Lana Sue Ka‘opua, PhD, DCSW, LSW

1. How is the disparate incarceration of Native Hawaiians a health issue? What can be done? The Health and Well-Being of Indigenous People Lana Sue Ka‘opua, PhD, DCSW, LSW Associate Professor, Chair of MSW Program and Health Concentration Myron B. Thompson School of Social Work lskaopua@hawaii.edu

4. Native Hawaiians: Once a healthy people In contemporary times, burdened by persistent differences in Inter-generational poverty, homelessness, un- and under- employment High rates of disability and premature mortality associated with chronic health conditions Over-representation in criminal justice system --the most stunning of disparities

5. As with other indigenous peoples living in the US, Native Hawaiians: • receive poorer care and have worse outcomes than non-Hispanic whites • experience more criminal justice involvement than whites • social determinants strongly associated with disparate health outcomes and disparate involvement with criminal justice system Our understanding, our efforts need to transcend current organizational/conceptual silos

6. Indigenous People Over-Represented

7. Frequently marginalized prior to CJS involvement and at risk for poor health • Experience multiple health care transitions potentiating risk to those with chronic health conditions • Communities and families whose members have high rates of incarceration affected by phenomenon similar to “forced migration.” Homestead-Prison-Tent City “The beach becomes home. I was incarcerated on the mainland for five years and lost my family. No more financial support. No more job. Lucky get one tent. These things can drive us back to criminal activities to survive.”

8. History of Study HCR 27: Empowers Office of Hawaiian Affairs (OHA) to conduct study on disparate treatment of Native Hawaiians in criminal justice system (CJS) and mandates government agencies to release information (2009). STUDY: 3 “arms” describe disparate treatment of Native Hawaiians in the criminal justice system: • quantitative analysis of CJS statistics allows us to pinpoint critical points for intervention, • qualitative analysis of interviews (pa‘ahao, family members, correctional officials, forensic social workers, community advocates, volunteers) allow a deeper understanding of human impact, • document analysis allows us to nest findings in the context of indigenous Hawaiians. ( See: http://www.justicepolicy.org/research/1902 ) METHOD: Community Based Participatory Research approaches guide collection/analyses of all data. Social workers play important role throughout.

9. BACKGROUNDNative Hawaiians make up about 24% of state population & 39% of those under custody of Dept of Public Safety

10. Disproportionate impact of criminal justice system on Native Hawaiians accumulates at each CJS intercept.Native Hawaiians make up 24% of the general population of Hawai‘i, but 27% of all arrests, 33 % of people in pretrial detention, 29% of people sentenced to probation, 36% admitted to prison in 2009, 39% of the incarcerated population, 39% of releases on parole, and 41%of parole revocations.

11. HISTORIC TRAUMA, PERSISTENT MARGINALIZATION Numerically, it’s true. Native Hawaiians are overrepresented in the system. The crime might be committed in the city, but the people are from communities around the Hawaiian Homesteads. I think it goes back to historical and cultural trauma that Hawaiians as a whole have. (Correctional Official, Native Hawaiian from an Hawaiian Homestead)

12. Lokahi Triangle Ola (health) as harmony in three key and interconnected relationships.

13. Historic Trauma- Collective Remembering-Persistent Marginalization

14. KUANA‘IKE: Adversity-Resilience I never fit into school cause of bad experiences… I stopped going, started hanging out with my older brother and his friends. My older brother was using marijuana and cocaine. He told me, “try this.” I started smoking. I was 14 when I went to detention home. I was 17 years old when I had my daughter and the only way I knew how to support her was through crimes. At the age of 18, I went to jail. At the age of 21, I committed a crime that sentenced me to life. I did 25 years in prison. .. went up to the mainland for five years and I lost my family. Hawaiians have such hardship in life. That’s how we end up in prison. Trying to take care of our families …. turning to drugs. I went up to the mainland for five years and I lost my family—wife and kids. You know the worse thing about it?! You no can let your family know you going. Stagnant time, dead time, more time.They give us these requirements to do, but they don’t have the means for you to do your programs. They expect you to get a GED but no always get schooling in the prison…Scary to think about re-entry…no more nothing for go home to… no license, no transportation, no job, lucky get one tent, yeah? I tried my best to do the good and keep my mind straight, strong--- mentally and physically. If you start deteriorating mentally and physically, you are going to lose it. I have seen a lot of inmates lose it. Most of my friends died in prison. One went and hanged himself. I think I am the only one left in my group.(He Pa‘ahao Kane)

15. The term ‘re-entry’ assumes that you’re entering somewhere that you’ve already been. Often, released inmates are entering somewhere they’ve never been. It’s like culture shock. (Forensic social worker) It’s hard to fathom what it’s like to be doing stagnant time… only standing to do head count. That’s not encouraging to someone like me who comes from an abusive background—it’s important to know who you are, your culture..it’s the kind of healing you need to imua. Otherwise, you feel like a dollar symbol with a revolving door back to prison.(Pa‘ahaowahine) criminal, Invisible, marginalized

16. The pathway to health and healing necessitates going back to the roots.

17. Promote holistic, culturally-responsive approaches for individuals exiting the CJS and re-entering community. Involve policy makers and CJS officials in dialogue and community forums on issues such as sentence-setting and discretionary parole. Sustain & increase existing programs for Family Strengthening, drug treatment, anger management, job training. Increase use of “public health” or community-based approaches to increase and enhance community involvement in programs promoting re-entry. Participant Recommendations

18. National Association of Social Workers • Social justice--the signature principle of the NASW Code of Ethics (2010). • Dual commitment to “offenders” and communities consistently emphasized in NASW workforce reports and policy statements. (Roberts & Springer, 2007; Wilson, 2010) • Social work leadership encouraged in the areas of policy formulation and development of service delivery within a continuum-of-care framework. (Wilson, 2010). Advocacy, education, and partnership critical to leadership.

19. What social workers &social welfare researchers can do

20. Beginning to Plant Trauma Informed Care Initiative Culturally/linguistically appropriate instruments developed, trauma training for CJS personnel. Strengthening Families Affected by Incarceration Initiative - Inaugural conference builds coalition of policy-makers, allies, and former pa‘ahao; increases opportunities between pa‘ahaoand other groups. ‘Ike ‘aina healing and empowerment literacies Disseminate study findings in various formats to local and national groups. Increase & elevate dialogue .

21. HealthThe state of complete physical, mental, and social well-being and not merely the absence of disease (WHO)