Beautiful beaches, tropical weather and the promise of leaving your everyday worries behind help portray Hawai’i as the ideal travel destination—a paradise—for anyone living on the mainland. However, the influx of tourists stretches already limited resources even thinner, causing Native Hawaiians to reap the negative consequences of having an economy so heavily reliant on the travel industry. According to the University of Hawai’i, tourism accounts for almost a quarter of the state’s economy.
Last year, Hawai’i saw over 9.6 million visitors. At the same time, high costs of living and other factors have caused residents to flee to other states, with a higher population of Native Hawaiians now residing on the mainland. Not everyone can leave or wants to leave, and those who remain are faced with dealing with the fallout.
“Tourists flock to our native land for escape, but they are escaping into a state of mind while participating in the destruction of a host people in a native place. To Hawaiians, daily life is neither soft nor kind. In fact, the political, economic, and cultural reality for most Hawaiians is hard, ugly, and cruel,” Native Hawaiian activist Haunani Kay Trask told Cultural Survival in 2010.
For years, locals have urged tourists from visiting the island, many taking to social media to voice their frustrations.
“Our locals feel like their homes are treated like a theme park and there’s no more privacy,” Keani Rawlins-Fernandez, a Native Hawaiian and local council member, told Business Insider in 2023. “We’ve heard stories of tourists trespassing on properties for photo opportunities. But they need to understand that unlike television or social-media posts, this is real life.”
The economic pressures from tourism can have significant and complex impacts on Native Hawaiian women’s reproductive rights, choices, and overall quality of life. Here’s an analysis of how this plays out:
Unemployment instability
According to a 2023 report by the State of Hawai’i from 2017 to 2021, an average of 47,431 Native Hawaiians worked in tourism per year, making up nearly 20% of the tourism workforce. An industry where work isn’t always guaranteed due to unpredictable shutdowns.
For them, tourism disruptors like the COVID-19 pandemic and natural disasters, such as the Maui wildfires where 51% of jobs are related to tourism, have devastating effects. According to Hawai’i’s Department of Business, Economic Development and Tourism, unemployment skyrocketed during the pandemic, causing Hawai’i to have one of the highest unemployment rates in the country, most significantly impacting younger workers, those with less education and low-wage workers.
Over 59% of Native Hawaiians in the industry are under the age of 40 and on average, they earned $38,825, around 12% less than the average worker who earns $44,004.
Native Hawaiian women and other Pacific Islanders working full-time, generally make only 66 cents for every dollar earned by a white man, according to the National Women’s Law Center. When part-time and part-year workers are included in the equation, the Native Hawaiian women only make 60 cents on the dollar.
This economic insecurity can limit access to consistent healthcare, including reproductive services.
Healthcare access
As Reckon reported in November, access to reproductive care varies greatly among each of the eight islands, but the high cost of living in tourist areas can push Native Hawaiian women to more remote, affordable locations where healthcare infrastructure is even more limited.
Moloka’i, which is considered the least developed of the islands, only has one emergency department, and Lanai has no maternal unit, so residents who need specialized care on either of these islands must fly out, which has become increasingly difficult since two of the airlines that service these islands shut down during the pandemic.
“There [are] very few care providers who are willing to drive to the rural communities, which means the majority of our rural moms literally drive on windy, treacherous roads just for a five-minute care appointment,” Kiana Rowley, co-founder of Pacific Birth Collective, said in November.
For those able to access healthcare, a lack of culturally competent medical personnel creates additional barriers. According to the Hawai’i State Data Center, more than a quarter of residents speak another language at home, but they aren’t always able to access care in those languages.
“I’ve observed these profound and harmful effects of language barriers on family members with limited English proficiency as they struggle with effectively communicating with health care providers, resulting in insensitive treatment and poor quality of care,” Tatyana Lum, Oahu native and 2023-24 health care ethics intern at Santa Clara University, wrote in May. She also stated that while Hawai’i enacted a Language Access Law in 2006, which mandates state agencies to provide live interpreters and written translation of documents to patients who need it, lack of funding and enforcement of this policy has prevented residents from reaping the benefits.
Language barriers have harrowing effects on the quality of healthcare patients receive. An October 2023 Obstetrics & Gynecology study found that patients with language barriers experienced xenophobia and racism, leading to lower gynecologic cancer screenings, more unscheduled C-sections and even forced sterilization.
Cultural erosion
Studies of the commodification of culture in Vietnam, Indigenous identity in the Andean and Amazonian regions of Peru, and other non-Western cultures all show the same—tourism has negative impacts on individuals native to the land.
