Supporting Health Equity in Native Hawaiian Communities

May is Asian American, Native Hawaiian, & Pacific Islander (AANHPI) Heritage Month, a time to recognize the contributions and experiences of AANHPIs. As a collaborative, CDC’s Project Firstline works with partners like the Asian and Pacific Islander American Health Forum (APIAHF) to meet healthcare workers where they are with infection control information and resources based on their communities’ needs and preferences.

This year, we had the privilege of speaking with one of APIAHF’s Infection Prevention and Control (IPC) champions Reid Elderts, Psy.D, a Native Hawaiian, licensed clinical psychologist, and member of I Ola Lāhui. Dr. Elderts shared his experiences building trusting relationships within Hawaiian healthcare communities, focusing on providing care that is based in science but also reflects the needs of the native populations, which is essential to successfully practicing infection control.

“I Ola Lāhui” means “so that the people will live and thrive” in Hawaiian. The I Ola Lāhui mission aims to provide culturally minded, evidence-based behavioral health care that is responsive to the needs of the medically underserved, predominantly Native Hawaiian and rural communities. Dr. Elderts encompasses the mission in his daily work by addressing health disparities faced by his people. Using an equitable approach to care, he recognizes there is a delicate balance between Western medicine, including infection control practices, and the traditional cultural practices of his community.

Empowerment and Community Outreach 

For Dr. Elderts, AANHPI Heritage Month is a time of reflection and celebration. He focuses on appreciating progress made in improving community health, while acknowledging much work remains.

Dr. Elderts was inspired to enter his field after seeing other Native Hawaiian providers succeed, realizing he could also attain that goal. Through a focus on community outreach, his dissertation advisor, a Black female psychologist, further shaped Dr. Elderts’ approach by emphasizing the need to meet people where they are, as underserved groups may not seek formal mental health care.

Similarly, Project Firstline strives to empower healthcare workers by meeting them in their own environments, tapping into their work-related motivations and existing strengths and knowledge sources, and teaching not only the “what” and “how” of infection control recommendations but also the crucial “why” behind them.

Advancing Health Equity 

Healthcare equity helps ensure that everyone has equal access and experiences within the healthcare system, and is a key part of the  Project Firstline mission. Through its partnership with APIAHF, Project Firstline provides Asian American and Native Hawaiian/Pacific Islander organizations like Dr. Elderts organization, I Ola Lāhui, with culturally appropriate infection control information to keep patients and themselves safe.

For Dr. Elderts, incorporating health equity involves understanding and respecting Native Hawaiians’ values and traditional practices. Dr. Elderts partners with community pillars like churches and recognizes the importance of culturally familiar treatments in Native Hawaiian culture, such as lāʻau lapaʻau (herbal medicine). He notes that while Western medicine often separates physical, mental, and spiritual health, Native Hawaiian culture recognizes their interconnection. Dr. Elderts acknowledges the significance of a holistic approach to health and wellness and believes his patients feel more comfortable being treated by someone who understands and respects their cultural background.

Dr. Elderts described an encounter with a Native Hawaiian patient suffering from chronic pain. The patient expressed appreciation for Dr. Elderts’ knowledge and respect for traditional Hawaiian healing practices, such as Lomi Lomi massage. The patient felt that this cultural understanding made his care more comprehensive. Dr. Elderts reiterated that patients feel their care is enhanced when treated by providers who demonstrate cultural knowledge and awareness, emphasizing the importance of representation within the native community. He noted that representation helps fosters that connection, with patients immediately relating to and trusting him as one of their own.

Infection Control and Cultural Awareness 

As a Project Firstline IPC Champion through  APIAHF, Dr. Elderts is part of a cohort of key informants, translators, and disseminators who provide insights into reaching their communities with critical infection control information. In this role, he has observed how measures like social distancing and masking, while important, disrupt Native Hawaiians’ cultural reliance on food, fellowship, and close contact. From his perspective, this social impact must be sensitively addressed, and he understands his role as a trusted messenger to help relay the message.

Even after the pandemic, he continues communicating the importance of infection control in keeping each other safe and healthy. It’s vital to recognize that everyone holds a responsibility to protect and uplift one another. By adhering to infection control practices, such as routine handwashing, cleaning and disinfection, and social distancing and masking during respiratory season, the community demonstrates a deep level of commitment to safe health care and respect for a more supportive environment for all.

Guiding Future Leaders in Health Care 

AANHPI Heritage Month is an opportunity to inspire a new generation of healthcare professionals who understand the importance of representation in promoting health equity and culturally competent care within their communities. Dr. Elderts’ insights exemplify the impact that culturally grounded, community-focused care can have on advancing health equity and infection control practices. His dedication to uplifting the well-being of Native Hawaiians serves as an inspiring model for future healthcare workers. We are grateful for his dedication and commitment to being an IPC champion.

Project Firstline is also strongly committed to supporting the development of a diverse and culturally competent healthcare workforce. By providing culturally appropriate infection control education and training resources, including translated materials for AANHPI healthcare professionals, Project Firstline aims to empower all healthcare workers to deliver equitable, high-quality care that respects and incorporates the unique needs and values of the communities they serve.

We have the power to stop infections. Together.

Dr. Reid Kekoa Ali’inui Likeke Elderts is a Native Hawaiian licensed clinical psychologist and faculty member at I Ola Lāhui. He provides psychological services, clinical supervision, and trainings in Hawai‘i. Dr. Elderts graduated from Pacific University’s School of Graduate Psychology with a doctorate in clinical psychology and an emphasis in health psychology. 

He has experience working on interdisciplinary teams and in integrated healthcare settings. He is passionate about collaborating with other health professionals to help improve health outcomes in medically underserved rural communities in Hawai‘i.

About the Authors

Mia Frederick (contractor, TANAQ) is a writer for CDC’s Project Firstline in the Division of Healthcare Quality Promotion.

Brittney Foster (contractor, St. John’s Group/Tanaq) is a senior health communications specialist for CDC’s Project Firstline in the Division of Healthcare Quality Promotion.