Hawaiian Culture

Welcome to the Hawaiian Culture

Group members: Kellie Riehle, Megan Stoker, Michelle Quach, and Yasmin Starwich.

Hawaii

Hawaii State Seal

Definition of Culture

Culture involves common beliefs, values, traditions, lifestyle, communication, region, and the way you look at the world. Hawaiian culture is a culture because it is a region that shares common beliefs, traditions, attitudes, goals, and values that characterize the way they live their lives and pass it down to generations.

Hawaii State Flag

Values/Norms

Concepts of social, religious, and environmental responsibility are fundamental to Hawaiian life and expressed through the language as a values system. There are many important Hawaiian values, including the ones listed below:

  • Aloha is the most cherished of all greetings. It is the value of  trust and friendship and includes strangers. Aloha represents safety, well-being, and peace of mind. It is also important in regards to the land and implies stewardship obligations as an expression of caring for the environment.
  • Alaka`i is a noun and a verb. The noun meaning a person who is a leader and the verb being the act of leadership by guiding or directing. As a value, Alaka`i is about a person’s willingness to assume the responsibilities of leadership.
  • Hanohano is to conduct oneself with distinction, honor, and dignity. It describes dignity and nobility that one earns through acts of distinction.
  • Ho`omau is the value of perseverance and endurance. To be determined and committed to achieving a goal or completing a difficult task.
  • Ho`ohiki is the value of keeping your promises. It is equivalent to a pledge or oath and a serious commitment to doing what you say you’re going to do.
  • Ho`oheno means to sincerely cherish and love another. It is the value of demonstrating your affection.
  • Po`okela is to the strive for excellence. It is the important value of to excel, to surpass, and to set your sights to the highest level of achievement.
  • Kõkua is the act of being helpful and to provide relief by assisting others. It is valued to lend support, therefore you assume the same sense of responsibility as the receiver of the assistance toward completing a task or activity.
  • Kuleana means to view responsibility as a privilege and honor. It is accepting responsibility as a duty, not for the reward, but because it is the right thing to do.
  • Küpono is adamant honesty. It means to be fair and just in your relationships and to always seek the righteous path in your dealings and decisions.
  • Lõkahi is the value of unity and is to be expressed with harmony.
  • Laulima is the value of cooperation that causes everyone to work together toward a common goal. It is about many hands working together without rank or position so that one person’s success is everyone’s success.

Beliefs/Attitudes

Aloha Aina

In Hawaiian, “Aloha aina” means “love of the land” and the phrase expresses the profound respect Hawaiians have for Hawaii and the care they take to protect the Islands. “Aina” means that the land is the source of food. Hawaiians believe the gods, the aina (land), and the kanaka (people) share a symbiotic existence. If the people took care of the land in a pono (correct) manner, the gods were appeased. Therefore, if the gods were happy, they would allow the land to provide nourishment for the people through fertile growth. Each god had many kinolau (forms) including human and animal forms.

The Shaka

There is some debate about the origin of the shaka, although most agree that its roots lie with surf and beach culture. The shaka is a simple but powerful symbol of the the Hawaiian principle of “malama i kekahi i kekahi” which means “take care of one, take care of all” because Hawaiians believe in looking out for each other on the islands and strive to spread aloha every day.

Shaka sign

The Tiki

Tiki statues were carved to represent the image of a certain god and as an embodiment of that specific god’s mana (power). Hawaiians believe that with tikis, people could attain protection from harm, strengthen their power in times of war and be blessed with successful crops. In Polynesian mythology, tiki often represents the first human being on Earth. The most recognized tiki character has a strong, stocky body with a rectangular head and a headdress. The tiki image is still used today in some Polynesian cultures in the context of spiritual practice. Since Hawaii became a state, tiki culture, the aloha shirt and other representations of the islands are incredibly popular.

