tourism issues in hawaii

Share full article

Supported by

Hawaii Is a Paradise, but Whose?

A growing number of Hawaiians say that tourism isn’t working for them. Here’s how they are trying to change it.

By Tariro Mzezewa

Locals in Oahu know that the best way to get from Waikiki’s crowded beaches to the cool North Shore is to drive along the island’s eastern coast. The road is framed by mountains, ocean and greenery so lush and beautiful, it’s hard to focus the eye on one place for too long, for fear of missing the next scenic attraction.

On a recent trip along the route, something else stood out: the upside down Hawaiian flags flying at almost every stop.

The flag, which has the union jack in the bottom left corner, instead of the usual top left, hung in storefronts in Waikiki and was printed on T-shirts in Waimanalo, it was stuck on the bumpers of passing cars in Kailua and flying from the backs of trucks in Kahuku and other towns on the North Shore.

The flag has become a symbol of solidarity among Hawaiians who oppose the construction of a large new telescope on Mauna Kea, on the island of Hawaii . Mauna Kea, at 32,000 feet from seafloor to summit, and with 13,796 feet above sea level, is one of the best places in the northern hemisphere, if not the world, to observe the cosmos, experts say. The telescope’s proponents say that it will bring hundreds of jobs to the island and advance humanity’s study of space.

But it has faced fierce resistance from some native Hawaiians for whom Mauna Kea is sacred ground and a place of roots, and their allies. Opponents of the telescope say they are tired of having their land taken for purposes that benefit others and for the often elusive promise of jobs that fail to deliver in terms of numbers or a living wage.

“The struggle at Mauna Kea right now is one of the biggest issues that has realigned many cultural political relationships in Hawaii,” said Kyle Kajihiro, an activist and lecturer at the University of Hawaii at Manoa. “It’s really quite an amazing emergence of Hawaiian activism of cultural awareness.”

The battle over the telescope has revealed fissures that have long existed in Hawaii, a place that is all but synonymous with tourism — the most-popular destination for honeymoons in the United States and a bucket-list perennial. The fight has inspired actions around the islands, all relating to how land is used and who benefits from it.

The spirit of protest is most visible in Oahu, where in Kahuku demonstrators have spent the last several months fighting the construction of eight wind turbines, each standing at 568 feet — taller than the tallest skyscraper in Honolulu. Protesters say the turbines will have adverse long term health effects on the population. The company building them says there is no evidence to support those claims and promises to bring jobs to the area. More than 160 people have been arrested there.

52 Places to Go in 2020

We picked destinations to inspire you, delight you and motivate you to explore the world.

In southeast Oahu, in September, 28 people were arrested trying to block the building of a park and recreation center in Waimanalo, a largely agricultural town. The developers behind the center say it will bring jobs and create a new community space, but opponents fear it will be a magnet for tourists and will destroy the forest and beach used by locals.

In Honolulu, in May, Hilton employees protested, demanding a better contract and job protections. In July, hotel employees went on strike to protest what they said were low wages and the firing of 45 workers by Diamond Resorts, an operator of multiple properties in the United States and Europe. The company said it would turn one of its hotels into a timeshare resort, which requires fewer workers than a traditional hotel.

“We value our dedicated team members at The Modern Honolulu and we were pleased to reach a contract agreement that includes a significant pay increase,” a spokesman for Diamond said. “We are continuing our planned efforts to convert the property into a world-class vacation ownership resort.”

Most people in Hawaii, especially in the tourism industry work more than one job to barely get by, said Bryant de Venecia, communications organizer for the workers’ union, Unite Here Local 5, which represents resort workers.

“Mauna Kea has lit a fire for Hawaiians who are tired of watching their land, resources and work be used at the expense of their well-being,” he said.

Hawaii is the most expensive state to live in, according to the 2018 Annual Average Cost of Living Index by the Council for Community and Economic Research. Groceries, for example, cost 60 percent more than the national average.

“People are tired of being decorative — Hawaiians as well as people who live in Hawaii,” said Maile Meyer, who owns Nā Mea Hawai’i , a bookstore in Honolulu that sells products from smaller local makers. “Y ou’re seeing a phenomenon of natives gathering again and completely finding our way back to each other as part of the solution.”

