The Hawaiians: Health, Justice, And Sovereignty
Hawai'i was one of the last large-scale Indigenous societies to be encountered by Western adventurers. At daybreak on January 18, 1778, in the midst of a voyage from Tahiti to the western coast of North America, sailors aboard two British ships sailing under the command of Captain James Cook unexpectedly Sighted the smallest of the high islands in the Hawaiian chain. In retrospect, it is not difficult to understand why Cook and his crews were astonished at what they had stumbled upon, since Hawai'i -- a string of eight major islands, the largest of which is more than six times the size of Tahiti -- is the most isolated archipelago on earth, more than two thousand miles in every direction from the nearest inhabited lands.
First settled by Polynesians well over a millennium earlier, the Hawaiian islands had by far the largest population and the most complex and hierarchical political system in all of the island Pacific. Estimates of the all-island population size have varied over time, increasing dramatically in recent years. The first attempt at a systematic population estimate for the islands in 1778 was carried out by an officer on board one of Cook's ships. His total came to approximately 400,000. The most recent revised estimate puts the figure at closer to 800,000.(1)
But whatever the population at the moment of Western contact, it did not remain that large for long. In their lengthy isolation the Hawaiians had been spared the ravages of every major epidemic disease (smallpox, typhoid, yellow fever, measles, and others) that had long infected much of the rest of the world, and they had no previous exposure to treponemic infections (such as syphilis) or to tuberculosis. The observations of those sailing with Cook unanimously support the findings of modern studies of skeletal remains that at the moment of Western contact the Hawaiians were extraordinarily strong, healthy, and free of serious infectious disease.(2) Unfortunately, the men on Cook's ships were so universally infected with syphilis and gonorrhea that they had been too weak to sail when originally scheduled to leave Tahiti, and tuberculosis -- which at the time affected nearly half the people in England -- was active and widespread among Cook's officers and crews.
Venereal disease and tuberculosis were already spreading among the Hawaiians by the time Cook's ships departed the islands for good in 1779. Seven years later the surgeon on board a French frigate that visited a remote part of Maui wrote that the majority of natives there had become infected with venereal disease. And six years later still, Captain George Vancouver, who had been with Cook in Hawai'i in 1778-79, revisited the islands and reported finding massive depopulation virtually everywhere.(3)
From this point on, account after account by European and American explorers reported on the visible ravages of newly-introduced disease among the Hawaiians, and the precipitous decline of this formerly robust population. Major epidemics were not uncommon -- typhoid in 1804; influenza in the mid-1820s; mumps and whooping cough in the 1830s; measles, mumps, and whooping cough in the late 1840s; smallpox in the 1850s; Hansen's Disease (then known as leprosy) throughout the latter part of the century -- and in each case as much as ten percent of the population was wiped out.
Ghastly as these scourges were, the most devastating long-term damage done to the islands' population occurred in the wake of these epidemics and, additionally, as a consequence of widespread tuberculosis and venereal disease among the people. Year after year, with virtually no periods of relief, disease-caused infertility and subfecundity produced recorded birth rates so low that, even in the absence of epidemics, missionaries and others routinely predicted the imminent extinction of the Hawaiians.(4)
In 1831 the first official all-island census counted only 130,000 people. At best -- if the 1778 population had only been about 400,000 -- that meant a decline of nearly 70 percent in just over fifty years, roughly twice the proportional devastation of the Black Death in medieval Europe; if, as is far more likely, the population in 1778 was closer to 800,000, the 1831 population represented a half-century decline of almost 85 percent. And it remained in free-fall. By 1850 the population was less than 85,000. By 1890 it was down to 40,000. And, finally, in 1900 -- in the immediate aftermath of the US seizure and annexation of the sovereign Hawaiian nation -- it reached a nadir of just over 37,000, an overall collapse of at least 90 percent, and probably more than 95 percent, since 1778.(5)
New immigrants continued to come to Hawai'i, and with each new wave the natives were pushed ever further from the corridors of influence and power. As the twentieth century progressed, however, the number of Hawaiians began to grow again, thanks to intermarriage, with consequently rising numbers of so-called "part" Hawaiians, though the size of the "full" (unmixed) Hawaiian population continued to decline. Today, the number of full-Hawaiians is well under 10,000; the number of part-Hawaiians is in excess of 220,000. But both separately and together they remain the most unhealthy and oppressed people in the Pacific.
