Culturally Relevant Physical Activity is Important for Achieving Health Equity: Case Study from Hawai‘i

Background: Culturally relevant physical activity can increase collective well-being and promote healthy behaviors for health equity. The World Health Organization recently highlighted the importance of cultural insights for health and noted this promising area is underexplored and underutilized globally.

Program Delivery: In Hawai‘i, questions about culturally relevant activities, including hula, outrigger canoe paddling, and spearfishing were added to the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS collects nationally harmonized data on preventive health practices and risk behaviors in the adult population. States can ask optional questions of relevance to their communities to give critical insights for health promotion that engages cultural preferences and strengths.

Evaluation: Disaggregated data collected showed engagement in hula and paddling was highest among Native Hawaiian and Pacific Islander communities. For example, almost 1 in 2 Native Hawaiians reported engaging in hula– a cultural practice with high physical activity demands that is being used as a tool for improving cardiometabolic health. Nationally harmonized measures may not capture such data of relevance to local community and cultural preferences.

Conclusions: The state level surveillance was possible from community relationships and systems and trust built over time. These led to the collection of insightful data on culturally relevant physical activity measures using BRFSS as well as ongoing health promotion activities in partnership with communities and other sectors.

Practical Implications: Implementing culturally relevant hula-based health programs and other similar programs engaging community strengths and preferences in physical activity are important, underutilized tools for health promotion and equity. This work provides practical and innovative insights for research and practice locally and globally.

Funding: Hawai’i State Department of Health’s Chronic Disease Prevention and Health Promotion Division, through a contract with UH Office of Public Health Studies and the Chin Sik and Hyun Sook Chung Endowed Chair in Public Health Studies.