25-05-2025
Molokai wins Culture of Health Prize
The island of Molokai is perhaps the most rural of all of the main Hawaiian isles, with a population of just about 7, 400 on about 260 square miles of land.
With its rugged landscape and steep sea cliffs, Molokai stands apart from other isles shaped by tourism and outside interests, according to the Robert Wood Johnson Foundation. Its close-knit community, meanwhile, has long prioritized the aina (land ) and residents' health and self-sufficiency.
These are the very reasons the foundation chose Molokai for its 2024, which comes with $250, 000. Out of hundreds of applicants from across the U.S. last summer, the foundation chose nine.
It's a first for Molokai—and a first for Hawaii.
'Honestly, this is really the first time our community has been recognized for our years and years of innovative efforts to try and solve our crises, ' said Kawaipuna Kalipi, a Ph.D. student in political sciences at the University of Hawaii at Manoa. 'Because on Molokai, especially, we know people won't come to save us.'
Kalipi, also general manager of the Molokai Heritage Trust, co-wrote the prize application with Momi Afelin, a Molokai native and Ph.D. student at the Harvard T.H. Chan School of Public Health, highlighting the community's efforts to be resilient.
Applying for the award also was intended to honor Molokai's beloved physician Dr. Noa Emmett Aluli, who at the age of 78. Aluli was a family practice doctor at the Molokai Family Health Center for decades, as well as a Native Hawaiian health advocate and activist renowned for protesting U.S. military bombing on Kahoolawe.
'We co-wrote the application in honor of Uncle Emmett and his dedication to Molokai—but really, his dedication to aina, to all of Hawaii, ' Kalipi said, 'and his reminder to us that the health of the land is the health of the people, and the health of the people is the health of the land.'
The Robert Wood Johnson Foundation, a national philanthropy dedicated to health equity that is based in Princeton, N.J., has been awarding the Culture of Health Prize since 2013.
The prize honors the work of communities 'at the forefront of addressing structural racism and other structural injustices to advance health, opportunity, and equity for all, ' according to the foundation website. Awardees are honored for taking unique approaches to health by reshaping food systems, emboldening youth leaders while honoring elders and changing the narrative about their communities.
The foundation recognized Molokai as a place 'where land and people have existed in a regenerative and symbiotic relationship.'
The community of Molokai has had to be resilient and resourceful while facing issues of access to health care, high poverty rates, ongoing threats to its land and resources, and other challenges.
'We have to be very creative in the ways we build out our health equity because it's challenging for doctors to come to Molokai, ' Kalipi said. 'It's challenging to get specialists, and on Molokai, by specialists I mean an eye doctor and dentist.'
The island has long faced a shortage of doctors, forcing residents to travel off island to seek routine and specialized health care, oftentimes without reliable transportation.
Among some of Molokai's accomplishments highlighted by the foundation are community efforts to buy back nearly a third of land from a developer to protect it for the benefit of the community.
That is the mission of the Molokai Heritage Trust, a member-managed nonprofit.
'I think Molokai has also understood itself to be aina momona, land of abundance, ' Kalipi said, 'so the planning that we do and the approach that we're trying to take is a holistic one—a planetary health approach.'
Without land, there is no sustenance, according to Kalipi, and Indigenous ownership and stewardship of land is necessary in order for people to cultivate their own food.
'Our communities rely heavily on our land for food, ' she said, 'and if we lose that land, imagine how many more people would have to rely on the food bank.'
According to the Molokai Community Health Center, about 45 % of the island's residents have incomes below 200 % of the federal poverty line.
Programs like the Mobile Market, which provides an outlet for some 65 local farmers and food producers to sell their locally grown produce to Molokai families, are a step toward self-sufficiency.
The foundation also noted other accomplishments, including the creation of a 'clean energy hui ' to plan and develop a portfolio of clean-energy projects islandwide supported by the community, along with efforts to prepare for climate change.
In the face of climate change, Molokai has already started planning how to adapt to erosion, flooding and sea-level rise.
Climate change is one of the big issues Molokai is facing, according to Kalipi, with questions of how to prepare for it discussed at community meetings. The majority of families on Molokai live at sea level on the east side of the island, and there are two homestead subdivisions on the coast.
Invasive species, including axis deer and macro algae, also pose threats to Molokai's ecosystem. The overpopulation of deer has dried out mountaintops, according to Kalipi, bringing topsoil down into the ocean and onto coral reefs.
Molokai's south shore is home to one of the longest, continuous coral reefs in the islands. The foundation lauded community partnerships to reclaim the shoreline by removing invasive macro algae that threaten nearshore fisheries. To date, more than 35, 000 pounds of algae have been removed and repurposed to enrich the soil.
All of it, Kalipi said, is a reflection of the community's efforts. The prize money, she said, will go back to the community and be shared among 10 or so nonprofits.
Other communities that were awarded the prize include Trenton, N.J.; Jurupa Valley and Sacramento, Calif.; Green Bay and Milwaukee, Wis.; Juneau, Alaska ; Lower Eastern Shore, Md.; Sussex County, Del.; and tribes in the Great Lakes region.
Juneau, Alaska's capital city, was recognized for addressing structural racism and unraveling generational trauma in order to heal, along with its leadership in reviving Indigenous culture.
Sacramento, California's capital, was selected for establishing an innovative youth program called the Children's Fund using local cannabis tax revenue to help finance programs addressing mental health, substance abuse, violence and homelessness.
