The COVID‑19 pandemic revealed just how vital Hawaiʻi’s public health workers are—from keeping water safe to tracking disease outbreaks. A new (HJH&SW) Special Issue maps out challenges, innovations, and opportunities shaping the future of public health in the islands.

Guest edited by University of Hawaiʻi at ����ԴDz� faculty members Tetine Sentell and Rebekah Rodericks from the in the , and Lola Irvin from the (DOH) along with many statewide partners, this special issue serves as a roadmap for sustaining and expanding Hawaiʻi’s diverse public health workforce. Conceived in response to the extraordinary efforts and capacity strains experienced during the pandemic, it highlights the urgency and opportunity to grow a workforce in ways that reflect and serve �Ჹ�ɲ���ʻ��’s communities.

Workforce challenges and urgent needs

Public health professionals help ensure clean air and water, safe food, and healthy environments for all residents. Yet, chronic underfunding, staff shortages, and burnout threaten this essential work. A recent DOH survey found that 43% of DOH employees (compared to 36% of other state employees) were considering leaving within a year. The department also reported a 30% vacancy rate, highlighting the ongoing workforce shortage. Nationally, public health and prevention make up less than 5% of all health spending and are often a target for budget cuts.

Areas of innovation and resilience

Despite these challenges, the special issue also provides solutions and successes:

• (PDF): providing policymakers with data to plan for future needs.
• (PDF): expanding career pathways and training for students in water, toxicology, and other areas of environmental health.
• (PDF): meeting the needs of kūpuna (elders) and caregivers.
• (PDF): social workers contributing through advocacy, disaster response, grief counseling, health promotion, and policy change to advance health equity.
• (PDF): the Department of Public Health Sciences strengthening workforce capacity, diversity, and connectedness by centering students and community.
• (PDF): integrating Indigenous knowledge in student training to support public health workforce diversity.
• (PDF): building future leaders through training and leadership opportunities.

“This issue articulates the multifaceted importance of this workforce in the state, as well as its size, needs, opportunities and areas of innovation and achievement,” said Sentell, professor and chair of the Department of Public Health Sciences. “We thank the journal, our amazing expert editorial board, and the reviewers and authors of the special issue for their time and expertise that made this possible.”

At the Hawaiʻi Health Workforce Summit on September 6, 2025, ����Vlog�ٷ� and DOH hosted a session on supporting Hawaiʻi’s public health workforce. A follow-up webinar on October 7, co-hosted with the Hawaiʻi Public Health Institute, continued the discussion and shared resources, including a .

The University of Hawaiʻi Maui College Campus Health Center’s medical director has been recognized for her leadership in promoting vaccines and protecting community health.

Hannah Litt has been named the 2025 Immunization Champion for the State of Hawaiʻi by the Association of Immunization Managers. Funded by the Centers for Disease Control and Prevention, the award honors individuals who go above and beyond to promote immunizations for children and adults in their communities.

Litt was nominated by Heather Winfield-Smith, the Hawaiʻi Department of Health vaccine supply and distribution section coordinator, who praised her passion and commitment.

“Hannah Litt is passionate about making a difference for her community and has actively pursued opportunities and partnerships with the Hawaiʻi Department of Health and community providers to increase access to lifesaving preventative services, including immunizations,” said Winfield-Smith. “Her great work as a COVID-19 vaccine provider during the pandemic and willingness to provide care to the Maui community after the wildfires speak to her commitment to immunizations as a vital component of preventative health care services.”

Reflecting on the recognition, Litt emphasized that the award represents a team effort.

“This award reflects not only my commitment to promoting vaccine education and access, but also the tireless efforts of ����Vlog�ٷ� Maui College Health Center staff, including Leslie Watson (clinical medical assistant), and the tireless support of Chancellor Lui Hokoana and many others, who led the island’s COVID-19 mass vaccination efforts prior to my arrival,” Litt said. “I remain dedicated to building on that foundation to strengthen immunization awareness and protect the health of our students and communities across Maui.”

Hokoana said the honor shines a spotlight on the entire health center team.

“We’re so proud of Hannah and thrilled that she has been recognized in this way,” he said. “The announcement is a good way to remind all of Maui Nui that this is National Immunization Awareness Month and also to celebrate Hannah and the staff of our Campus Health Center. They are true public health leaders on our campus and in our community.”

Litt is currently enrolled in ����Vlog�ٷ� ����ԴDz�’s School of Nursing & Dental Hygiene’s post-master’s in organizational leadership .

New research on weakened COVID-19 vaccine responses in people with obesity and diabetes is the featured study in the latest issue of , conducted by the University of Hawaiʻi at ����ԴDz�’s (JABSOM), accompanied by cover art from a post-doctoral fellow.

The study, led by JABSOM third year medical student Brent Fujimoto and PhD alumna Olivia Smith in Professor Axel Lehrer’s lab, examines how different COVID-19 vaccines perform in individuals with obesity and diabetes—two conditions that increase vulnerability to the virus. Brien Haun, a postdoc fellow at Kapiʻolani CC, also contributed to the research and designed the cover art.

Funded by the Victoria S. and Bradley L. Geist Foundation via the Hawaiʻi Community Foundation, the study tested vaccine responses in mice with obesity and Type 1 and Type 2 diabetes. Results showed that all three conditions weakened immune responses post-vaccination, particularly in diabetic mice. However, mRNA vaccines produced strong antibody responses in all cases. Additionally, an enhanced protein vaccine developed at JABSOM (adjuvanted subunit vaccine) helped boost antibody strength in obese and diabetic mice.

mRNA vaccines remain highly effective, but people with obesity or diabetes may need additional doses or tailored interventions to enhance immune protection.
—Brent Fujimoto

“This shows us that mRNA vaccines can still be good at blocking virus responses and the CoVaccine adjuvanted subunit vaccine (enhanced protein vaccine) helps strengthen the quality of antibodies in obese and diabetic mice, making them better at recognizing and attaching to the virus,” said Smith.