Jobs aren’t enough

A common thread between these protests is that they are being led by locals. They say that since Europeans first arrived in the 18th century, Hawaiian land has been taken and misused by non-Hawaiians, and often to the detriment of Hawaiians and their traditions. The endeavors that have sparked these recent protests all promise jobs, just as tourism and defense have in the past.

But perhaps for the first time in recent Hawaiian history, natives and locals are saying the quality of these jobs is not good enough.

“We’re having to move away from quantity to quality,” said Laurien Baird Hokuli’i Helfrich-Nuss, the founder of Conscious Concepts , a company that works with local organizations on sustainable tourism initiatives. “Now that local people are getting more agency, they are learning more, going into a more curious space of saying ‘It’s great that this company is providing jobs, but what kind of jobs are they? Are they good jobs? Are they paying a livable wage?”

Tourism is the biggest driver of Hawaii’s economy, accounting for 21 percent of jobs. Nearly 10 million people visited the state in 2018 and in 2019, guest arrivals were expected to surpass that number, hitting a record high. And although more people are visiting Hawaii, they are spending less there.

Locals say that resorts are often owned and run by non-Hawaiians, with Hawaiian people employed in the lower-paying service jobs, and that development often benefits outsiders at the expense of native and local well-being.

“There historically hasn’t been enough consideration for how tourism and tourists can contribute to making life sustainable and really livable for the locals who serve them here,” Mr. de Venecia said.

More than a “play land”

The feeling of escape — of fleeing to a nearby paradise with stunning beaches and luxurious resorts — has long been Hawaii’s appeal to the traveling public. While the hottest trends in travel now are the search for authenticity and ways to experience local life, many people who visit Hawaii are looking to get away from daily life. They come to sit on the beach and drink a matai without thinking about much else. Their interaction with local culture is often limited to watching a hula show at the hotel luau.

“We realized a lot of folks who would visit us who would normally have more consciousness about history and social justice concerns seem to turn off that part of their brain when they think about Hawaii,” Mr. Kajihiro, the activist and lecturer, said, adding that people treat the islands as a “play land.”

But this decision to turn off their brains is hurting Hawaii and Hawaiians, he said.

While working for the American Friends Service Committee, the Quaker peace and justice organization, Mr. Kajihiro and his colleague Terrilee Kekoʻolani studied the environmental and social effects of colonization, militarization and overdevelopment of Hawaii. They learned that tourism was one of the industries with some of the most damaging effects on Oahu, he said, citing overcrowding, a higher cost of living and higher prices for goods.

The pair began offering alternative tours of the island, which they call DeTours, in 2004 and have seen increased interest in recent years. Their work was included in the recently published Duke University Press book “ Detours: A Decolonial Guide to Hawaii, ” a collection of essays, interviews and family histories about ethical and contextualized tourism in the islands edited by Hokulani K. Aikau and Vernadette Vicuña González.

The tours are given to groups of people who want to learn about Hawaii from the perspective of local Hawaiians. They include a deep history on the ways military life is hidden across the island. During a typical tour, guests go to Iolani Palace, the Hawaiian royal residence, then to Chinatown and some of the old neighborhoods where new immigrants to Hawaii traditionally settled. The next stop is usually Fort Shafter, the headquarters of the United States Army Pacific; then Camp Smith, but the main part of the tour is Ke Awalau o Puʻuloa — Pearl Harbor.

During a DeTours of Pearl Harbor, Mr. Kajihiro pauses in the “Oahu court” between the Pearl Harbor galleries and the museum and asks guests to look at the placards in the hallway. At the placard that says, “The Hawaiian Kingdom was overthrown in 1893,” he explains that this one sentence has been controversial with the United States government because it acknowledges the government-backed overthrow of Queen Lili’uokolani, which unsettles American claims to Hawaii. In the museum’s Attack Gallery, Mr. Kajihiro points to a small image of the Hono’uli’uli internment camp where Japanese people were held during World War II and uses it as a jumping-off point for a conversation about immigration and civil rights.

