While life expectancy across the U.S. declined significantly during the COVID-19 pandemic, a new study led by researchers at the University of �鶹��ý and the found that �鶹��ý experienced a smaller decline compared to national trends.

Yan Yan Wu, Michael Phillips and Kathryn L. Braun from the UH ��å�ԴDz� , along with Lance Ching and Claire Prieto from the , found that life expectancy in �鶹��ý declined by 1.4 years, from 82.1 in 2019 to 80.7 in 2021. Nationwide, the decline over the same period was 2.4 years, from 78.8 to 76.4. Their findings were published in the .

“The smaller magnitude and delayed timing of �鶹��ý’s decline may reflect the state’s geographic isolation and early implementation of public health interventions,” said Wu, the study’s lead author. “In 2022, life expectancy partially rebounded by 0.5 years in �鶹��ý and by 0.9 years nationally, with �鶹��ý remaining about four years higher than the U.S. average throughout the pandemic.”

“�鶹��ý ranks among the top U.S. states for COVID-19 vaccination coverage. By May 2023, data reported by the U.S. Centers for Disease Control and Prevention (CDC) showed that more than 90% of residents received at least one dose and more than 80% were considered fully vaccinated with the primary COVID-19 vaccine series,” said Ching, epidemiologist with the DOH Chronic Disease Prevention & Health Promotion Division. “These high vaccination levels—reached over the course of the pandemic—helped delay the peak of COVID-19 mortality in �鶹��ý by approximately six months compared to the national average and contributed to the state’s distinction of having the lowest age-adjusted COVID-19 death rate in the country.”

Key Findings

• Life expectancy in �鶹��ý remained stable from 2018 to 2020 (82.3, 82.1, and 82.0 years, respectively).
• A decline occurred in 2021 to 80.7 years, followed by a partial rebound to 81.2 years in 2022.
• Among males, life expectancy fell from 79.2 years in 2018 to 77.5 years in 2021, then rose to 78.2 years in 2022.
• Among females, life expectancy fell from 85.4 years in 2018 to 84.0 years in 2021, rebounding to 84.4 years in 2022.
• The gap between female and male life expectancy widened to 6.5 years in 2021 before narrowing to 6.2 years in 2022—the same as in 2019.
• Despite these fluctuations, �鶹��ý‘s overall decline in life expectancy remained less severe than the U.S. average throughout the pandemic.

Policy Implications

The researchers note that �鶹��ý‘s better outcomes underscore the effectiveness of early public health interventions, strong community engagement, and high vaccine uptake. They recommend that future policies build on these strengths by investing in rapid-response infrastructure and maintaining high vaccination coverage to better protect vulnerable communities during future disease outbreaks.

The COVID‑19 pandemic revealed just how vital �鶹��ý’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 Mānoa 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 �鶹��ý’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 �鶹��ý Health Workforce Summit on September 6, 2025, UH and DOH hosted a session on supporting �鶹��ý’s public health workforce. A follow-up webinar on October 7, co-hosted with the �鶹��ý Public Health Institute, continued the discussion and shared resources, including a .

Hanauma Bay Nature Preserve, a popular snorkeling destination that attracts nearly a million annual visitors, underwent a remarkable and rapid recovery when tourism ceased during the 2020 COVID-19 pandemic. A study from the University of �鶹��ý at Mānoa (HIMB), published in , found that this period of human absence led to clearer water, increased sightings of endangered Hawaiian monk seals, and more active fish populations.

“We took advantage of a unique ‘natural experiment’ created by the COVID-19 pandemic,” said Aviv Suan, project manager in HIMB’s Elizabeth Madin Lab, which leverages cutting-edge technology to research human impacts on marine ecosystems. “Hanauma Bay is normally a heavily visited site, but was completely closed to the public for seven months. We collected data on water quality, monk seal sightings, fish abundance, and fish behavior before, during, and after the closure. This allowed us to directly compare how the reef responded to different levels of human activity.”

By measuring the physical and biological health of the ecosystem, the research team found that when human visitors were absent, the reef in Hanauma Bay quickly returned to more natural levels. Fish densities changed, and vital herbivores such as parrotfish became more active in grazing algae.

“The ecosystem responded in remarkable ways,” said Elizabeth Madin, lead author of the study and principal investigator of the Elizabeth Madin Lab. “These kinds of changes happened quickly, suggesting that everyday human presence can have a real and measurable impact on reef health. It’s a powerful reminder of just how sensitive and responsive coral reef ecosystems are to our activity.”

Resilience and recovery

This research serves as a valuable case study for marine managers around the world, and provides a science-based roadmap for sustainable tourism and effective conservation strategies that can benefit both the environment and the economy.

“Putting caps on the number of visitors to reefs—especially those that are currently unregulated—could help restore lost ecological function and ease human pressures while still maintaining access,” said Madin. “Protecting these ecosystems doesn’t have to come at the cost of the economy. Yes, reef tourism brings in billions of dollars each year, both globally and here in �鶹��ý. In fact, research shows that many visitors are willing to pay more to experience healthier, more vibrant reefs. That means we can potentially reduce crowding and still support the tourism industry and everyone who depends on it–if we manage it wisely.”

The team’s findings provide a clear and powerful message: coral reef ecosystems are incredibly resilient, and at least some key parts of the ecosystem can begin to recover quickly when human pressures are reduced.

“This study is an example of how research at the UH can directly serve the people of �鶹��ý by helping to guide reef management, protect natural resources, and support a more sustainable future for both ecosystems and local communities,” said Suan.

A new drug delivery system developed by researchers at the University of �鶹��ý at Mānoa (JABSOM) and Sungkyunkwan University in South Korea may significantly reduce serious lung damage. The study was recently published in the .

