Abstract
ABSTRACTThis article speaks to the abundance and wisdom of indigenous community members in Kalihi, an urban neighborhood in Honolulu, Hawaii. Its findings result from community members sharing their stories of health, health care, and healing. These stories evolved into a distinct framework for health—Pilinahā or the Four Connections Framework. Pilinahā addresses 4 vital connections that people typically seek to feel whole and healthy in their lives: connections to place, community, past and future, and one's better self. This article describes the origins, intent, key concepts, and implementation of this framework. By doing so, the authors hope to add to the growing body of work on community and indigenous well-being, further the dialogue with other indigenous communities, and collectively foster a more meaningful and effective health system for all.
Highlights
The larger context of this article is two discrepancies
The discrepancy between what we know as indigenous people and what we experience as participants in the health care system inspires us to remember our indigenous practices and reconnect our lahui to its traditional sources of healing and health
It motivates us to widen our gaze from biomedical measures of health and illness to Keywords: indigenous health, community health, Native Hawaiian, health equity, framework
Summary
The larger context of this article is two discrepancies. First, indigenous people come from a lineage of interconnected well-being that is abundant and sustainable [1, 2]. To help ensure maximum variation in perspectives, organizers used a sampling frame based on individuals’ 1) vocation, including local farmers, producers, educators, academic professors, and leaders of cultural, health, and youth organizations; 2) relationship to KKV, including staff, patients, and stakeholders; 3) relationship to the Kalihi community, including residents, service providers, and advocates; and 4) connection to the Native Hawaiian community, including individuals of Native Hawaiian descent and/or those representing organizations working with Native Hawaiian communities.
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