“People already come here with so many images and ideas about what Hawaii is that it’s really hard for them to see something different, so that’s why we started calling our work ‘DeTours,” Mr. Kajihiro said. “To swerve off the path that most people are going to see or understand and consume and shake it up by raising some more critical perspectives and introducing a lot of historical facts that are not so pleasant.”

A new type of tourism

The DeTours team is part of a movement looking to change what tourism means in Hawaii. Ms. Nuss, of Conscious Concepts, is originally from Oahu and returned in 2009 after working in hospitality in the Caribbean, New York, Miami and other places on the United States mainland.

“ I came home seeing something happening in Hawaii that I didn’t see when I left,” she said. “My generation was stepping into their leadership roles and doing it differently, reconnecting for a movement back to the land.”

But she quickly realized that what many companies were doing didn’t align with her vision for supporting tourism while ensuring the well-being of overworked Hawaiians.

In 2015, Ms. Nuss created her company to find ways to support Hawaiian businesses function sustainably while also remaining a key part of the most important sector in Oahu — tourism. Ms. Nuss has worked with farms, artists and nonprofit organizations to change their offerings so they can appeal to tourists, while still benefiting Hawaiians. A farm hoping to attract tourists to volunteer might turn to her to figure out the best ways to reach them. She described her work with as “consciously creating experiences for travelers and opportunities for locals.”

“I had a realization about how our tourism industry is presently run, which is coming from the commodification of culture,” she said. “I realized what was happening in my communities and the value systems that were driving it were contradictory to the form of tourism that I was being a part of.”

To give tourists a more authentic experience of “the real Hawaii,” the artists Roxy and Matt Ortiz, invite them into their studio in the Kaka’ako district of Honolulu. The couple is known for their elaborate murals of fanciful tree houses, which they create under the name Wooden Wave .

“When people come see us work, it gives them a totally different way to experience Hawaii,” Ms. Ortiz said. “And it’s a fun way for us to give tourists a different experience than they usually see in those brochures.”

In these studio visits, guests can see the couple’s work in progress, but also learn about ahupua’a, the ancient system of land division, in which the island was separated into slices, each slice running from the top of the local mountain to the shore. During the visit, Mr. Ortiz explains that each ahupua’a included forest area up high and a cultivated area below, and depending on the politics and economy of each ahupua’a, its size was different from another.

Mr. Ortiz said that even the slightest opportunity for tourists to think about how water and land have always worked together and why they hold importance to Hawaiians can encourage them to be more thoughtful when interacting with locals and the land and sea while visiting.

“When people have some of the history and context they can appreciate the art more and they can experience the island in a more meaningful way,” he said.

Another way tourists can learn about the land and engage with locals is by visiting a local farm like Kahumana Farm in Waianae on the west side of Oahu.

In November, Chloe Anderson, a therapist and teacher in California, visited the farm and stayed for four of her six days in Oahu. There she shared a room with others, did yoga, learned about the produce grown and cooked on the farm and generally felt like she got a more meaningful experience than she would have at a luxury resort, removed from daily Hawaiian life.

“We had like three or four different activities we would do every day,” she said. “But so many things were based off the farm and at the farm. We still had the experience of being a tourist in Hawaii and going on hikes and beach excursions, but also of experiencing something more.”

Some business owners are committed to staying in the tourism sector, and are trying to be as environmentally friendly as possible.

“I don’t think it’s reasonable to expect that people just won’t work in the main industry there is and I don’t think Hawaiians want to stop tourism altogether, but we are all working to find ways of doing it responsibly and thoughtfully,” said Shane Hiroshi Gibler, who co-owns Royal Hawaiian Catamaran , which is based in Honolulu and offers snorkel tours, sunset cruises and private charters.

On Mr. Gibler’s boat, guests are asked not to bring any plastic and recycling is available aboard. Mr. Gibler educates guests an education about fishing, food and the importance of the ocean and the land to Hawaiians. The Royal Catamaran team regularly gathers people to clean up the shoreline and has been working with the Surfrider Foundation to remove ghost nets — fishing nets that have been lost or left behind by fishing boats — from reefs or the ocean.

