unhealthy lifestyles. Their study won’t be confined to the walls of the University. MA‘O Organic Farms, a nonprofit, 25-acre farm in Waiʻanae is a key partner in the project. MAʻO is an acronym which stands for the Native Hawaiian terms Mala (garden), ʻAi (food) and ʻOpio (young). It was founded in 2001 with the goal of producing organic foods and plants used in Native Hawaiian healing traditions, while also reconnecting the people of the Leeward Oʻahu coast — especially the young — to their Native Hawaiian cultural roots. Youth employment and educational programs are centered on the farm.

“MAʻO has a large impact in Waiʻanae,” said Dr. Maunakea, a biomedical researcher in the Epigenomics Research Program at the UH John A. Burns School of Medicine (JABSOM) Department of Native Hawaiian Health.

“Communities like MAʻO are grassroots organizations, and we have a strong belief that in order to effectively address health disparities, these organizations should be part of the mix of academics, health practitioners, and the government,” said Dr. Juarez. “While we expect this project will create valuable information for MAʻO, our collaboration may provide a model for other organizations to fund their programs in a more sustainable way.”

The study is being funded by HMSA Foundation, which was established in 1986 by health insurer HMSA to stimulate research of issues that confront Hawaiʻi’s health care industry.

Juarez says the study represents a start of a new line of research in Hawaiʻi that could enable community organizations to optimize their programs to more intentionally improve health and reduce health disparities for their constituents.

“The impact of socioeconomic networks on diseases of health disparities in Hawaiʻi has never before been measured,” said Dr. Maunakea. “We hope to provide the first measure in the state of Hawaiʻi.”

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