Fujimoto emphasized the real-world impact. “mRNA vaccines remain highly effective, but people with obesity or diabetes may need additional doses or tailored interventions to enhance immune protection.”

Haun’s cover art, inspired by Zen philosophy and the Roman god Janus (god of beginnings and endings, gates and doors), symbolizes the delicate balance between resilience and fragility in immune responses.

“I’m so proud that our collaborative efforts in the middle of the Pacific are not only advancing our understanding of the virus, but it’s also earned us a spot on the cover of COVID,” Lehrer said. “These are achievements we can all be proud of and it’s a testament to the power of teamwork in research.”

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Babies born during the COVID-19 pandemic in India were more likely to have a lower birth weight (LBW) than those who were born before the pandemic. Newborns with LBW are at a higher risk of physical and cognitive deficits and behavioral abnormalities later in life.

The new research from the and the University of Notre Dame shows that the prevalence of LBW was 3% higher during the pandemic (20% vs. 17%). LBW is defined as a birth weight less than 2,500 grams or approximately 5.5 lbs.

“We suspect that the stress caused by the pandemic, combined with reduced access to health services, likely contributed to the higher prevalence of LBW in India. Additionally, the direct impact of the SARS-CoV-2 virus on pregnant women might have played a role,” said Tim Halliday, (����Vlog�ٷ�ERO) research fellow and ����Vlog�ٷ� ����ԴDz� associate professor of economics.

Halliday added, “The effects of the COVID-19 pandemic on birthweight in poorer and middle income countries such as India are likely to be more severe than in wealthier countries. For example, the evidence suggests very muted effects in the United States. Moreover, interpreting these findings requires a great deal of nuance. Particularly, we do not know of any national study in the U.S. based on the universe of births prior to and during the pandemic documenting large increases in LBW.”

The scientists analyzed data on birth outcomes during the pandemic (April 2020–April 2021) and before the pandemic (July 2014–December 2019). The study included 198,203 infants, with 11,851 born during the pandemic and 192,764 born before it.

The researchers explored differences by maternal education, household wealth, caste (hereditary classes of society) and religion. Significant differences in birth weight were observed based on religion, but not by maternal education, caste or wealth group. Non-Hindu infants were particularly affected, showing a 35-gram (approx. 1.2 ounces) decrease in birth weight during the pandemic.

“We demonstrate that there was an increased risk of low birth weight during the pandemic, underscoring the need for targeted interventions to support maternal and neonatal health during future crises,” Halliday said. “Our findings call for a strengthened focus on healthcare services to mitigate the adverse effects of pandemics on vulnerable populations, especially in low- and middle-income countries such as India.”

These findings were published in in June 2024.

����Vlog�ٷ�ERO is housed in ����Vlog�ٷ� ����ԴDz�’s .

Maveric Abella is a spring 2024 graduate of the University of Hawaiʻi at ����ԴDz� (JABSOM) who entered medical school during the peak of the COVID-19 pandemic. Abella’s path to becoming a physician has been marked by a series of transformative experiences and a deep-rooted commitment to serving her community.

Her passion for medicine was ignited during her high school years at Kamehameha Schools, where she interned at the . Initially drawn to clinical research, she found her interests shifted toward engineering during her undergraduate studies at Columbia University in New York City. However, it was a research expedition to the Marshall Islands, assessing the aftermath of nuclear tests, that pushed her toward a career in medicine. Witnessing the lack of healthcare access in rural communities left an impression on Abella, inspiring her to pursue a path focused on patient care.

“I wanted to know what patient care was like, getting to know patients on a one on one level, treating people. I think that was lost in engineering for me. It was very much a lot of research and development and you never really got to see the end result of that,” said Abella.

Entering JABSOM in 2020 during the pandemic, Abella’s resilience and dedication were further demonstrated as she embraced the challenges of virtual learning and adapted to the evolving healthcare landscape. Despite the obstacles, she found fulfillment in her clinical rotations, particularly during an OB-GYN rotation where she assisted in delivering a baby.

Check out more stories of our ����Vlog�ٷ� spring graduates

“Just establishing that rapport pretty early on and then actually being able to help deliver that baby, it just felt like it all came full circle,” she said.

Inspiring parents, upbringing

As Abella prepares to embark on the next phase of her career with a residency at Cedars Sinai in Los Angeles specializing in orthopedic surgery, she reflects on the influence of her upbringing and family in West Oʻahu. From her father’s unwitting influence during their home renovation projects to her mother’s support, Abella credits her family for nurturing her passion and determination.

She plans to return to Hawaiʻi to practice medicine to give back to the community that shaped her and is grateful for the educational opportunity at JABSOM, embodying the values of compassion, resilience and community engagement that define her journey.

“I think it’s something so special to be able to talk and learn medicine and treat people from your community,” said Abella. “Really, the kind of doctors that I shadowed at Queen’s West and the surgeons—that’s exactly who I wanted to be. And I knew I could do that if I went to medical school [at JABSOM].”

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An analysis of the COVID-19 pandemic’s effect on food supply chains in Hawaiʻi and Fiji has earned a faculty member in the (DURP) at the a national award.