Traditions

The Flower Lei

The flower lei is a symbol to represent the beauty of the Hawaiian Islands and the spirit of aloha. Only in Hawaii May 1st is “Lei Day” and celebrations include making and exchanging different types leis, music and entertainment, and an abundance of local food. A lei is a very special gift, because it not only represents beauty, but a blessing and the giving of time, since each one is handmade with care. Lei making is an art form that some people take very seriously. A lei is given to someone for many reasons and can symbolize love, friendship, welcoming, affection, parting, a wish for safety, congratulations, graduation, union of marriage, health, birth, transition in death and several other messages of peace. Nowadays the lei may be accompanied with a kiss on the cheek; however, this practice is was not a part of ancient Hawaii. According to tradition, a lei recipient should not remove a lei while in the presence of the lei giver. Leis are used in many facets of life in Hawaii, including tourism, religion and politics. The governor of Hawaii and other important political figures may wear a lei during public appearances, state holidays, or even on a daily basis.

Hawaiian Leis

The Hula

Hawaiians as a culture and as a people like to tell stories. Kapunas, or chiefs, told stories to their people as a way of teaching about life and customs. These stories were part of the Hawaiian oral tradition. The hula, an indigenous dance, is a way of telling a story. Along with the dance is a chant, or in Hawaiian “mele”. There are two very distinct styles of hula. One style of hula, which was created by the original Polynesian inhabitants, is called Kahiko Hula. The newer style of hula, which was created in the 19th and 20th centuries after western influence, is called Auana style. Although hula has undergone changes throughout the years it remains an important part of local culture and is enjoyed as a participant or viewer.

Here are some of our fellow Cougars in Pullman, WA performing some Hawaiian dances.

Sense of self/space

Hawaiian culture is not that different from American culture in the area of space and self. They believe that you will have more respect for the things that you truly earn and work hard for. Space for a comfortable conversation tends to be around two feet, but may be closer for some people because of the Chinese influence in the area.

Communication Style/Language

Hawaiian is a difficult language to master as it is made up of soft sounds with words having many hidden meanings. Hawaiian is made up of only five vowels and eight consonants, therefore making it the shortest alphabet in the world. One of the most famous and important of all Hawaiian words is “aloha”. “Aloha” means hello, goodbye and love as well as sympathy, kindness, compassion, affection and fondness. The word is more than a greeting or expression of love – it is the basis of what Hawaiians consider to be one of the culture’s core values.             English is the dominant language in Hawaii, but it is mixed with Hawaiian words, phrases and pidgin slang. The Hawaiian language is only spoken by an estimated 9,000 people, but 85% of all local place names are Hawaiian and most often have interesting stories behind them. Hawaii’s early immigrants communicated with each other in pidgin, which is a simplified form of English which still exists today as a vivacious, constantly changing local slang.

Dress/Appearance

Before Hawaii was inhabited by China, Japan, and the West, native Hawaiians created their clothing from plants and trees. Men wore a malo also known as a loincloth and Hawaiian women wore a skirt called a pa’u.

Pa'u skirt for women.

The international symbol of clothing recognized around the world is the Hawaiian shirt. Hawaiian and tropical designs are popular among tourists and for specific events like luaus, parties, dinners designed as “Aloha attire”.  Popular with tourists, Hawaiians that live in Hawaii wear clothing like mainland U.S.

Hawaiian Food

Hawaiian culture is made up of many different groups of people thus there is a variety of food consumed that is traditional Hawaiian food. These groups of people include Native Hawaiians, Samoans, Tongans, Chinese, Japanese, and Filipino.

Ahi- yellow fin tuna

Haupia- coconut pudding

Laulau- pork, butterfish, beef, or chicken wrapped in taro leaf and steamed in an imu (underground oven)

Manapua- Chinese style filled steam buns

Naau- stewed beef intestines

Poi- staple starch of the Hawaiian diet, made from boiled taro root (a tuberous vegetable)

Spam- Hawaii’s favorite canned meat

A Luau is a Hawaiian feast where traditional Hawaiian food is served, hula dancers perform, and ukulele and wooden drums are played. Poi made from boiled taro root is often eaten with sugar or soy sauce. Poke is raw fish marinated in lemon or lime juice served with coconut cream. A Kalua pua’a or roast pork is one of the most common items at a luau. This usually involves roasting the whole pig. White meat island fish may also be included. Dark purple Hawaiian sweet potatoes are usually included in salads. Taro rolls are made from taro flour. Fruit such as pineapple and watermelon are always included along with other assorted fruit. For dessert there may be haulpia (sweet custard cubes made with coconut cream) or coconut cake.

