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 .

The University of �鶹��ý 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 �鶹��ý 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 �鶹��ý 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 �鶹��ý 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 UH 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 UH Mānoa’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 �鶹��ý 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 �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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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, (UHERO) research fellow and UH Mānoa 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.

UHERO is housed in UH ����ԴDz�’s .

Maveric Abella is a spring 2024 graduate of the University of �鶹��ý at Mānoa (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 UH 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 �鶹��ý 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 �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.

The at the University of �鶹��ý (ARL at UH) 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 UH 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 UH. “ARL at UH is at the forefront of technological innovation for disaster response, which will be crucial for �鶹��ý as climate change continues to impact our state.”

COVID-19 pandemic

ARL at UH partnered with the �鶹��ý 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 �鶹��ý’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 �鶹��ý 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 UH who helped work on the forecasting tool. “It also allowed us to develop a strong relationship with other groups in �鶹��ý that had a shared passion for helping the community.”

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

“ARL at UH 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 UH Mānoa School of Nursing on the facemask tracking app allowed ARL at UH to help and serve the �鶹��ý community.”

ARL at UH 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 �鶹��ý 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 �鶹��ý. 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 �鶹��ý Department of Health. With a focus on internal medicine and an interest in infectious diseases, he will soon begin an internship with Kaiser Permanente �鶹��ý.

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 �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 .