Subhashni Raj, a DURP assistant professor, is one of 11 recipients of the ’s (FFAR’s) 2023 New Innovator Awards. Raj’s projects focus on understanding the role of Indigenous and ancestral food pathways in maintaining food security during a crisis.

“Establishing food security post-disaster is critically important, yet marginalized or vulnerable communities—especially island communities—are less likely to be prioritized in these scenarios,” said Raj. “My hope is that, through this comparative research we will undertake In Fiji and Hawaiʻi, we can demonstrate that creating space for traditional, cultural, ancestral, and Indigenous foodways in our communities is central to building resilience.”

Raj, who has a PhD in urban and regional planning from the State University of New York at Buffalo, was a Fulbright scholar and Kaufman doctoral fellow in food systems planning.

The New Innovator Award is bestowed on early-career scientists supporting research in one of FFAR’s research priority areas. Cumulatively, the recipients share a total of $4.8 million over three years.

The at the University of Hawaiʻi (ARL at ����Vlog�ٷ�) is known for its research in renewable energy, coastal defense for sea-level rise, cybersecurity and more but it has also been active in supporting the community, especially in times of crisis.

Maui wildfires

ARL at ����Vlog�ٷ� worked with the Maui tech community to distribute Starlink terminals to Lahaina as part of the wildfire recovery effort. Approximately 500 Starlink terminals were distributed over two days, reestablishing communications for emergency personnel and those affected by the wildfires. The team also developed an app to organize information about missing community members and coordinated financial and supply donations for the Lahaina community, acting as “boots on the ground” to support recovery on Maui.

“Our work is community-driven. We help meet the needs of many of the emerging problems �Ჹ�ɲ���ʻ��’s communities are facing,” said Margo Edwards, director of ARL at ����Vlog�ٷ�. “ARL at ����Vlog�ٷ� is at the forefront of technological innovation for disaster response, which will be crucial for Hawaiʻi as climate change continues to impact our state.”

COVID-19 pandemic

ARL at ����Vlog�ٷ� partnered with the Hawaiʻi Pandemic Applied Modeling Work Group to create a forecast tool that allowed epidemiologists to visualize the future state of the COVID-19 pandemic. The tool helped Hawaiʻi’s medical professionals prepare for hospital capacity and overflow.

“Several online tools exist that incorporate the SEIR [model for infectious disease dynamics] model, however, what we did was take those tools and customize it for Hawaiʻi to support �Ჹ�ɲ���ʻ��—a�����⾱�Բ� the lessons from around the world and also factoring in �Ჹ�ɲ���ʻ��’s unique circumstances,” said Baseem Missaghi, an application developer at ARL at ����Vlog�ٷ� who helped work on the forecasting tool. “It also allowed us to develop a strong relationship with other groups in Hawaiʻi that had a shared passion for helping the community.”

With the ����Vlog�ٷ� Mānoa College of Engineering, ARL at ����Vlog�ٷ� assisted Hawaiʻi physicians to develop a technique for ventilating up to four patients using a single ventilator with a “multi-split ventilator system.” ARL at ����Vlog�ٷ� also partnered with the ����Vlog�ٷ� Mānoa School of Nursing to develop and deploy an app to count how masks were being worn in Hawaiʻi.

“ARL at ����Vlog�ٷ� has the ability to quickly build services, tools and apps,” said Missaghi. “Our work with the Department of Education on a check-in app and the ����Vlog�ٷ� Mānoa School of Nursing on the facemask tracking app allowed ARL at ����Vlog�ٷ� to help and serve the Hawaiʻi community.”

ARL at ����Vlog�ٷ� is the fifth U.S. Navy-sponsored University-Affiliated Research Center, bringing in a total of $139 million since it was established in 2008.

Research from recent graduate Brock Santi of the University of Hawaiʻi at Manoa (JABSOM) explored the link between COVID-19, insurance coverage, race, ethnicity and vaccination, shedding light on previously unexplored aspects of the pandemic’s impact in Hawaiʻi. The study was on May 1. The study found different times during the pandemic provided disparities with different groups.

“We wanted to ensure that patients in the hospital, as soon as they were admitted for COVID-19, were receiving equal care,” explained Santi, who graduated less than a year ago and is currently working with the Hawaiʻi Department of Health. With a focus on internal medicine and an interest in infectious diseases, he will soon begin an internship with Kaiser Permanente Hawaiʻi.

The study looked at more than 1,000 people. Researchers found no significant differences in outcomes based on insurance type, challenging preconceptions about healthcare access. However, disparities among racial and ethnic groups surfaced, with Filipinos facing a higher risk of in-hospital mortality. The availability of vaccines proved to be a turning point, significantly reducing disparities in outcomes across different ethnicities.

Santi’s journey from medical student to published researcher highlights the importance of passion and dedication in pursuing meaningful research. “Find something that you’re passionate about,” he advises future students.

As Santi looks to the future, his enthusiasm for research remains, with plans to delve into RSV and flu research to continue making strides in understanding and combating infectious diseases.

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Amid the aftermath of heightened xenophobia and racism toward Asian Americans during the COVID-19 pandemic, faculty from the University of Hawaiʻi at ����ԴDz� exposed the challenges and resilience of these communities in three publications.

Yeonjung Jane Lee, Sophia Lau and Clifford Bersamira, alongside master of social work student Jaron Yamauchi, aimed to address anti-Asian racism by understanding the experiences of Asian American social workers with the current climate of division and hostility.

“We saw community members in action, mobilizing, advocating and supporting one another,” Lau said. “We felt it was imperative that, as frontline workers during the COVID-19 pandemic, Asian American social workers’ stories, experiences, as well as their recommendations on advocacy efforts to combat anti-Asian racism were heard.”

