Native Hawaiian men continue to face some of the highest rates of chronic illness and premature death in Hawaiʻi. Conditions like heart disease, diabetes, liver disease, and cancer are not only more common, but they’re often diagnosed late, when treatment options are limited.
But why is that? And how can we create pathways for our kāne to engage in healing before crisis strikes?
Stories from within our primary care clinic, supported by research, shed light on why many kāne underutilize healthcare.
From a young age, many are taught that masculinity means being strong, silent, and self-reliant. Asking for help or showing pain can feel like a failure of their kuleana as providers and protectors. Yet this stoic ideal often comes at a high cost: symptoms are ignored, emotional distress is hidden, and care is delayed until the situation becomes serious.
Historical trauma continues to shape how Native Hawaiians engage, or disengage, with medical care. Western healthcare systems are often viewed not just as unfamiliar, but as extensions of institutions that have excluded, mistreated, or ignored us.
These spaces can feel disconnected from the cultural values and ancestral healing practices that once sustained our people. As a result, many kāne approach these settings with mistrust or a sense of not belonging.
That feeling deepens when kāne walk into a clinic and see no one who looks like them, speaks their language, or understands their worldview. The unspoken message? This isn’t for you.
Mental health is often the invisible thread running through physical illness – yet it is rarely named. Depression and anxiety are common among kāne but often show up as back pain, fatigue, irritability, or substance use. Because our people are resilient, suffering is frequently masked by strength. Yet in clinical settings, these emotional struggles are often missed, especially when providers lack cultural awareness.
Even for those ready to seek care, logistical barriers persist, such as limited insurance, transportation, inflexible work schedules, and lack of nearby services, especially on the neighbor islands.
We need more Native Hawaiian health practitioners, expanded language access, and clinical spaces rooted in cultural safety; places that don’t just serve us, but truly welcome who we are. But healing needs to extend beyond the clinic to enact the cultural shift in the current kāne mindset regarding health.
Peer mentorship programs, talk-story circles modeled after the traditional Hale Mua (where young men learned the roles and responsibilities of manhood) and hoʻoponopono offer ways for men to process emotions, release burdens, and restore balance, especially when words are hard to find.
These gatherings can help normalize conversations about health by reframing care-seeking as an act of strength, not weakness, and honoring it as an expression of one’s kuleana to ʻohana and future generations.
Restoring wellness also means reconnecting to ʻāina. Working the loʻi, gathering limu, or casting net for nourishment, cultural grounding, and personal purpose.
Kāne are more likely to thrive when care is not something done to them, but something built with them – guided by culture, community, and respect.