Hawaiian Luau

Kalua Pork

Time Consciousness

Hawaiians tend to be on the late side. This is not the case for everyone or for every event but it is common. Hawaiians realize they tend to be late and make a joke about it.

Relationship/Social Structure in Hawaii

Today Hawaii’s social structure and relationships are much like the rest of the United States. However, in ancient Hawaii a strict social structure did exist. Separate kingdoms existed and they consisted of a King, a chief minister, and a high priest. The next in the ranking were chiefs also called “ali’i” they had power based on their genealogies of their parents. The majority of Hawaiians were considered commoners or “ainana” these people did most of the labor in Hawaiian society. Their work consisted of construction, farming, fishing, and fighting in wars. The lowest ranking people in ancient Hawaiian society were “kauwa” or outcasts, this depended on what family the person was born into.

Mental Process/ Learning

Hawaii fosters student achievement, community and school improvement based on high expectations. Hawaii is ranked 5th in the U.S. for the number of adults who have completed college and 85% of the adults have completed high school. Hawaii’s educational institutions offer a variety of courses and in over 80 different languages. Hawaii holds high expectations of what students should be able to know and focus on promoting student learning. Hawaii has viewed education as the vision for students to exercise their rights and responsibilities. More importantly, the No Child Left Behind federal law has been supported by Hawaii to provide equal education opportunity for everyone.

Work Habits/ Practices

Hawaii’s work ethic is based around “Ohana” meaning family. Hawaiians are laid back yet are one of the most dedicated workers. Hawaii is recognized for friendliness, “ohana”, loyalty, dedication and for excellent customer service skills. According to the Department of Business, Economic Development and Tourism, Hawaii is has one of the best records in the U.S. for low absenteeism and diverse language skills. Overall, Hawaii is known for their strong work ethic.

The City & County of Honolulu’s Economic Development website highlights Hawaii’s work ethic and workforce:

  • Hawaii ranks 12th in the U.S. in annual wages paid to employees.
  • Hawaii is 5th in the U.S. in percentage of college graduates in the work force.
  • 63% of Hawaii’s women participate in Hawaii’s civilian work force.

Demographics/Statistics/Fun Facts


  • Barack Obama is the first president to be born in Hawaii.
  • Hawaii is the most isolated population on Earth.
  • The Hawaiian archipelago spans the distance of 1,524 miles (2,451 km) making Hawaii the longest island chain in the world.
  • Hawaii was the 50th state admitted to the United States on August 20, 1959.
  • Hawaii officially became known as the “Aloha State” in 1959.
  • When measured from east to west, Hawaii is the widest state in the United States.
  • Hawaii is the only U.S. state that grows coffee. Coffee plantations in Hawaii make up 6,200 acres. In 2003, 8.5 million pounds of coffee were produced.
  • Sugar is mainly produced on Maui and Kauai, altogether 70,000 acres. In 2002, 340,000 tons of raw sugar were produced. One ton of water is needed to make a pound of sugar.
  • Hawaii produces about 320,000 tons of pineapple each year.
  • Hawaii is the only state in the U.S. where the majority population is non-white, and is also home to the largest percentage Asian-Americans in the United States at 41.6% according to the 2000 Census.
  • Hawaii has the highest population density in the United States.
  • The largest industry in Hawaii is tourism, as it contributes to just under a quarter of the total Gross State Product.
  • Hawaii has its own time zone called Hawaiian Standard Time. There is no daylight savings time in Hawaii, which means that in the summer Hawaii is two hours behind the Pacific Time, and in the winter Hawaii is three hours behind.
  • Hawaii is the only U.S. state whose land area is increasing (from volcanic eruptions).
  • Among all U.S. states, Hawaii has the highest percentage of women in the workforce at about 63 percent as of 2003.
  • More birds have become extinct in Hawaii than in any other part of the world.
  • Hawaii has the highest number of married couples living with others, mostly because Hawaii has the lowest percentage of home ownership.
  • Hawaii has the highest life expectancy in the United States. Life expectancy for men is 75, and for women 80 years.
  • Hawaii has the fewest overweight people in the United States. About 19.7 percent of Hawaii residents are overweight, compared to about 30 percent on the mainland.