The team interviewed 17 social workers across the nation. Their collaborative efforts helped shed light on the multifaceted nature of discrimination and its implications. Their findings were published in , and .

Among the findings:

• The damaging impact of stereotypes, such as the model-minority and perpetual foreigner tropes, which perpetuate unfair pressures and ostracization.
• The urgent need for social work education to better equip students with tools for supporting marginalized communities and for workplaces to address bias and discrimination.
• The call for specialized support for older generations of Asian Americans, who are more vulnerable to mistreatment yet may hesitate to report incidents.

“Our hope is that this study encourages future research on how we can support Asian American social workers and those from other marginalized communities and address their needs,” Bersamira said.

Lau added, “Raising visibility about the unique circumstances that Asian Americans experience that includes their strengths and resiliency is critical on so many levels. In addition to the diverse ways bias and discrimination can look and be experienced, understanding the scope and intensity of these issues can support more meaningful interventions and outcomes.”

—By Maria Pou

One of the largest studies on wildlife activity—involving more than 220 researchers, 163 mammal species and 5,000 camera traps worldwide—reveals that wild animals react differently to human activity levels depending on where the animals live and what they eat. Hawaiʻi-based authors include University of Hawaiʻi at Mānoa researchers Melissa Price and Derek Risch.

The study used data from before and during the COVID-19 lockdowns to examine wild mammal behavior amid changing human activity levels. Bigger herbivores—plant-eating animals such as deer—tend to become more active when humans are around, while meat-eaters such as wolves tend to be less active, preferring to avoid risky encounters. Hawai‘i lacks native land-based mammals other than the Hawaiian Hoary Bat, an insectivore. Herbivores such as Axis Deer and feral goats, and small predators such as feral cats, were introduced by humans in the last few centuries.

“The tendency for large herbivores to become more active near humans presents a number of challenges especially here in Hawaiʻi where nearly all of our terrestrial mammals are non-native,” said Risch, a researcher in the . “Animals being more active and increasingly nocturnal around humans increases the likelihood of harmful human-wildlife conflicts like car strikes and disease transmission. People can help by appropriately disposing of trash and refraining from feeding wild animals.”

Why it matters

These findings highlight the importance of measures to minimize any detrimental effects of human disturbance on wildlife, especially in Hawaiʻi where many of our wildlife are endangered with less than a few thousand or even a few hundred individuals remaining.

“In the Hawaiian Islands, people are very active in coastal areas where our native seabirds and sea turtles are impacted by human activity, artificial lights, plastic pollution, and invasive cats, rats, and mongoose,” said Price, a ����Vlog�ٷ� Mānoa professor of wildlife. “Knowing that our choices matter is the first step in taking better care of our native plants and animals.”

Communities can help by turning off artificial lights during the seabird fledgling season in October and November, participating in beach clean-ups and other mālama ‘āina volunteer days, and keeping pets on a leash when outside.

In more remote areas, keeping human activity low may be necessary to protect sensitive species. In areas where people and animals overlap more, such as cities, nighttime is an important refuge for wildlife, and keeping it that way can help species survive—and humans thrive. For example, efforts such as the Dark Skies Initiative protect seabirds and sea turtles while improving human health and our ability to see the stars.

Unique opportunity

Urban animals such deer or feral pigs may become more active around people, as they get used to human presence and find food like garbage or plants, which they can access at night. But animals living farther from cities and other developed areas are more wary of encountering people.

“COVID-19 mobility restrictions gave researchers a truly unique opportunity to study how animals responded when the number of people sharing their landscape changed drastically over a relatively short period,” said lead author Cole Burton, an associate professor of forest resources management at University of British Columbia and Canada Research Chair in Terrestrial Mammal Conservation.

The study was published March 18, in .

Antibodies are versatile proteins that identify and eliminate microbial invaders, toxins and cancer cells. Monoclonal antibodies (mAbs)—highly purified antibodies developed in laboratories using biotechnology—have played an instrumental role in developing immunotherapies that have curbed the severity or prevented outbreaks of critical illnesses. Since the COVID-19 pandemic, global awareness and understanding of the benefits and potential of antibodies have become commonplace, and the market for antibodies is exponentially growing.

Decades before the COVID-19 pandemic, ’s Monoclonal Antibody Service Facility and Training Center (MASFTC) had been developing antibodies for public impact research and educational purposes. MASFTC has worked with researchers across the state and the country to develop hundreds of antibodies to support the development of potential immunotherapies for cancer, Zika, COVID-19 and the Ebola virus.

MASFTC has also provided antibodies to illuminate research related to wildlife diseases. In partnership with Thierry Work, wildlife disease specialist and project leader for the National Wildlife Health Center Honolulu Field Station, MASFTC developed mAbs that led to novel discoveries about Hawaiʻi’s endangered green sea turtles.

“As a fundamental tool for biomedical research, we are incredibly fortunate to have a facility in Hawaiʻi that operates as a partner and an engaged, constructive member of Hawaiʻi’s scientific community,” said Work. “I would find it hard to see how we could do some of this specialized research here without them.”

Expanding educational and training opportunities

In 1994, Kapiʻolani CC microbiology Professor John Berestecky expanded the facility into a training center to provide undergraduate and graduate students opportunities to engage in higher level laboratory activities through federal funding. Since then, more than 70 students have graduated from the program into advanced degrees or careers with biotech companies, the Hawaiʻi State Department of Health, clinical diagnostic labs and COVID-19 testing facilities.

