We are impacted every day by the depth of the health care system disconnects on Hawaii Island — starting with shortages of providers, lack of patient access and barriers to workforce recruitment and retention. Dig a little deeper, and long-standing inequities in health outcomes and access to care within our Hawaii Island community become apparent. The COVID pandemic, which pushed our health care system and our community to the limit, exposed and exacerbated these issues.
When federal funding to address minority health disparities became available in 2021, Community First Hawaii collaborated with UH-Hilo and the Hawaii County Research and Development Department. Kuleana Health was created and became the vehicle to implement the grant and distribute funds to community-based health organizations across Hawaii Island. Through the COVID pandemic and beyond, Kuleana Health has catalyzed conversations and initiatives to support the people of Hawaii Island to be healthy and thriving through making it all of our kuleana to care for our own health and the health of our community.
One of the root causes of health disparities and inequities is health literacy. Even under the best of circumstances, we know that health care providers can only treat the patients who come to see them and know how to ask for the help they need. Likewise, patients can only get quality care if the providers they seek out can understand not only their symptoms, but also their personal situations and cultural context. Personal health literacy and organizational health literacy, then, are key to making the best use of the limited health resources we have in our community.
From 2021 to 2023, we endeavored to answer the question, “How does our community become empowered to take charge of their health?” Through Kuleana Health, we were able to reach those hardest hit by COVID and most at-risk for adverse health outcomes, including Filipinos, Hispanics, Native Hawaiians, Pacific Islanders and rural populations, and learned that we need to meet people where they are at — geographically and culturally. Over the two-year grant period, Kuleana Health and our partners engaged in 360 community outreach events, translated critical health materials into seven languages, and directly reached over 36,000 members of our community.
We learned that it was important to provide community members a voice to direct and provide feedback to providers, and to offer providers training to develop the skills they needed to effectively work with community members. On the surface, health literacy may look like understanding the risks of diabetes or kidney disease or why it’s important to go to your annual checkup, but it reaches much deeper into the fabric of our community. The health of our community depends on how well we can understand, communicate with, and ultimately care for each other — at the doctor’s office, at home, and in communal spaces.
We are deeply grateful to our partners in government, education and the health sector who participated in Kuleana Health and who are still deeply invested and engaged in the health of our community. Moving forward, it is essential that we continue promoting cultural fluency in health care as well as offering health literacy resources in accessible ways so that each of us may take responsibility for our own health and the well-being of others.
Randy Kurohara is executive director of 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 www.communityfirsthawaii.org or its Facebook and Instagram pages at @communityfirsthawaii.