Interview

Note: This interview was an email interview. Michelle Quach interviewed Kodee Martin here is a little about Kodee Martin:Just as an note before you read any of these descriptions, I have been raised in Hawaii since I was little, I have no Hawaiian blood in me whatsoever, so all of my answers are based solely on personal experiences, Hawaiian classes, and stories from my friends with Hawaiian ancestry. Please keep that in mind when you are reading all of these answers.”

Question 1: What are some of the values that people in the Hawaiian culture demonstrate?

Kodee Martin: “One of the most basic Hawaiian Acronyms is A.L.O.H.A. in Hawaiian which stands for A-Akahai (gentleness), L-Lokahi (Harmony), O-‘Olu’Olu (Graciousness), H-Ha’aha’a (Humility), A-Ahonui (Patience). All values which people that are Hawaiian or live in Hawaii try to show these values.”

Question 2: What are some of the basic beliefs that Hawaiian hold?

Kodee Martin: “Hawaiians believe in Gods and Goddesses revered throughout the islands. Some Gods are believed to be a “God of” something. An example is “Pele”, she is the Goddess of the Volcano. It is sometimes believed that these Gods can be seen through still photographs as ghosts, and some people have some pictures of what they think are the Gods. The Hawaiian Gods and Goddesses are heavily revered and the natives will do anything to keep them happy, otherwise they believe the Gods will act in response to their actions.”

Question 3: What traditions essential to the Hawaiian culture?

Kodee Martin: “Hawaiians as of any other culture have many different traditions, here are a few of many other Hawaiian traditions. Hula- It is a beautiful flowing Hawaiian Dance that tells a story. The music is combined with repetitive chants called “mele” either alone or combined with music. Luau-is known as the Hawaiian barbeque. It is usually a large party where the main course is Kalua pig- a whole pig steamed in an “imu” (underground oven).”

Question 4: What is the sense of self and space like in the Hawaiian culture?

Kodee Martin: “The Hawaiian Culture is pretty much the same as most other cultures in that the sense of self and space is the same where you would treat others as you would like to be treated. Sense of space being similar in that, you truly respect things that you have made for yourself, which makes it more rewarding.”

Question 5: What is the communication style of Hawaiians?

Kodee Martin: “The Hawaiian culture has 2 different communication styles. First because Hawaii is such a “melting-pot” of different cultures, English is always a must. But for a lot of the natives, The Hawaiian Language is still very much apart of this culture, in some places more than others. The other Communication Style is what is known as “pidgeon-English.” Which is basically a slang version of the english language, something that anyone who has lived or been to Hawaii for a certain period of time can truly attest to.”

Question 6: What is the usual dress of the Hawaiian culture?

Kodee Martin: “The Hawaiian Culture is the same as any other culture in how they dress. The normal is usually a lot of shorts here in Hawaii due to the heat, weather, and humidity. Some of the Women in the Hawaiian Culture like to grow out their hair from birth, and choose not to cut it, that is why you see some hula dancers where their hair is close to or even on the ground, because that has been their hair since birth. But for the most part, the appearance and dress is the same as majority of the other cultures.”

Question 7: What are the eating habits of the Hawaiian culture?