The state of Hawai'i is proud to call itself "The Health State." And not without reason. Overall life expectancy in Hawai'i is almost 76 years for males and more than 82 years for females -- in each case roughly four years greater than the national average.(6) Since Hawai'i is unique as the only state in which no single race or ethnic group constitutes a majority of the population, this across-the-board index of well-being is extraordinary.
But for Hawaiians the story is very different, with life expectancy, according to U.S. Census reports, of less than 65 years for males and less than 72 years for females. These are by far the lowest life expectancies of any major population group in Hawai'i. The combined male-female rate is approximately the same as the overall state and national figures of half a century ago -- and is roughly equivalent to that of such countries as El Salvador, Paraguay, Nicaragua, and the Dominican Republic today.(7)
The pattern of mortality is especially telling. Below one year of age the Hawaiian death rate is more than double the overall state average. Between one and four years of age it is triple the state figure -- and so on, through early adulthood. In every age category up to age 30 the Hawaiian death rate is never less than double, and often is triple, the equivalent general mortality rate in the islands. Indeed, with just under 20 percent of the state's population, Hawaiians account for nearly 75 percent of the state's deaths for persons less than 18 years of age. Only after age 70 does the Hawaiian mortality rate fall below the state average -- and that is because at that point there are relatively few Hawaiians left to die: after 70 years of age fully 64 percent of the state's non-Hawaiian population is still alive, compared with barely 40 percent of the Hawaiian population. Particularly alarming is the fact that while, as expected, the mortality rate for non-Hawaiians decreased significantly between 1980 and 1990, for both full- and part-Hawaiians it actually increased in that period.(8)
The causes of this exceptionally high mortality rate are numerous. And not only numerous but, like the mortality rate itself, they are worsening. For example, between 1980 and 1990, rates of death from heart disease, cancer, stroke, and diabetes either declined significantly or held steady for non-Hawaiians, while for Hawaiians they all increased, and in some cases increased dramatically. Moreover, for full-Hawaiians the rate of death from cancer and stroke was three and a half times that of non-Hawaiians; for heart disease it was four times that of non-Hawaiians; and for diabetes it was nine times that of non-Hawaiians.(9)
These and similar reports have set off alarms in the Hawai'i health and social service communities. Professional agencies, both public and private, have aggressively sought out the principal reasons for this health crisis, and they have found them in the easily labeled "abnormal" behavior of Hawaiians themselves. That is, the state's social pathologists have focused their efforts almost entirely on blaming the victim.(10)
Hawaiians, it turns out, have the highest rates of any group in the islands of obesity, smoking, and both acute and chronic drinking. Teen-age motherhood among Hawaiians is almost double the state average, while the maternal substance abuse rate is much higher among Hawaiians than among non-Hawaiians: two and a half times higher for fetal alcohol syndrome; three times higher for cocaine use; and almost five times higher for methamphetamines. More than one-third of the state's confirmed child abuse and neglect cases are found in Hawaiian families.(11)
Following a ritualized, vague, and gratuitous acknowledgment of tragedies in the past -- the conveniently distant nineteenth century past -- the diagnoses of the helping professions in Hawai'i relentlessly focus on the Hawaiians' own allegedly self-destructive practices in the present. Programs have been set up to teach Hawaiians healthier eating habits; drug and alcohol rehabilitation units have been established; planned parenthood and perinatal care services are in place -- and more. Many of these are laudable activities, no doubt. But in locating the problem within the victims themselves, the institutions and agencies that would help the Hawaiians out of their present condition consistently ignore the routine oppression and discrimination Hawaiians face in everyday life -- oppression and discrimination that is the root cause of the seemingly deviant behavior that is so upsetting to the social and behavioral scientists.