The idea, one echoed by Mr. Kajihiro, is to encourage tourists to think about how they can leave their resort, even for one day of their trip, and contribute to the place they are visiting.

“The point is to make folks more responsible when they come here and to interrogate this notion that Hawaii is somehow a place for them,” Mr. Kajihiro said. “If you are thinking about coming here, ask yourself: Who are you in relation to this place? Are you bringing something that will be of value to the host, the people who live here? What will be your impact and your legacy be?”

52 PLACES AND MUCH, MUCH MORE Discover the best places to go in 2020, and find more Travel coverage by following us on Twitter and Facebook . And sign up for our Travel Dispatch newsletter : Each week you’ll receive tips on traveling smarter, stories on hot destinations and access to photos from all over the world.

An earlier version of this article misstated the cost of groceries in Hawaii. They cost 60 percent more than the national average, not more than 60 percent of the national average.

How we handle corrections

Tariro Mzezewa is a travel reporter at The New York Times. More about Tariro Mzezewa

What’s Up in Space and Astronomy

Keep track of things going on in our solar system and all around the universe..

Never miss an eclipse, a meteor shower, a rocket launch or any other 2024 event that’s out of this world with our space and astronomy calendar .

Scientists may have discovered a major flaw in their understanding of dark energy, a mysterious cosmic force . That could be good news for the fate of the universe.

A new set of computer simulations, which take into account the effects of stars moving past our solar system, has effectively made it harder to predict Earth’s future and reconstruct its past.

Dante Lauretta, the planetary scientist who led the OSIRIS-REx mission to retrieve a handful of space dust , discusses his next final frontier.

A nova named T Coronae Borealis lit up the night about 80 years ago. Astronomers say it’s expected to put on another show in the coming months.

Is Pluto a planet? And what is a planet, anyway? Test your knowledge here .

United States

The Case for Caps: Overtourism in Hawaii

In January 2022, the Hawaii Tourism Authority (HTA) marked the first time Native Hawaiians— kanaka maoli —comprised a majority of its 12-member board of directors. As tourism represents the largest industry in Hawaii, around 21 percent of the state’s economy, this situation provided an opportunity for much greater influence and input from kanaka maoli on the policies that effectively determine the fate of their islands. In particular, the Board was exploring changes in fees, reservations, and education policy. At the heart of these changes, the Board discussed the fundamental issue of their mission : Their primary focus shifted from “marketing and brand management” to “destination management.” Through their Destination Management Action Plans (DMAPs), they aim to “rebuild, redefine and reset tourism’s direction,” with a “ focus [on] stabilization, recovery, and rebuilding. ” Unfortunately, these goals still fail to address the fundamental problem of tourism in Hawaii: The islands, their environment, and infrastructure cannot support the sheer number of tourists visiting the islands. To address this, the State of Hawaii must cap the number of visitors it allows into the islands.

Within the United States, Hawaii is one of the most popular tourist destinations. Despite its relatively modest population, Honolulu is the seventh most-visited city in the United States, with a record 2.75 million tourists in 2019. At the time, around 216,000 jobs were directly involved in or depended on the tourism industry. The surplus of tourists in 2019 allowed the State of Hawaii to raise over two billion dollars in taxes, but these benefits aren’t without their consequences.

While tourism is the largest sector of the state’s economy, it is also the root cause of many of Hawaii’s fundamental problems. Tourists, who outnumber locals seven to one, severely strain the infrastructure designed for Hawaii’s small population. Perhaps the lack of water best illustrates this phenomenon. Currently, tourism accounts for 44.7 percent of total water consumption. While local residents suffer from droughts and face restrictions on watering their lawns or washing their cars, the tourism industry enjoys seemingly unfettered access to Hawaii’s water supply. The tourism industry also consumes a significant amount of energy. Researchers from the University of Hawaii at Mānoa found that at one point, hotels and their guests consumed around 60 percent of Hawaii’s fuel and electricity. Even facing the challenges to the tourism sector during the coronavirus pandemic, in 2020, hotels alone were responsible for 8.7 percent of electricity consumption on the island of Oahu. Tourists are also responsible for propagating an already dire affordable housing crisis. For decades, tourists have participated in illegal short-term vacation rentals, eager to capitalize on the islands’ popularity. Expensive rentals on Airbnb and VRBO, and rising prices of homes, condos and apartments make housing practically unaffordable for local communities. Even with surplus taxation from the tourism sector, most of the money from tourism unfortunately leaves the islands in the hands of shareholders of the Hilton, Marriott, and other multinational hospitality companies.