Kodee Martin: “The Hawaiian Culture is pretty much the same in the sense that they eat normally as any other person would, as explained earlier, the “luau” is a very popular barbeque here in Hawaii, but is usually only for a special occassion, and is on a much bigger scale, if not, then it is just considered a barbeque. The Hawaiian culture loves to eat things procured from the land, things such as “poi”, which is from a plant, “poke” which is raw fish, or “lau-lau” which is pulled pork hunted from the land, those are just some of many classic hawaiian dishes.”

Question 8: How time conscious are people of the Hawaiian culture?

Kodee Martin: “There is actually a joke here in Hawaii, for either Hawaiians or those who live in Hawaii, “I am Not late, I stay on Hawaiian Time.” That saying is on T-shirts available here because the tendency for some of the Hawaiian culture is to be late to events. This is not the case for everyone all the time, it is just tendencies that someone thought would be funny.”

Question 9: What are relationships like in the Hawaiian culture?

Kodee Martin: “As far as I know relationships are no different than any other culture. There is no pressures of marrying only within the Hawaiian culture. I think they are free to date whoever, but there are the same parent issues where meeting the son/daughters significant other takes a little more than one try.”

Question 10: What is education like in Hawaii?

Kodee Martin: “Learning in Hawaii, or the Hawaiian culture or just the state of Hawaii in education ranks somewhat towards the bottom in the country. That is not saying that all native hawaiians, or hawaii inhabitants are on the lower end of education, it is just saying that the state average is on the lower end of American standards. But Hawaii is always trying to make drastic changes to boost their standings.”

Question 11: What are the work habits like in the Hawaiian culture?

Kodee Martin: “The Hawaiian culture practices a lot of things mostly in common with all the other cultures. Nothing really that different than most. It is just the plain simple fact of working hard, and keeping your head down will eventually lead to a pay off.”

Health Care Environment

“Determinants of Infant-Feeding Choice Among Young Women in Hilo, Hawaii”

This research article examines the factors that influence mothers to decide whether to breastfeed or bottle-feed their babies. Hilo is one of the largest settlements in Hawaii with about 40,000 citizens. The average rate of births is 600 per year. This makes Hilo to have the highest birth rates in Hawaii. The population in Hilo, Hawaii consists of Hawaiians, Chinese, Japanese, Filipinos, European Americans, and Portuguese. The mix of cultures emerged and is recognized as “local culture” (Morrison et al).Family is important to Hawaiians and the influence of their family is strongly considered. The rate of breast-feeding is lower than parts of mainland United States. The determinants of infant feeding choice among women in Hawaii come from four influences. These influences consist of mother’s influence, partner’s influence, public infant feeding, sexuality and motherhood. There is a high rate of pregnancy in the younger population in Hawaii. The majority of young women chose to bottle-feed because their focus is to return to high school, avoiding sore nipples and the embarrassment of breast-feeding. The benefits of breast-feeding were acknowledged, but emerging themes were considered the primary reason to select a different infant-feeding method. Hawaii’s cultural setting has been reinforced in young mothers. If an experience from their mother’s previous experience was a positive one, the young mother would more likely to adopt that behavior. Also, many young women who have children still live with their mother which extends the influence of the grandmothers’. One common goal of choosing to bottle-feed is that family members are willing to help the young women to go back to school by offering to feed the baby and take care of it. There are many other situations that influence the infant-feeding choice.

There does seem to be a perceived discrimination problem with infant-feeding choices. Most people in Hilo and other places deem public breast-feeding to be inappropriate. It seems that it is far less acceptable in Hilo as onlookers have a negative perspective and lead to public confrontation. There is a big difference in the Hawaiian culture and the US culture. The traditions, beliefs/ attitudes, dress, food, communication styles are recognizably different. Both cultures see that public breast-feeding is inappropriate but they both know that breast-feeding is beneficial for the baby and mother. There are some health risk factors that are associated with the Hawaiian culture in Hilo which is a concern. Hilo has high rates of pregnancy and sexually transmitted disease. There are important things to take note of in the Hawaiian culture. Family is an important influence in the Hawaiian culture. There is strong support from the immediate family. Hawaiians value the importance of family because they greatly impact who people are as a person. Family in Hawaii is referred to as “ohana”. There are five important things a nurse of a health care provider should know about someone that identifies with this culture. They include the importance of family influence, sex education, Hawaiian healing practices, food/feeding habits, and communication style.