Consider, for example, just four very visible potential areas of concern -- areas in which the major social service agencies have little or no action-oriented interest: housing, income, education, and criminal justice.
Hawaiians represent roughly 20 percent of the state's population, but they occupy less than 10 percent of the housing units in the islands -- and the percentage of units rented by Hawaiians that contain six or more persons is more than double the state average. Yet, despite these crowded conditions (and the potential for multiple incomes per household), more than one out of four Hawaiian rental households have total incomes below the official poverty threshold -- a rate almost double that for the state at large.(12)
Some Hawaiians, of course, do own their own homes. But those homes are far and away the lowest in value among all ethnic groups in Hawai'i, and the percentage of Hawaiian families in owner-occupied homes who receive public assistance and/or have incomes below the poverty level is almost twice the state average.(13) In brief, whether they rent or own their housing units, Hawaiians tend to be far more impoverished, and to live in the worst and most crowded conditions of any people in the islands.
And whether they rent, own, or are homeless (the sight of Hawaiian families permanently camped in public parks and on beaches is commonplace), Hawaiians have the highest unemployment rate of all ethnic groups in the state. They represent more than 28 percent of the individuals receiving Aid for Dependent Children, almost triple the percentage of any other identified group. They constitute the largest percentage of families in the islands that are living below the poverty line, more than double the statewide average. And the proportion of Hawaiians in the categories of persons who earn less than $10,000 a year and less than $5,000 a year is more than twice those rates for all other groups combined.(14)
As for education, the higher the level the lower the participation of Hawaiians. Statewide in the elementary and secondary public school systems more than 25 percent of students are Hawaiian and just under 75 percent are non-Hawaiian. At the community college level 16 percent of the students are Hawaiian, while 84 percent are non-Hawaiian. At the main campus of the University of Hawai'i less than 9 percent of the students are Hawaiian -- more than 91 percent are non-Hawaiian. And of recent MA, PhD, JD, and MD degrees awarded by the university barely one-half of one percent went to Hawaiians, while more than 99 percent went to non-Hawaiians.(15)
This drastic situation with its debilitating long-term social consequences has indirect causes ranging from institutional racism in the professional work force (that systematically locks Hawaiians out and thereby discourages belief in the value or efficacy of higher education) to the need for young and impoverished Hawaiians to care for families at a much earlier age than non-Hawaiians (thereby forcing them prematurely into low-level jobs that preclude time for educational pursuits). But more direct causes of the undermining of Hawaiian educational opportunity are conscious public decisions by government and education leaders -- such as dramatic recent increases in higher education tuition levels, while the university and the state legislature refuse to fund requests for tuition waivers or other educational aid specifically targeted for Hawaiians. Remedial academic programs for all groups that may incidentally benefit Hawaiians address none of the real reasons for their gross under-participation in education at the higher levels. In fact, like nutrition-training for the desperately poor and hungry, such programs only reinforce the perception that Hawaiians are to blame for their own educational shortcomings.
