By Annika Lee
For generations the land was our provider, offering fresh fish, taro, ʻulu, and coconut that fueled Native Hawaiian and Pacific Islander (NHPI) communities. These foods weren’t just nourishment – they represented our culture and identity.
However, colonization disrupted this way of life, replacing our Indigenous knowledge with industrialized food systems. Over time, traditional diets were replaced by fast food, canned meats, and sugary drinks, contributing to Hawaiʻi having one of the highest type 2 diabetes rates in the country.
As this crisis escalates, could reclaiming ancestral food traditions help heal our communities?
Hawaiʻi’s NHPI population has a 20-25% prevalence of type 2 diabetes. This crisis stems from colonization which replaced nutrient-rich traditional foods with processed, high-fat, high-sugar diets. Food insecurity is a major factor: 42% of NHPI households in Hawaiʻi struggle to access healthy meals, compared to 33% of all Hawaiʻi residents. With 85% of food imported, NHPI families must rely on expensive processed foods or go hungry.
The lack of investment in local agriculture and dependence on imports has weakened Hawaiʻi’s ability to feed itself, perpetuating health disparities in NHPI communities. To address type 2 diabetes, solutions must target systemic barriers and strengthen local food systems.
Expanding community agriculture programs that restore native food sources, such as Hui Mālama Ola nā ʻŌiwi, is crucial. This initiative integrates traditional Hawaiian food production, such as taro farming and local fisheries, into public health strategies. The government must support similar community-led initiatives to reduce reliance on unhealthy imports.
Policy changes are necessary to support these efforts. Redirecting government subsidies from multinational food corporations to NHPI farmers would ensure traditional crops remain accessible and affordable. Expanding Supplemental Nutrition Assistance Program (SNAP) benefits to cover fresh, locally grown food and offering tax incentives for grocery stores that stock traditional NHPI foods would improve food security.
Additionally, State of Hawaiʻi food procurement policies should require schools, public institutions, and hospitals to source a percentage of food from NHPI farmers.
This would create a sustainable market for local producers while increasing access to culturally relevant food. Currently, only 6.2% of food purchases are sourced locally. Raising this to 30% could generate $15-$20 million annually for local farmers. Farm-to-school initiatives can supply students with fresh, traditional foods while teaching the value of Indigenous diets. Hospitals should integrate locally grown produce into their meal plans, reinforcing nutrition’s role in disease prevention.
Type 2 diabetes is the seventh leading cause of death in the U.S., responsible for nearly 90,000 deaths annually. This isn’t just a health crisis, it’s a systemic failure. We must advocate for policies that restore traditional food systems and make nutritious, affordable foods accessible. Breaking the cycle of diet-related illnesses like type 2 diabetes requires more than awareness – it demands decisive action to protect NHPI communities in Hawaiʻi.
Annika Lee is currently a global public health student at the University of Washington in Seattle. She is from Hilo, Hawaiʻi Island, and graduated from Hilo High School.
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