“Our hope is to transform MASFTC into a ����Vlog�ٷ� core facility to be able to service any ����Vlog�ٷ� campus or department as well as other local companies and organizations that need antibody research and development,” said Berestecky. “I’m hoping our efforts allow us to eventually run a research lab to support and develop our antibody therapeutics capacity and initiatives.”

For more on MASFTC, . Noelo is ����Vlog�ٷ�’s research magazine from the .

Assistant Professor Michele Lani Bray of the University of Hawaiʻi at ����ԴDz� (NAWSON) was honored for her exceptional contributions to public health by the (HAH). Bray received the Public Health Award at the HAH Awards and Scholarship Gala on October 21, at the Hawaiʻi Convention Center in front of an audience of nursing leaders, healthcare colleagues and student scholarship recipients.

“The world is evolving, and our healthcare system must evolve with it,” said Bray, a Native Hawaiian scholar and a dedicated registered nurse with more than 30 years of experience as a pediatric and community health nurse.

As a nurse educator at NAWSON for more than 10 years, Bray has continued to advance public health in Hawaiʻi with her unwavering commitment. She is the director of the that provides registered nurses with the opportunity to attain a bachelor’s degree and further their professional growth. She also teaches in the where she shares her expertise and passion for public health to a new generation of nurse leaders.

Leading public health initiatives

Bray was a public health nurse for 10 years with the Hawaiʻi Department of Health. She spearheaded transformative initiatives including the School Health Asthma programs and was selected to be the H1N1 Liaison for the state—roles that demonstrated her commitment to improving the health of Hawaiʻi’s youth and her exceptional foresight in preparing for public health crises.

During the challenges of the COVID-19 pandemic, she helped spearhead essential pandemic response efforts, including training hundreds of contact tracers and orchestrating the deployment of nursing students as vaccinators.

Bray, a proud ����Vlog�ٷ� ����ԴDz� alumna, has been exceptionally committed to raising awareness among nurses regarding the growing importance of attaining knowledge and skills in public/population health to address major societal trends impacting health.

“Preparing nurses to work collaboratively with professionals and community members on initiatives that contribute to public health will help all of us in Hawaiʻi tackle the complex challenges of our time, such as climate change adaptation and disaster readiness,” she said. “Nurses and all health professionals really need to align our efforts to contribute to safeguarding the health and well-being of our communities, and the sustainability of our ʻāina.”

One reassuring, expert voice during the COVID-19 pandemic was University of Hawaiʻi at ����ԴDz� (JABSOM) alumna and Assistant Clinical Professor Theresa Wee, who blogged on practical healthcare, combined with personal encounters of loss, resilience and the guiding presence of faith. Readers related to her experiences, and found comfort and solace in her posts.

Wee published My Covid-19 Diary: Practical Tips and Scriptures for Improbable Times from an American Doctor, based on her blogging journey, which she started on March 23, 2020—the day Gov. David Ige ordered the first lockdown—and continued through December 2020.

“I found it comforting to journal my thoughts and decided to do it for one month,” Wee said. “I posted it daily, and soon, a growing number of people became regular readers. Some even told me they would wait for it daily, like the Star-Advertiser. I was encouraged to continue writing daily blogs and never ran out of things to write about.”

Wee shared her personal experiences, concerns and her solution and actions, and always ended her posts with an uplifting tip or message. She said she hopes others find the book helpful when they’re going through tough times.

“We all have good and dark times. I’m hoping that people can pick up this book at any time and find it helpful or encouraging. There are many valuable tips on maintaining physical health, managing stress and nurturing mental wellness amid trying times. I want people to know there is always hope,” she said.

Wee is a pediatric health and wellness expert who has been in private practice for 40 years. Her non-profit organization, “,” meets weekly at Central Oʻahu Regional Park to educate and encourage people of all ages to take that first step toward better health. The organization also offers “” with JABSOM students every fourth Sunday of the month at Kakaʻako Waterfront Park.

My Covid-19 Diary: Practical Tips and Scriptures for Improbable Times from an American Doctor is .

From aiding in recovery for patients with neurologic damage to analyzing the long-term brain effects of COVID-19, the University of Hawaiʻi at ����ԴDz�’s is at the forefront of deepening our understanding of the brain and how it impacts our behaviors.

The lab features state-of-the-art equipment, including an 72-channel electroencephalograph that measures electrical activity in the brain; functional magnetic resonance imaging that measures brain activity by detecting changes in blood oxygenation; and transcranial direct current stimulation—low, direct current delivered via electrodes on the head to help patients with brain injuries or neuropsychiatric conditions.

The ����Vlog�ٷ� lab is also one of the first in the country to use new technology called optically pumped magnetometry, which gives researchers a sharper image of brain activity, which is critical when we want to understand the brain.

“Understanding how the mind works and finding better tools to measure how our minds and our brains are not performing is critical to be able to understand them and to be able to do something about it,” said Jonas Vibell, lab director and assistant professor in the in the .

Investigating COVID-19 brain fog

Vibell’s team of approximately 10 students (undergraduate and graduate) are currently working on several projects, including one that is investigating the effects of COVID-19 on the brain. According to Vibell, many people who have contracted COVID-19 have reported experiencing brain fog. Through a nearly $40,000 grant from the ����Vlog�ٷ� ����ԴDz� , Vibell’s team will investigate the brain’s neuronal latencies to figure out why those who have contracted COVID-19 have reported experiencing brain fog. The researchers are currently recruiting volunteers to be part of the study. Anyone interested can .