It is perhaps within the criminal justice system, however, that evidence is most vivid regarding the true reason that Hawaiians persistently rank at the bottom of virtually every index of social well-being. Throughout the past decade and more Hawaiians have constituted the overwhelming plurality of adults in Hawai'i sentenced for felony convictions. Almost 40 percent of state prison inmates are Hawaiian, double their proportion of the general population and twice the rate of any other group.16 It is commonly assumed, therefore, that criminal behavior among Hawaiians also is disproportionately large. But actually -- despite the fact that, like African Americans in the rest of the United States, Hawaiians are particular targets of police investigation and harassment -- Hawaiian arrest rates are no higher than the proportion of Hawaiians in the population at large. Put differently, although Hawaiians constitute two out of every five inmates in the prisons, they represent only one out of every five arrestees for all crimes, both Part I Index offenses (crimes of violence and serious property theft) and Part II Index offenses (lesser crimes such as vandalism, prostitution, and drug possession). Indeed, even among Part I offenses, Hawaiian arrest rates are highest for non-violent crimes such as auto theft and burglary and lowest for violent crimes like murder, rape, aggravated assault, and arson -- for which, combined, their arrest rate actually is lower than their proportion of the state population.(17)
The only possible explanation for this enormous disparity between arrests and incarceration is that Hawaiians are singled out by the court system for especially harsh treatment. Apart from the sheer injustice of this deliberate practice, its effect on other indices of social well-being is nothing short of debilitating. The cruelly disproportionate criminalization of huge numbers of Hawaiians not only cripples those individuals' life chances, but it undermines every aspect of their families' existence -- from income loss to emotional stability. Thus, it is not at all surprising to discover that Hawaiians have more than double the statewide rate of families containing children under the age of eighteen that are headed by females (with no adult male present) or that Hawaiian families receive all forms of public assistance at two to three times the rate of other groups.(18)
What is particularly devastating, however, is that this entire complex of interlocking oppressions has become the fundamental source of a widely-held self-fulfilling prophecy that labels Hawaiians as incorrigibly deviant -- and treats them as such. Within the juvenile justice system, for example, the same pattern observable regarding Hawaiian adult arrests and convictions not only exists, but is growing worse. During the middle years of the 1990s well over half of all minors incarcerated in state correctional facilities were Hawaiian -- a figure more than 50 percent higher than the Hawaiian juvenile arrest rate for all offenses.(19) And, as with Hawaiian adults, that arrest rate was roughly equivalent to the proportion of Hawaiians in the state's overall juvenile population.
Despite the fact, then, that Hawaiians demonstrably do not commit significantly more crimes than would be predicted by their mere proportional presence within the state's population, the justice system in Hawai'i is embarked on a patently transparent campaign to incarcerate and thus create a multi-generational class of Hawaiian criminals. In so doing it is meshing its efforts with those of other social service and social control units that consistently declare the Hawaiians at fault for their own misery. Within each institutional category, then -- health, housing, employment, education, criminal justice, and more -- the racist mistreatment of Hawaiians is, simultaneously, both cause and consequence of the discrimination and suffering that is meted out by each of the other overlapping agencies. And palliative efforts confined to addressing mere symptoms of oppression (nutritional counseling, remedial school programs, menial job training, and the like) only serve to distract attention from those symptoms' fundamentally racist and institutionally systemic roots.
Nearly thirty years ago, in his original analysis of the "blaming the victim" phenomenon, William Ryan described "ideological warfare against the poor in the interest of maintaining the status quo" as "one of the most detestable forms of blaming the victim."20 The Hawaiian people today are victims of a concerted ideological war that is being waged against them, as Indigenous people, by both public and private sector agencies. Direct assaults by the criminal justice, employment, and educational bureaucracies are effectively concealed by the social service organizations that relentlessly find that the fault of the Hawaiians' poverty and ill-health lies within the Hawaiians themselves.
So the suffering continues. And so it will continue until the Hawaiians' ongoing struggle for political and economic self-determination achieves a measure of success sufficient for the Hawaiians to support and to care for themselves -- as they did for many long centuries before that winter of 1778, when the first European ships came into view on the distant horizon.
(1) James Cook The Three Voyages of Captain James Cook Round the World, Volume VII by James King (London, 1821) pp. 118-119; David E. Stannard, Before the Horror: The Population of Hawai'i on the Eve of Western Contact (Honolulu: University of Hawai'i Press, 1989).
(2) The accounts of Cook and his officers are conveniently collected in J.C. Beaglehole, ed., The Journals of Captain James Cook, Volume III in two parts (Cambridge: Hakluyt Society and the University Press, 1967). Among the more extensive osteological surveys, see Charles E. Snow, Early Hawaiians: An Initial Study of Skeletal Remains from Mokapu, O'ahu (Lexington: The University Press of Kentucky, 1974); and Sara L. Collins, "Osteological Studies of Human Skeletal Remains from the Keopu Burial Site," in Toni L. Han, et al, Moe Kau Ho'oilo: Hawaiian Mortuary Practices at Keopu, Kona, Hawai'i (Honolulu: Bishop Museum Department of Anthropology Report 86-1, 1986), Chapter Eight.
