Nā honua mauli ola[i] is a Hawaiian philosophy that encompasses the understanding that health (mauli ola) is connected and central to three core elements of the human experience, the pikoʻī (spiritual connection), ʻō (inherited connection), and ʻā (the creative/procreative connection). These piko[ii] connections operate within three environments (honua)—family, community, and nation/world, which are experienced over an individual’s lifespan from childhood (keiki), to adulthood (mākua), and to elder (kūpuna) status. Disruption of any one of the piko connections during any phase of development is thought to cause the imbalance of mauli ola and lead to health problems.

To enrich and maintain a balance of all three piko connections essential for good health, traditional Hawaiian principles and practices were indoctrinated into society. Principles such as aloha,[iii] lōkahi,[iv] and laulima,[v] and practices such as mālama ‘āina,[vi] hoʻoponopono,[vii] and lāʻau lapaʻau,[viii] are manifestations of nā honua mauli ola philosophy. An important aspect central to this philosophy is the interconnectedness of the environment and health. This could include social environment to mental/emotional/spiritual health, as evidenced by practices of hoʻoponopono or physical environment to physical health as evidenced by practices of mālama ‘āina or lāʻau lapaʻau. Engaging in these practices reinforce the principles essential to living a balanced lifestyle within the framework of nā honua mauli ola. Perturbations in this balance mediated by drastic changes in the environment result in cultural trauma for Indigenous Peoples post-“western” colonization. This extrinsically induced imbalance of mauli ola may underlie the increased burden of chronic disease conditions Hawaiians and Pacific Islanders experience today.

Role of the Environment on Diseases of Health Disparities

According to a report released in 2013 by the DNHH, “In general, Hawaiians and Pacific Islanders (NHPI) bear a disproportionately higher prevalence of many chronic medical conditions, such as obesity, diabetes, and cardiovascular disease, collectively known as cardiometabolic disorders. Hawaiians not only have higher rates of death for diabetes and heart disease but also for cancer and other leading causes of death as compared to the overall State’s population.” Although these diseases arise under specific genetic circumstances, DNA sequence alone does not fully explain their origin. Indeed, the diseases of health disparities likely originate from a combination of gene-environment interactions, consistent with the Hawaiian concept of mauli ola. The model that best characterizes this critical interface is centered in the study of epigenetics.

Our unique study will combine indigenous perspectives of health which incorporates 'āina based practices with social and economic networks.


The above is partially extracted from D. Ko'omoa and A. Maunakea, Linking Hawaiian Concepts of Health with Epigenetic Research:
Implications in Developing Indigeneous Health. W Lee and M Look, Ho‘i Hou Ka Mauli Ola: Pathways to Native Hawaiian Health (Hawai‘inuiākea), where more information can be found.

[i] Nā Honua Mauli Ola: Cultural Pathways for Culturally Healthy and Responsive Learning Environments.

[ii] When used in this context, piko refers to a connection.

[iii] Aloha, love, compassion, kindness, sympathy.

[iv] Lōkahi, unity, harmony, accord.

[v] Laulima, cooperation.

[vi] Mālama ‘āina, take care or preserve the land.

[vii] Hoʻoponopono, to be correct.

[viii] Lāʻau lapaʻau, medicine.


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