Ulu Laukahi: Addressing health care inequities

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At Kipuka o ke Ola (KOKO) Native Hawaiian Rural Health Clinic, our mission is to provide cultural, spiritual, medical and psychological services to all residents of North Hawaii, with a special emphasis for Kanaka Maoli (Native Hawaiians).

We believe that mauli ola (the power of healing) is improved with the balance of one’s physical, spiritual and mental health. Yet, the Western-silo approach to treating modern-day chronic disease often addresses these conditions in isolation, ignoring the interconnectedness of many chronic conditions.

This approach not only disregards Native Hawaiian healing techniques rooted in traditionally holistic remedies, but further disenfranchises our Native Hawaiian community. In Hawaii, Native Hawaiians make-up only 20% of the population, yet experience disproportionately higher morbidity and mortality rates, see higher rates of chronic disease, possess higher behavioral health risk factors, and are less likely to engage in preventative health services than all other ethnic populations in the state.

In 2018, KOKO implemented a Native Hawaiian health and wellness program titled, Ulu Laukahi (grow together), in an effort to address these inequities in our Hawaii Island community. The Ulu Laukahi Program (ULP) was designed and continues to be a culturally informed prevention and intervention program that addresses the medical and behavioral health needs of Native Hawaiians struggling with obesity, hypertension, diabetes, anxiety and depression.

ULP features chronic care management while providing access to fitness centers, one-on-one sessions with health and fitness coaches, nutritional food bags and recipes, monthly exercise classes open to participants and their ‘ohana, as well as quarterly visits with our KOKO primary care and psychotherapy providers. During its first four years, 347 community participants have completed the nine-month wellness program, 269 (78%) of which have seen clinically significant improvements in at least one of their chronic disease diagnoses.

We recently had the privilege to sit down with well-respected community-member, educator, and ULP participant, Aunty Malani Deaguiar who shared the following about her ULP experience:

“Everybody knows that when you exercise, you’re gonna feel great. So when you combine exercise with eating better, you get better sleep, you have wonderful perspectives about everything around you, and people see you differently. I run into people in the store that I haven’t seen for awhile and they’re like, ‘What are you doing different?’ or (my students will) say ‘You look younger.’ The exercise, the eating well, provides this new Malani. I’m happier, I’m smiling more, and my grandchildren are happy. Ulu Laukahi is the best thing that’s ever happened to me. Receiving the food, implementing the recipes, and learning to use them in a new, healthy manner, makes all the difference in the world.”

Our long-term goal for Ulu Laukahi is to continue supporting dedicated participants like Aunty Malani to make healthy and sustainable lifestyle changes. In the years to come, we encourage all of our health care partners throughout Hawaii to continue seeing the value in providing holistic, traditionally rooted wellness programs for our Native Hawaiian community members.

KOKO envisions a community where Native Hawaiians will enjoy the highest quality of comprehensive health care from prenatal to end of life, and we look forward to working toward this goal together.

We are unable to do this work without the support of our board members, community partners, funders, donors and those that have come before us. Mahalo nui loa for the continued support.

Claren Kealoha-Beaudet, PsyD, is KOKO chief executive officer and psychologist. Audra Gill, MPH, is KOKO Ulu Laukahi project manager

This editorial is brought to you by Community First Hawaii, a nonprofit serving as a convener and catalyst for solutions to improve health and access to health care. For more information, please visit our website at www.communityfirsthawaii.org or Facebook and Instagram pages at @communityfirsthawaii.