(3) M. Rollin, M.D., "Dissertation on the Inhabitants of Easter Island and the Island of Mowee," in J.F.G. de la Pérouse, A Voyage Round the World Performed in the Years 1785, 1786, 1787, and 1788 (London, 1799), Volume II, pp. 337-38; see also Volume I, p. 341. George Vancouver, A Voyage of Discovery to the North Pacific Ocean and Round the World, 1790-1795 (London, 1798), Volume I, pp. 158-60, 187-88.
(4) See David E. Stannard, "Disease and Infertility: a New Look at the Demographic Collapse of Native Populations in the Wake of Western Contact," Journal of American Studies 24 (1990), pp. 325-350; reprinted in Kenneth F. Kiple and Stephen V. Beck, eds., Biological Consequence of the European Expansion, 1450-1800 (London: Ashgate, Ltd., 1997).
(5) Reports on the missionary and subsequent government censuses of the nineteenth century can be found in Robert C. Schmitt, Demographic Statistics of Hawai'i, 1778-1965 (Honolulu: University of Hawai'i Press, 1968), pp. 42-43; and Eleanor C. Nordyke, The Peopling of Hawai'i, Second Edition (Honolulu: University of Hawai'i Press, 1989), p. 178. Both of these sources, however, severely underestimate the population of the islands prior to the existence of censal records; see discussion in Stannard, Before the Horror, pp. 4-14, 50, 59-60, 103-146.
(6) State of Hawai'i Data Book (Honolulu: State Department of Business, Economic Development, and Tourism, 1995), p. 64, Table 2.10.
(7) Mark Eshima, compiler, Native Hawaiian Data Book (Honolulu: Office of Hawaiian Affairs, 1998), p. 404, Table 6. 1; Robert C. Schmitt, Historical Statistics of Hawai'i (University Press of Hawai'i, 1977), p. 52, Table 2.6; The Statistical History of the United States from Colonial Times to the Present (Stamford: Fairfield Publishers, 1965), p. 25, Series B 92100.
(8) Eshima, Native Hawaiian Data Book, p. 414, Table 6.67; Mele A. Look and Kathryn L. Braun, A Mortality Study of the Hawaiian People, 1910-1990 (Honolulu: The Queen's Health Systems, 1995), p. 8, Figure 1.
(9) Eshima, Native Hawaiian Data Book, p. 428, Table 6.74.
(10) This now-commonplace phrase deserves to have its provenance acknowledged; see William Ryan, Blaming the Victim (New York: Pantheon, 1971).
(11) Ibid., p. 430, Table 6.75; p. 394, Table 6.55; pp. 372-73, Tables 6.41-6.41a; p. 284, Table 5.11.
(12) Ibid., p. 92, Table 2.7; p. 111, Table 2.17; p. 112, Table 2.18; p. 114, Table 2.19;p. 124, Table 2.25.
(13) Ibid., p. 120, Table 2.2; pp. 142-43, Table 2.35 and Figure 2.35.
(14) Ibid., p. 584, Table 8.42; p. 268, Table 5.4; p. 50, Table 1.24; p. 542, Table 8.18, pp. 516-17, Table 8.5 and Figure 8.5.
(15) Ibid., p. 206, Table 4.2; p. 222, Table 4.10; p. 220, Table 4.9; p. 232, Table 4.14.
(16) Ibid., p. 486, Table 7.13.
(17) Ibid., p. 470, Table 7.5; p. 474, Table 7.7.
(18) Based on calculations drawn from ibid., p. 104, Table 2.13; p. 270, Table 5.4; p. 276, Table 5.7; p. 278, Table 5.8.
(19) Ibid., p. 494, Table 7.17; p. 472, Table 7.6; p. 476, Table 7.8.
(20) Ryan, Blaming the Victim, p, 210.
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