Morrison, L., Reza, A., Cardines, K., Foutch-Chew, K., & Severance, C. (2008). Determinants of infant-feeding choice among young women in Hilo, Hawaii. Health Care for Women International, 29(8/9), 807-825. Retrieved from CINAHL with Full Text database.

Hilo, Hawai

“Mental Health During Pregnancy: A Study Comparing Asian, Caucasian, and Native Hawaiian Women”

This article researched pregnancy issues in the Hawaiian culture. Specifically, mental health during pregnancy, this study consisted of eighty-four participants who were seeking prenatal care. According to the study sixty-one percent of the participants had identified at least one mental health issue. Some of the issues they were screened for include substance abuse, depression, and anxiety. Thirteen percent reported drinking during their pregnancy and five percent reported a drinking problem during their pregnancy.Fifteen percent reported smoking during the pregnancy. The highest incidence of cigarette smoking was by far among native Hawaiians at thirty-five percent. This study also found that the Native Hawaiian population was more likely to binge drink compared to the Asian and Caucasian populations that were studied. The studies main conclusions were that proper screening and treatment needs to be implemented specifically for the Hawaiian population early in the pregnancy. This way it will have a chance to make a difference in the pregnancy. Based on the results of this study I feel that there needs to be more education for Hawaiians planning on getting pregnant. Including the risks associated with unhealthy behaviors and the effects that can have on an unborn baby.

More research with larger sample sizes needs to be done in this Hawaii to confirm these findings. However, the results of the study still have some important implications. The implications for health care among the Hawaiian population of childbearing age, especially the native Hawaiians is huge. First and foremost it is important for nurses to be aware of the high incidence of mental issues and substance abuse among native Hawaiians. This will allow nurses to be aware of the necessary complications as well as specific questions to ask about within this particular population. According to the study the complications with even one mental disorder include, preterm labor leading to a premature baby, lower birth weights and increased risk of a c-section. A c-section carries more complications for the mother and a longer recovery as well. Overall, it is important to learn from this article that more education and early screening of potential risks for the mother and baby are very important within the Hawaiian population.

Based on this research article I do not feel that there is a perceived discrimination problem when it comes to pregnancy in Hawaii. There are some differences between the Hawaiian culture and the U.S. culture especially when it comes to pregnancy. As explained earlier there is a higher incidence of risky behaviors during pregnancy in the Hawaiian culture versus the United States Culture. As nurses this is extremely important to be aware of when caring for patients. From researching this culture I didn’t find any taboos in the Hawaiian culture that would be relevant to nursing care. The top five things that someone should know when caring for a person that identifies with the Hawaiian culture include high risk behaviors within the culture, such as the ones during pregnancy. A health care provider should be aware of what people in that culture value. They should also be familiar with some very common words that Hawaiians use. They should also be familiar with their communication style and their sense of self/space. All of these important points have been covered in the blog.

Goebert, D., Morland, L., Frattarelli, L.,  Onoye, J., & Matsu C,. (2007). Mental Health During Pregnancy: A Study Comparing Asian, Caucasian and Native Hawaiian Women” Matern Child Health 11 (244-55) Retrieved from: http://www.cinahl.com/cgibin/refsvc?jid=1602&accno=2009589404

“Nurse Practitioners and Traditional Healers: An Alliance of Mutual Respect in the Art and Science of Health Practices”

