Excerpted From: Heather Skrabak, Coming Home to Health: Addressing Housing Insecurity to Improve the Health of Native Hawaiians in Hawai'i County, 27 Asian Pacific American Law Journal 25 (2023) (179 Footnotes) (Full Document)


HeatheSkrabak.jpegHawaii has one of the nation's largest and fastest growing unhoused populations as well as one of the highest costs of living in the country. Native Hawaiians experience housing insecurity at the highest rates among all communities within Hawaii. Hawai'i County, encompassing the entire Big Island of Hawaii, has the highest percentage of Native Hawaiians and demonstrates the unique housing challenges faced by rural Native Hawaiians in the rapidly modernizing and tourist-heavy state. In Hawai'i County, three factors drive Native Hawaiian housing insecurity: 1) high cost of living, 2) insufficient economic opportunities, and 3) the historical underfunding and belated assignment of home lands.

This widespread housing unaffordability among Native Hawaiians in Hawai'i County has a detrimental impact on Native Hawaiian health. Native Hawaiians who face threat of eviction are more likely to experience increased depression, high blood pressure, childhood lifetime hospitalization, and poor child health. Additionally, Hawaii has the nation's highest utility costs, displacing funds from food and medical needs. When faced with housing unaffordability, many households resort to overcrowding, which Native Hawaiian families report at a higher rate. Overcrowding has been found to contribute to respiratory and digestive diseases. Families faced with housing unaffordability also tend to resort to subpar living conditions, which has been connected to increased lead exposure, a health risk Hawai'i County reports at higher rates. Subpar living conditions also drive environmental triggers for asthma, which impacts Native Hawaiian children at higher rates.

Ameliorating the situation requires addressing each of the factors discussed above. First, Hawaii could address the high cost of living by limiting or regulating short-term rentals and vacation homes. Many other large vacation destination cities have made similar efforts which provide Hawaii a range of options to consider. Second, Hawaii could improve economic opportunities in Hawai'i County by restructuring the economy to include more medium and high skill jobs and specifically incentivizing Native Hawaiian educational attainment and job training. Third, legal advocates could maintain pursuit of home lands distribution through litigation. While progress has been slow and efforts may take decades, the tide of mounting legal victories is slowly shifting and recent changes mean the long-awaited watershed victory may be on a distant horizon.

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Without urgent and significant changes, housing instability of Native Hawaiians will continue to grow as Hawaii's cost of living and vacation destination status show no sign of abatement. Though the causes are complex, and the need for change is daunting, the tremendous impact of housing insecurity on the health of Native Hawaiians prompts action. Addressing the cost of living by limiting short-term and vacation rentals, encouraging growth of medium to high-wage jobs through economic investments, and maintaining litigative action on the home lands would move Native Hawaiians in Hawai'i County closer to housing stability and health equity.