“It’s really exciting and it really feels like we’re on the forefront of science,” said Kyra GauthierDickey, a Brain and Behavior Lab member and ����Vlog�ٷ� ����ԴDz� psychology PhD student. “Had I not been in this lab, I would have no idea that these kinds of fascinating projects are being created. To be able to work on something that has a local impact, it feels good.”

Cutting-edge research

Vibell also noted that studies of the brain have greatly influenced artificial intelligence (AI), where AI programming tries to mimic brain scans of how neurons are connected in the visual cortex (primary region of the brain that receives, integrates and processes visual information relayed from the retinas).

Aside from the COVID-19 study, GauthierDickey is focused on advancing classic brain experiments, such as the Posner Task that measures attention, into virtual reality. The ����Vlog�ٷ� Hilo alumna said that traditional lab experiments previously used 2D stimuli. She is interested in analyzing the results of 3D stimuli on human subjects to see how the added dimension is expressed in the brain.

“Even though we’re a small lab on Oʻahu, we do have a global impact and influence,” GauthierDickey said. “I think that Hawaiʻi can continue to grow as a scientific hub that’s internationally connected. I want to encourage everyone, especially our �첹����ʻ�徱�Բ�, to explore their curiosity and interest in science.”

Community involvement

The Brain and Behavior Lab, which is located in both the ����Vlog�ٷ� ����ԴDz� Biomedical Sciences building and Sakamaki Hall, partners with the ����Vlog�ٷ� ����ԴDz� and the Queen’s Medical Center on research projects. Vibell’s team also regularly visits local high schools to get students involved in STEM research. And, as research projects require participants, Vibell encourages anyone from the general public to email the lab if they are interested in becoming part of a study.

“Just like computers get better every 10 years, so do brain cameras,” Vibell said. “We can see things much, much clearer than we used to and this enables us to answer some of the questions, even some of the questions that have been asked for thousands of years. Based on these new abilities to see things I think we stand before quite a revolution, and the impact that this will have in the next five to 10 years will be dramatic in many fields.”

—By Marc Arakaki

While Hawaiʻi’s economic reliance on tourism took a major hit during the COVID-19 pandemic, the industry has periodically been punctured by shocks. For example, the 1991 recession, 9/11, the 2001 recession and the Great Recession all led to sharp declines in tourist numbers and spending.

A new and by Assistant Professor Steven Bond-Smith provides insights into how the state can diversify its economy, so when tourism contracts, other sectors expand. Bond-Smith has provided a short list of industries with potential to “make use of uniquely Hawaiʻi capabilities and are appropriate for our small scale.”

Economic opportunities

Based on recent research, Bond-Smith said economies grow by diversifying into related industries. Two industries are related if they both use similar capabilities, such as a shared pool of workers with particular skills. For example, Hawaiʻi’s expertise in caring for visitors could transfer to health support and rehabilitation in the healthcare industry, which would have very different demand dynamics than the tourism industry.

According to Bond-Smith, if some of those conditions to be successful are uniquely tied to Hawaiʻi, then those industries cannot easily shift somewhere else. For example, Hawaiʻi is located on the trans-Pacific internet cables. This makes it a potential location for data centers to host international web-based services that would act as a stepping stone for U.S. start-ups seeking to expand internationally.

“In this way, Hawaiʻi becomes a gateway to Asia for bits and bytes,” Bond-Smith said. “Similarly, Hawaiʻi could be the ideal stopover location for transit between Asia and South America, specifically targeting business travel. China and Brazil are two of the fastest growing economies in the world. And astronomy relies on Hawaiʻi’s high mountains and clear air, which brings a unique STEM industry that is otherwise difficult to come by.”

Hawaiʻi’s economy is small, so Bond-Smith said that we need to find industries that suit small economies. Finance is more suited to very large cities, such as London, New York and San Francisco. However, professional, scientific and technical services are much more common in metro areas of around one million people, such as Honolulu. Similarly, food manufacturing is common in smaller cities with surrounding agriculture, such as around Hilo.

Evolution of tourism

For a long time, tourism in Hawaiʻi experienced significant growth in both visitor numbers and expenditures. Technologies such as the jet engine, and a growing and increasingly wealthy middle class who wanted to vacation in Hawaiʻi, made tourism a lucrative industry. This translated into substantially higher real GDP per capita in Hawaiʻi than in the rest of the U.S. However, visitor spending stopped growing in recent decades while the number of tourists continued to increase. For several decades, the tourism industry has not contributed to growth in per capita GDP in the same way that it had in the past.

“All of this research agenda aims to identify which industries we should expect to see in Hawaiʻi and each of its counties, but are currently missing or weak,” Bond-Smith said. “Then policy makers and entrepreneurs can take a closer look at those industries to see what is preventing them from being stronger. Initiatives need to be designed with a commitment by governments and community organizations to address these barriers.”

To read the entire blog, visit .

����Vlog�ٷ�ERO is housed in ����Vlog�ٷ� ����ԴDz�’s .

More than three years since COVID-19 was introduced to the world, most Hawaiʻi residents consider their health to be good or excellent. But there are significant differences across socio-economic and demographic categories, including ethnicity, according to the results of a (����Vlog�ٷ�ERO).

The ����Vlog�ٷ�ERO Public Health Report, “Shaping Health in Hawaiʻi: The Influences of Poverty, Housing and Food Insecurity,” surveyed 1,575 adult residents across the state. The study examined the links between mental health, food security and socio-economic determinants, such as housing conditions and poverty status. The report shows that those experiencing housing insecurity, food insecurity and poverty were more likely to have been negatively impacted by the pandemic and reported worse physical and mental health.