The rise of “mainstream” or Westernized practices has led to issues for Indigenous midwives who’ve been carrying out traditional birth practices for generations.
In 2019, a Midwifery Restriction Law took effect, forcing licensure restrictions on birth workers whose cultural and traditional practices did not fall in line. Though an exemption in the original law allowed traditional Hawaiian midwives to keep working, it expired in July 2023.
“We are not against licensure, we have never been against licensure, for those who want to pursue that path,” Kiʻinaniokalani Kahoʻohanohano, lead plaintiff and Native Hawaiian cultural practitioner told The Guardian in February. “But the wisdom of our elders defies settler logic, which sees our teachings and rituals as less than.”
This July, a state court ruled that Native Hawaiian midwives would be able to resume pregnancy and birth care temporarily.
The commodification of Hawaiian culture extends beyond birth practices. Native Hawaiian activists and scholars Haunani Kay Trask and Mililani Trask explain in 2010 in Cultural Survival, “Tourism converts these attributes into profit. Hula dancers wear clown-like makeup, don costumes from a mix of Polynesian cultures, and behave in a smutty manner, rather than in a powerfully erotic manner. The hula is erotic because it depicts the energy of the life force – in the earth and among the people of the earth”
Environmental impacts
Sustaining the amount of resources, including land, to maintain the influx of tourism the state receives is nearly impossible. Estimates show that tourism accounts for over 21% of the island of Hawai’i’s (not the entire state’s) energy consumption, almost 45% of its water consumption, and almost 11% of its waste production.
This also results in more pollution. According to the Hawaii Wildlife Fund (HWF), every year about 15 to 20 tons of marine trash wash up on the shores of Hawai’i’s eight islands, 96% of which is plastic.
“Remember that you’re visiting an island. Whatever you ‘throw away’ here doesn’t have anywhere else to go,” Billy Middleton, a Hawai’i-based ocean technology engineer told SFGate in 2023. “‘Away’ is right around the corner and often ends up in the ocean.”
Additionally, various Hawaiian plants have been linked to medicinal purposes for sleep, anxiety, and pain. The flowers of `Ohi`a Lehua, for example, a flowering tree native to the islands, have traditionally been used to manage the pain of childbirth. Tourism development can lead to environmental degradation and deforestation, potentially affecting traditional medicinal plants used in reproductive health practices.
Drinking water
Hawai’i has faced natural impacts to its water supply like less rain and droughts, with tourism further contributing to the struggle to maintain enough clean, drinking water for residents.
The dryer islands also see higher amounts of tourism, adding to the unmeetable demand.
“We are in a water crisis; that has to be made very clear,” Wayne Tanaka, director of Sierra Club of Hawai’i, told CBS in April. “We may come to a point where we have to decide who gets water and who doesn’t.”
For example, the island of Oahu relies on an underground aquifer for residents. According to CBS, it takes one drop of water around 25 years to make it from the sky to the aquifer. Oahu was also hit with jet fuel leak in 2021, spilling 20,000 gallons of fuel into the drinking water supply, poisoning thousands and causing long-term health issues for some residents.
According to the United Nations, water crises are a gender issue. Women and girls who have specific needs for water tied to menstruation and pregnancy management, are disproportionately impacted by poor water quality. Water is also especially important for pregnant people, essential in supporting fetal development, with studies showing contaminated water is linked to fetal health complications and miscarriage.
Housing insecurity
The tourism-driven real estate market can lead to housing insecurity for Native Hawaiian women.
A 2020 report by Hawaiʻi Public Radio revealed that almost a quarter of homes in Hawai’i are purchased by out-of-state buyers, which is in part due to the state having the lowest property taxes in the country. But as tourists seek land in Hawai’i as investment properties or vacation homes, locals are struggling to afford to live there themselves.
According to CBS, about 15,000 native Hawaiians leave the state each year, with the mainland now home to a larger Hawaiian population than the islands.
In 2024, Hawai’i is the most expensive state to live in. According to online bill payment service doxo, residents spend an average of $3,091 on essentials like rent or mortgage, utilities and other household costs, which is 45% above the national average.
Studies show that housing and healthcare are linked; stress from costly or unstable living conditions can impact healthcare and where seeking care ranks on one’s priority list.
As multiple factors play into how tourism stretches beyond resorts to impact the overall quality of care Native Hawaiians can access, the economic contribution the industry makes to the state’s economy makes it a more complex issue.