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Abstract The role of genomic research and medicine in improving health continues to grow significantly, highlighting the need for increased equitable inclusion of diverse populations in genomics. Native Hawaiian and Pacific Islander (NHPI) communities are often missing from these efforts to ensure that the benefits of genomics are accessible to all individuals. In this article, we analyze the qualities of NHPI populations relevant to their inclusion in genomic research and investigate their current representation using data from the genome-wide association studies (GWAS) catalog. A discussion of the barriers NHPI experience regarding participating in research and recommendations to improve NHPI representation in genomic research are also included.

Indigenous communities in North America have distinct colonial histories with their own story of how their ancestors were able to survive the mass effort to take their land, resources, language, culture, and sometimes even their lives. These stories have been passed down orally and through the DNA of the descendants of survivors via epigenetics. The Historical Loss Scale (HLS) and Historical Loss Associated Symptoms Scale (HLASS) are two validated scales that measure historical trauma among Native Americans. However, as different Indigenous communities have different colonial histories, it is critical to ensure that tools used to measure historical trauma are valid for that specific communities. When these scales are applied to Native Hawaiians, these measures may not provide an accurate picture of the historical trauma experienced by Native Hawaiians. As part of the effort to adapt the HLS for Native Hawaiians, we conducted a crosswalk analysis of the HLS and HLASS with a recent study on Native Hawaiian historical trauma (NHHT) to identify areas of overlap and divergence. We found that while there was significant overlap, several areas of divergence emerged likely stemming from the unique colonial histories of different Indigenous communities.

ʻĀina (land) is central to Native Hawaiian culture and ways of life. The illegal overthrow of the Hawaiian Kingdom and annexation to the US resulted in the loss of Hawaiian crown and government land, which was placed in trust for the benefit of the Hawaiian people. These lands, now managed by the State of Hawaiʻi, were reconstituted as the Public Land Trust (PLT) with one of the articulated uses being the betterment of Native Hawaiians. While the Hawaiʻi State Constitution restored Native control over a proportional share of revenue generated from PLT lands, the US Supreme Court removed Native self-determination over the trust by opening its selection of trustees to non-Native Hawaiians. Applying a critical policy lens, this paper explores the rise and end of Native Hawaiian control over their own PLT share. Using the policy surveillance methodology, this study explores the recent expansion of Native Hawaiian consultation law and whether this has restored some self-determination over the Native Hawaiian PLT share, with the study finding that it has not. Thus, while Hawaiʻi’s laws clearly articulate a desire for Hawaiians to control the use of their share of the PLT, Hawaiian control of these resources has eroded, suggesting a need to adopt policies that realign with the original purpose of the PLT.