One of the biggest differences between Hawaiian culture and US culture is that Hawaiians are often more in tune with the environment. The balance of God (Akua), man, and nature is very important and essential for sustaining life. Hawaiian alternative therapies focus on balancing energies, increasing circulation, proper body positioning, and physical manipulation to help the body to heal itself. Another big difference is diet, Hawaiians who eat a Hawaiian diet focus on whole foods with lots of seafood and fruit. Americans on the other hand tend to eat a diet with a lot of processed food and very little fruit or vegetables. Because of such a difference in diet when Hawaiian started to change their diets to look more like an American’s diet, their health suffered. Since the transition to a more Western diet and increasing stress there has been increasing incidence of  diabetes, hypertension, hypercholesterolemia, cardiovascular problems, asthma, and obesity

Ancient Hawaiian health care included use of a Hawaiian healer that used methods such as black magic, sorcery, prayer, and herbal tonics. This all changed when Hawaii became part of the United States. Hawaiian healers were not as popular and the people who still went to them only went in secret. Traditional healers, or kahuna, were brought back in 1988 with the Native Hawaiian Health Care Act. In this study only ten percent of the respondents felt that only Western medicine should be used, while 21 % thought only traditional Hawaiian medicine should be used. This leave 76% of the respondents who believe Western medicine and traditional Hawaiian medicine should be used in conjunction. Ailments seen by Hawaiian healers were mostly musculoskeletal and 23% had already seen a Western health care provider for that ailment.

A nurse would need to know that some Hawaiians use both Western medicine and traditional Hawaiian treatments, thus, it would be important to ask a Hawaiian patient what other therapeutic treatments they are receiving. Hawaiians may feel some dissatisfaction with conventional medicine because it does not offer a very holistic and spiritual stance. It would be important to assure Hawaiians that it is ok to use traditional healers and medicine, but it is essential that they reveal all other alternative therapies they are using in order to avoid interactions. It is important to establish a good relationship with your patient from the Hawaiian culture because often if the patient does not have an established relationship with the provider their level of care decreases. When levels of care decrease Hawaiians are more likely to turn solely to traditional Hawaiian medicine, which may mean they are not getting the full therapeutic care they would if they were using both Western and traditional Hawaiian medicine. In addition, it is estimated that 12% of Hawaiians do not have health care insurance because they cannot afford it; these people would have to seek mainly traditional Hawaiian healers and methods because of the cost of Western medicine. In this study Hawaiians were more satisfied with their Western health care experience if they were able to spend more time with their health care provider. As a nurse it is important to try not to rush through exams and try to identify all of the holistic problems the patient may be facing, not just the physical ailments. As stated earlier it is very important to encourage Hawaiian health therapies along with Western therapies because the combined effect will be greater than only one therapy alone.

Broad, Lauriann Mahealani. Allison, Dale M. (2002). Nurse Practitioners and Traditional Healers: An Alliance of  Mutual Respect in the Art and Science of Health Practices. Holistic Nurse Practitioners. 16(2): 50-57.

Perceived Discrimination problem

There is perceived discrimination because some Hawaiians are made to feel inadequate because of the health beliefs they hold to be true. Often Hawaiians are discriminated against for believing in traditional Hawaiian therapies and remedies, which causes some Hawaiians to seek these treatments in secret.

Another discrimination problem in Hawaii has to due with breast feeding. Breast feeding in Hawaii is discouraged due to the fact that most Hawaiians view breast feeding in public as inappropriate. This encourages bottle feeding which does not contain the mother’s antibodies which are very beneficial to the baby. Nurses can use this information to be aware of this issue within the Hawaiian population and can educate mothers about the importance of breast feeding. This will hopefully encourage the mothers to breast feed even though it may not be the easiest way to go in their society.

Biggest Differences between U.S. culture and Hawaiian culture

Hawaiians are very in touch with the environment.

-Hawaiians use alternative therapies to balance their energy and body.

-Hawaiians have a huge focus on the body healing itself.

-The diet of Hawaiian people is largely seafood and fruits, not processed foods that are high in fat and salt.

-Hawaiians prefer a holistic and spiritual approach to medicine.

High Risk Behaviors Common to this culture:

-Hawaii has a high rate of drinking and smoking during pregnancy.