“The survey underscores the intricate links among health, socio-economic status and lifestyle conditions in shaping individual well-being,” said lead researcher Ruben Juarez, ����Vlog�ٷ�ERO-HMSA Endowed Professor in Health Economics. “The pervasive impacts of the COVID-19 pandemic, particularly Long-COVID, highlight the continuous need for multifaceted interventions that address economic stability, housing security and equitable healthcare.”

Long-COVID affected 35% of respondents, up from 30% in 2022. Juarez said that there is a clear association between long-COVID and unemployment, with 49% of unemployed vs. 28% of employed individuals reporting long-COVID in May 2023.

Other key findings include:

• General health outcomes. More than 70% of participants considered their health to be good to excellent, but Native Hawaiians and Filipinos tended to report lower health ratings in comparison to Whites and Non-Filipino Asians. Individuals with high income or food security tended to have more positive health perceptions, while those dealing with the long-term effects of COVID-19, or who had delayed healthcare, especially mental health services, reported lower health scores.
• Mental health and well-being. One-third of participants reported symptoms of depression, with significant risk factors being unemployment and recent COVID-19 positivity. Housing instability, housing cost burden and poverty were also correlated with higher rates of depression symptoms. About 80% of respondents reported no food security issues, but—compared to findings in 2022—there was a small increase in those reporting very low food security. Unemployment, recent COVID-19 positivity, younger age, certain ethnicities such as Native Hawaiians and Filipinos, poverty and housing instability all correlated with increased food insecurity.

This report is based on results from the third wave of the ����Vlog�ٷ�ERO Rapid Health Survey conducted in June 2023 by ����Vlog�ٷ�ERO’s public health team, in partnership with the . In future reports, the team aims to increase the sample size of survey respondents and deepen its exploration of these findings, including exploring causality and cost, to offer a more thorough understanding of these complex social determinants of health.

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Due to the ongoing effects of the COVID-19 pandemic, the at the University of Hawaiʻi at ����ԴDz� (JABSOM) will temporarily stop accepting donors from Monday, July 10, until further notice.

Donors and their loved ones are urged to look for alternative arrangements at this time. If a donor dies during this temporary closure, loved ones or other appropriate individual(s) are kindly asked to notify the program.

In the meantime, new enrollment paperwork will continue to be screened with only acknowledgement of receipt until the program is able to accept new applicants.

The support from the community to the program has been tremendous. The program is grateful to all donors who ensure JABSOM’s mission of attaining lasting optimal health for all continues and looks forward to reopening in the near future.

For questions or more information, visit the .

Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky spoke to future doctors and faculty in a special forum at the University of Hawaiʻi at ����ԴDz� (JABSOM) during her visit to Hawaiʻi in March.

Walensky’s talk touched on parallels between her role as head of the COVID-19 pandemic response and her first year as an internal medicine resident during the AIDS epidemic in the 1990s; dealing with biases of being a woman in medicine and academia; and lessons learned during her career.

Motivated to fight diseases

As a child, Walensky always knew she wanted to become a physician and serve others, one patient at a time. However, she never anticipated that she would one day hold the title of former chief of the Division of Infectious Diseases at Massachusetts General Hospital, the teaching hospital of Harvard, be a prolific author of papers on the epidemiology of HIV or become the 19th director to lead the CDC.

“Embrace the pursuit” has been Walensky’s guiding principle throughout her illustrious career.

Describing her time as a first-year resident during the height of the AIDS epidemic, Walensky said she felt helpless while admitting patients into the hospital that either had HIV or were dying of AIDS.

“All you could really offer was your hand, an ear to listen to and your heart (in place of) where many people had been stigmatized and their families had left them,” she said.

But that all changed by the end of December 1995, when a cocktail of antiretroviral drugs was first FDA-approved to combat the AIDS epidemic.

“It was a time where all of a sudden, one day people did not have hope and the next day you could give them some potential for life expectancy—and it was really remarkable!” Walensky said.

Motivated and energized by how quickly science was changing, she “rushed toward the disease where very little was known, where people had been stigmatized and where the cost of antiretroviral therapy, at $15,000 a year, was too expensive for the populations that were contracting the disease.”

“Those patients were the ones that shaped my career, ignited my passion for public health and ignited my passion for giving a voice to those that didn’t really have a voice and for fighting diseases and disparities. And that is why I went into the field of infectious diseases,” Walensky said.

She acknowledged how tough the past few years have been on everyone due to the Coronavirus pandemic, especially on healthcare workers, and that the U.S. is in a better place since it started.

“We have this incredible opportunity (in healthcare), this incredible gift that we get to do the work that we do and give back to people. Embrace that gift everyday,” Walensky said. “Have some grace and take the time to take care of yourself so that you can give back in full force.”

Inspired medical student

As a second-year medical student finding himself pulled by many different interests including clinical care, health policy and public health, Anson Lee relished the fact that even Walensky did not go through medical school knowing the entire trajectory of her career.

He was excited to be in the audience to hear from the director of the CDC—a rare occasion for any medical school and a gem for JABSOM.

“For her to come to the ����Vlog�ٷ� medical school, I think it’s pretty crucial especially because we’re in the middle of the Pacific, there’s various patient populations here that you might not see on the continental U.S. and so the fact that she’s willing to speak with us here and trying to get a better perspective on the challenges that we’re facing here in Hawaiʻi—it’s great,” Lee said.

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From the abrupt switch to online learning in the fourth quarter of their 10th grade year to returning to in-person instruction in the last quarter of 12th grade, students in Hawaiʻi’s public high school class of 2022 experienced unprecedented disruptions to their high school careers. These experiences impacted the recent graduating class’ post-high college enrollment, as reflected in the data in this year’s report. Since 2009, the CCRI has provided information on the academic achievement of public school graduates and how well they have transitioned to college.