The team designed tiny particles, called lipid nanoparticles (LNPs), to carry two drugs directly to immune cells in the lungs called neutrophils. Using COVID-19 as a model, they showed that the LNPs only targeted these lung cells, didn’t cause harm and reduced inflammation and early signs of scarring in mice.

The researchers hope this new method can also be used to treat other lung conditions like the flu and sepsis by targeting different immune cells or delivering other types of medicine.

“This project is a great example of how interdisciplinary research can facilitate the development of novel drug delivery platforms and evaluate their efficiency in animal models,” said Saguna Verma, JABSOM professor of tropical medicine. “Recently, LNP-based selective organ targeting (SORT) has been developed for specifically targeting the liver, lung or spleen. However, the strength of this study is that our LNPs are designed not only to target the lung but specifically to lung neutrophils.”

Researchers used UH’s high-security lab to safely study the virus. For the first time, they were able to send two drugs—DNase I and Sivelestat—directly to infection-fighting cells in the lungs using a new delivery method.

Normally, these immune cells release web-like traps (called NETs) to catch germs. However, when too many are made, they can harm the lungs and lead to serious problems, especially in illnesses like COVID-19, explained Juwon Park of UH ����ԴDz�.

“Although drugs that block NETs exist, they often require high doses due to instability in the body and nonspecific off-target effects,” Park said. “Our new approach overcomes these limitations by delivering both drugs directly to lung neutrophils using lipid nanoparticles, which improves drug effectiveness and minimizes side effects.”

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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 �鶹��ý at Mānoa’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 �鶹��ý 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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A study from the at the University of �鶹��ý at Mānoa, reveals the crucial role that Filipino cultural values played in fostering resilience and empowerment within the community during the COVID-19 pandemic.

The research, conducted by Clifford Bersamira, assistant professor, and Jethro Macaraeg, a master of social work graduate, was published in .

“Intersecting Kapwa, Resilience, and Empowerment: A Case Study of Filipinos in �鶹��ý During the COVID-19 Pandemic” addressed a significant gap in the existing literature on Filipino American resilience. Traditionally, the role of Filipino values in navigating adversity has been overlooked, but this study aims to bring these cultural values into the spotlight.

Focusing on the Filipino population in �鶹��ý, which Bersamira describes as a “unique context compared with other Filipinos in the U.S.,” the study emphasized the community’s ability to overcome challenges through deeply ingrained cultural values.

“We often hear these narratives about how hardworking and resilient Filipinos are in light of the conditions they face, such as during the pandemic,” Bersamira said. “This study helps us understand the role of our culture and values in overcoming challenges and transforming our circumstances.”

This research highlighted not only the resilience of the Filipino community during the pandemic but also serves as a call to action for integrating cultural values into the broader discourse on empowerment and resilience.

Key values emerged from interviews

The study utilized data from 17 semi-structured interviews and employed narrative analysis to identify key Filipino values that emerged in stories of resilience and empowerment. Among these values, kapwa (shared identity) and karangalan-dangal (internal dignity) were found to be central. In the context of resilience, values such as kagandahang-loob (acts of goodwill), pakikisama (companionship), lakas ng loob (inner strength), hiya (propriety), and bahala na (determination) were highlighted. Meanwhile, values like pakikibaka (resistance), pakiramdam (shared inner perception), karangalan-puri (external dignity), utang ng loob (debt of gratitude), and katarungan (justice) were associated with empowerment.

“Our research highlights how Filipino cultural values like kapwa (shared identity) and karangalan-dangal (internal dignity) are vital for fostering both resilience and empowerment, helping the community not just endure challenges but actively transform the systems that create them,” said Macaraeg.

The study’s findings suggest that a deeper understanding of Filipino American resilience and empowerment requires an appreciation of these specific cultural values. For researchers and service providers, the study advocates for developing resources that are grounded in these cultural traditions, ultimately inviting a rethinking of strategies to support the Filipino American community.

—By Maria Pou

Assistant Professor Frankie B. Hale of the (SONDH) at the University of �鶹��ý at Mānoa earned an award for writing excellence of a first-time school nurse author.

Hale, who teaches pathophysiology, among other undergraduate and graduate courses at NAWSON, served as first author of the manuscript, “Effects of the COVID-19 pandemic on school nurses’ resiliency and ability to cope: A mixed methods study in the state of �鶹��ý.” Co-authors included Deborah Mattheus, Betty Fletcher, Alexandra Michel and Holly B. Fontenot.

Hale’s honor is the First Publication Award from The Journal of School Nursing (JOSN).

“Winning this award from JOSN/Sage was humbling, and I am incredibly thankful for everyone involved,” Hale said. “I believe when we think of frontline nurses, school nurses should be among them. We need to know about the hard work school nurses input daily, from their front line, in their everyday effort to promote a healthy and safe school environment.”

Hale is now working on a follow-up study with Mattheus, exploring school nurses’ stress, resilience and workplace issues in the aftermath of the COVID-19 pandemic.

The manuscript was chosen from eligible manuscripts in 2023 in JOSN, a bi-monthly, peer-reviewed journal that focuses on improving the health of school children and the health of the school community, published by SAGE Publications.

Before joining academia in 2010, Hale served as a registered nurse for 14 years. She earned her bachelor of science in nursing from Howard University, specialized in nursing education for her master of science from Georgetown University and earned her PhD in nursing from UH ����ԴDz�.

An analysis of the COVID-19 pandemic’s effect on food supply chains in �鶹��ý 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 �鶹��ý, 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.

Amid the aftermath of heightened xenophobia and racism toward Asian Americans during the COVID-19 pandemic, faculty from the University of �鶹��ý at Mānoa 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. �鶹��ý-based authors include University of �鶹��ý 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 �鶹��ý 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 �鶹��ý 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 UH 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 .