UH Research Focuses on Improving Public Health With Hula

The end of the Merrie Monarch Festival in Hilo on the Big Island doesn’t mean hula gets put on the shelf for a year. In fact, findings in a study by University of Hawai‘i researchers suggest people could hula their way to better health.

The study by the University of Hawai‘i at Mānoa Office of Public Health Studies on the prevalence and popularity of hula in Hawaiʻi found that a quarter of the state’s residents have danced or still do — and nearly half of those who identified as Native Hawaiian have danced hula. According to researchers, these findings present a valuable opportunity to innovatively promote better public health within mutlicultural communities in the islands.

“It is a remarkable opportunity to have a quarter of our state population say they engage in a culturally-relevant physical activity,” said Tetine Sentell, interim dean of the Thompson School of Social Work & Public Health and study lead, in a press release. “Overall, strong engagement with hula was seen across gender, age, education, income and health status, especially among Native Hawaiians and Pacific Islanders. Notably, 65% of Native Hawaiian women had participated in hula over their lifetime, as had 31% of Native Hawaiian men.”

According to the release, kumu hula and scientists agree that hula restores and creates health from a multi-level approach involving physical, mental, emotional and spiritual health.

Questions about lifetime experiences with hula were added in 2018 and 2019 to the Hawai‘i-specific Behavioral Risk Factor Surveillance System, a national gold standard surveillance tool that provides a picture of public health in the state. UH researchers analyzed results from more than 13,500 respondents to quantify hula engagement across important public health factors.

“This work is exciting for health promotion in our state, especially from a strength-based approach to build health equity,” said Lance Ching, a DOH collaborator, in the press release. “These findings indicate that hula is enjoyed among people in a wide array of life circumstances, making it a promising area for community health promotion to support wellness and prevent chronic disease.”

Given that only 24% of adults in Hawai‘i meet physical activity guidelines, and rates of physical activity among Native Hawaiians and other Pacific Islanders are lower than the state average, scientists recognize the need for culturally-relevant approaches to public health programming, research and practice.

“There are real opportunities here,” said Mele Look, of the Department of Native Hawaiian Health at UH-Mānoa’s John A. Burns School of Medicine and a study collaborator, in the press release. “We can promote a popular, accessible, health-creating activity that celebrates the best of our island home and Hawaiian culture.”

She also noted in the release that health insurers such as AlohaCare and UHA are taking note and discussing ways to help members participate in hula classes.

“This work is also important because, typically, statewide public health surveillance systems do not measure culturally-relevant activities, limiting key knowledge for research, policy and practice,“ said Sentell in the press release. “Hula is so important to our communities. We are pleased to have hula included in this state-level data along with key health indicators, like diabetes and heart disease rates. We can see relationships and make plans from this work to improve public health for all.”

The study was a partnership between the UH-Mānoa Office of Public Health Studies, the state Department of Health and the Department of Native Hawaiian Health at UH-Mānoa’s John A. Burns School of Medicine.

The study’s findings will be presented at the International Union for Health Promotion and Education, a major upcoming international public health conference in Montreal.