-Hawaiian have a high rate of sexually transmitted diseases.

Cultural Taboos/Important Notes

-It’s important to note that Hawaiians have their own traditional medicine that they value and it’s important to be aware of this and respect their view of medicine.

-It is taboo and offensive to rush through a medical exam with a Hawaiian. Not spending enough time with the patient is often the reason Hawaiians stop seeing Western health care professionals.

It is an important cultural value in Polynesian cultures to spend time to “talk story”. Being able to spend this time with Hawaiian patients helps them feel more satisfied with their care.

-Hawaiian patients would prefer a health care provider to holistically look at their health and focus on what problems identified whether it is physical, emotional, or social, not just the identification of physical dysfunction.

Top 5 things a Health care provider should know

  1. Hawaiians often combine traditional and western medicine.
  2. Hawaiians have a high risk of smoking and drinking during pregnancy.
  3. Hawaiians focus on the body healing itself.
  4. There is a high rate of sexually transmitted diseases in the Hawaiian population
  5. Hawaiians may not feel comfortable sharing about their traditional medicine practices because they feel discriminated against for utilizing these practices.

OahuOahu, Hawaii

Oahu, Hawaii

References:

Alternative Hawaii. Ethnic Food Glossary. http://www.alternative-hawaii.com/gloss.htm

Broad, Lauriann Mahealani. Allison, Dale M. (2002). Nurse Practitioners and Traditional Healers: An Alliance of  Mutual Respect in the Art and Science of Health Practices. Holistic Nurse Practitioners. 16(2): 50-57.

Carini, Joe. 2008. http://www.hawaiipictures.com/pictures/index/module/media/category/gallery|luau/pId/102/id/185/

Characteristics of hawaii’s workforce. (n.d.). Retrieved from http://www.co.honolulu.hi.us/menu/ecodev/tools/workforce.htm

Goebert, D., Morland, L., Frattarelli, L.,  Onoye, J., & Matsu C,. (2007). Mental Health During Pregnancy: A Study Comparing Asian, Caucasian and Native Hawaiian Women” Matern Child Health 11 (244-55) Retrieved from: http://www.cinahl.com/cgibin/refsvc?jid=1602&accno=2009589404

Liu, T.E. . (2006, February 03). State of Hawaii: department of business, economic development and tourism. . Retrieved from http://hawaii.gov/dbedt/business/workforce/unique-workforce

Martin K. Personal communication, March 11, 2010.

Morrison, L., Reza, A., Cardines, K., Foutch-Chew, K., & Severance, C. (2008). Determinants of infant-feeding choice among young women in Hilo, Hawaii. Health Care for Women International, 29(8/9), 807-825. Retrieved from CINAHL with Full Text database.

Okihiro, Gary Y. (2008). Island World: A History of Hawai’I and the United States. Berkeley and Los Angeles, California: University of California Press.

Pollard, Art. Local Kine Recipes v2.0. http://www.hawaii.edu/recipes

Polynesian Cultural Center. 2008. Luau. http://www.aliiluau.com/luau/luau.html

Rural Policy Research  Institute. 2006. Demographic and Economic Profile Hawaii. Retrieved from http://www.rupri.org/Forms/Hawaii.pdf

State of Hawaii: department of education. (n.d.). Retrieved from http://doe.k12.hi.us/about/intro_mission.htm

The Hawaii Islands. 2007. http://www.pacificislandtravel.com/hawaii/about_destin/country_profile.html

To Hawaii. 2010. http://www.to-hawaii.com/

http://www.hawaiihistory.org/index.cfm?fuseaction=ig.page&CategoryID=318

WSU Hawaii Club: Waikaloa youtube video is credited to user cjmg0523. http://www.youtube.com/watch?v =zq8Hbymxly8

WSU Hawaii Club youtube video is credited to user cable8productions. http://www.youtube.com/watch?v =8o4amZipLSk

Oahu pictures were taken by Lisa Carrington in Oahu, Hawaii August 2009.

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