College enrollment rates have risen slightly to 51% after dipping to 50% at the start of the pandemic, but the rate for the class of 2022 is still four percentage points lower than pre-pandemic levels. This mirrors a nationwide trend of a slow recovery of college enrollment.

Pandemic impacts and recovery have differed for various student groups. Native Hawaiian students saw the largest declines in college enrollment rates, decreasing from 44% in the class of 2019 to 35% in the class of 2020, and further dropping to 34% in the classes of 2021 and 2022. The statewide on-time high school graduation rates also have dipped from 86% to 85%.

The CCRI also provides valuable insight into how public school graduates have transitioned into college-level coursework at the University of Hawaiʻi. For those from the class of 2022 who enrolled at ����Vlog�ٷ� (both four-year and community college campuses), 46% had completed a college-level math course in high school or enrolled in college-level math in their first semester, a one percentage point drop from the class of 2021. However, for English, the percentage of students who completed a college-level English course in high school or enrolled in a college-level English course in their first semester dropped six percentage points to 59%, its lowest level since 2016.

“The class of 2022 experienced the brunt of the pandemic, which disproportionately impacted our most vulnerable populations,” said Hawaiʻi State Department of Education (DOE) Deputy Superintendent Tammi Oyadomari-Chun. “We pay close attention to trends in CCRI outcomes since the CCRI provides the most consistent data of post-high outcomes of our graduates. The data are used to inform planning and support at the school and state levels as well as our partnership with the ����Vlog�ٷ�.”

• Related ����Vlog�ٷ� News story: Report shows college enrollment disrupted for Hawaiʻi’s class of 2020, March 24, 2021

“The CCRI is an objective view of the performance of the graduated class. The headline of this year’s CCRI is that we are not seeing as many of our students continuing their education after graduation as in the past. What gives us reason for optimism is we have alignment among the DOE, ����Vlog�ٷ� and the broader education community to ensure that our students have more opportunities to further their education after high school and find good careers right here at home in Hawaiʻi,” said Hawaiʻi P–20 Partnerships for Education Executive Director Stephen Schatz.

����Vlog�ٷ� President David Lassner added, “We are excited about the work to build pathways from high school to college and the workforce. Our 10 campuses have great programs for high school graduates, whether they envision becoming teachers, welders, doctors or entrepreneurs. And regardless of the pathway they choose, we want our public school graduates to know that there is a place for them at ����Vlog�ٷ�.”

Hawaiʻi’s CCRI reports are continuously recognized by national organizations, including the Data Quality Campaign, Achieve and the National Governors Association, as a leading example of collaboration between K–12 and higher education and for providing useful information on college readiness. The and can be found online.

Nearly 100% of Hawaiʻi residents aged 18—35 surveyed, utilized some form of digital or social media to find information about COVID-19 or related topics, according to by the University of Hawaiʻi at ����ԴDz� . Researchers hope their findings, published in the International Journal of Environmental Research and Public Health, will help to guide future policy and create equitable public health programs.

Led by Thompson School faculty member Michael Phillips and Professor and Interim Dean Tetine Sentell, the study was conducted by an interdisciplinary research team that included both doctoral and undergraduate public health students. The overall objective was to describe and better understand the health information pathways of young adults in the state of Hawaiʻi to provide practical insights for achieving health equity.

“With so much reliance on social media for health information searching and sharing there has been a continual growth in the need to develop active social media-based health promotion campaigns to combat misinformation,” said Phillips. “Our study supports that goal with practical information.”

Of the 324 participants surveyed for the study, 99.7% used digital or social media as a resource for COVID-19 or health-related topics. The two main digital media sources were Facebook and Instagram being used by the majority of participants; however, Twitter, TikTok, Reddit, Snapchat and YouTube were also mentioned. With the understanding that Facebook and Instagram tend to be heavily utilized by young adults, researchers found this information can be leveraged in public health interventions targeting young adults.

This study also highlighted the increasingly well known fact that health information searching and engagement is a distributed effort across social networks and not siloed for individuals. It was discovered that on average, the participants were discussing their own health with 2–3 people and listening to roughly the same number of people talk about health issues.

Respondents reported searching for digital health information themselves, as well as for parents, grandparents and children among others. The Pacific Islander group had the highest percentage of searching for “others” specifically.

Health communications within communities

Native Hawaiian, Pacific Islander and Filipino communities have experienced deep COVID-19 inequalities and are considered priority populations in public health planning and action in the state of Hawaiʻi. The study revealed insights into young adults’ social networks and information sources that can support and designing effective health communication.

“Creating public health communications that acknowledge and build from community strengths is critical to achieve goals of health equity,” said Sentell. “For Native Hawaiian, Pacific Islander, Filipino, as for many communities in Hawaiʻi, this includes intergenerational and communal perspectives of health and wellbeing.”

Enhancing trustworthiness of online content

This study highlighted and quantified characteristics in social networks across our communities. It found that many are left out of social networks, with more than 28% indicating they shared their health concerns with no one. In addition, social relationships can have both negative and positive influence on health information or health behaviors. Social networks can also have limited information in them. Thus, it is important to introduce trusted information into these networks.

“There is a need to expand the frequency and sophistication of health interventions utilizing digital media to enhance the trustworthiness of online content and digital health literacy,” said Phillips.

Other study authors include: Rosana Hernandez Weldon, Anam Maniar and Uday Patil, ; Uliana Kostareva, ; Julia Finn, Thompson school; and Joy Agner, University of Southern California.