These issues led resident sentiment to turn on tourism in recent years. During Hawaii’s strict Covid-19 policies, some residents claimed that they “got their islands back” on account of the lack of tourists. But when the islands reopened, many called for continued controls on tourism. In July 2021, the Mayor of Maui, for example, asked airlines to pause their post-lockdown frenzy of flights. An additional 2022 survey found that 67 percent of Hawaii residents believed that their island was “being run for tourists at the expense of local people,” and 66 percent supported halting approval of new hotels, condos, and timeshares. This shift in attitude served as an inspiration for the HTA’s new destination management vision.

One of HTA’s new destination management policies is educating tourists on the concepts of traveling pono (exploring with care) and mālama (to take care of). This change, however, arguably does nothing substantial to curb tourism’s greater effects. A recent effort by Hawaiian Airlines, for example, displayed a five minute video on being a “good tourist,” full of seemingly obvious reminders such as not approaching endangered species. But recent air incidents (such as Southwest Flight 1380, where passengers didn’t know how to use oxygen masks properly) illustrate that many people likely do not pay attention to the in-flight safety briefings. Most importantly, these “crash courses” fail to consider that even educated tourists are still tourists.

Education isn’t the only nonanswer being propagated in discussions surrounding tourism in Hawaii. One popular policy pushed by activists and politicians is the instatement of a tourist “green fee,” a $50 per visitor fee that would fund environmental conservation. This policy has already been implemented in other destinations in the Pacific, but their success is questionable. In the Micronesian nation of Palau, for example, a $100 “Pristine Paradise Environmental Fee” added to the cost of flights had little observable effect on the trend of tourism in Palau. In Hawaii, a territory that receives an average of 195 percent more (or an average of 7.45 million more) tourists a year than Palau, a green fee would certainly bring in revenue –about $400 million based on 2019 numbers–but would not do much to address the sheer number of tourists the islands see every year.

Ultimately, the problem lies in the proximity that the mainland United States has to the island, facilitating the massive influx of tourists. Even amid a pandemic, visits to Hawaii skyrocketed when tourism reopened . Faced with a lack of hotel rooms and rental cars, tourists even resorted to renting out U-Hauls and camping on the beach, while local residents were ordered to decrease their water usage to provide for the resorts. No matter the barriers, economic or otherwise, tourists will flock to Hawaii. Ultimately, the solution to Hawaii’s tourism problem is for the government to step in and limit the amount of tourists allowed to travel to the islands.

The most straightforward way for the government to limit tourists would be supplementing the proposed “green fee” with a “green cap” on tourists, a policy that has already been implemented in Bhutan . The HTA and private organizations are already pursuing some similar policies on a smaller scale by enforcing a reservations policy for beaches and state parks in the islands, limiting the number of visitors to popular sites like Diamond Head. According to the CEO of HTA John De Fries, limiting visits to state parks reduces the daily tourist strain on these locations, “ protecting its natural environment and cultural sites.” A similar statewide implementation would reduce the strain on the existing infrastructure. Limiting visitors to Hawaii, however, does raise a cause for concern. As the largest single sector of Hawaii’s economy, a downsizing of tourism would have consequences for the state’s 242,000 employees in tourism, and could send a ripple effect through its connected industries.

Hawaii’s current relationship with tourism is unsustainable for the islands and their residents. But despite the well-intentioned efforts, policies, and proposals of the Tourism Authority and activist groups, these fail to address the root of the problem: tourists put immense pressure on Hawaii’s modest infrastructure–whether it be roads, water, or energy–and educating them or making them pay a fee does not change this. Ultimately, Hawaii must be seen through the words of Maui Mayor Michael Victorino: “a community first and a vacation destination second.” The State of Hawaii must put heavier emphasis on its community, even at the detriment of tourism. Until then, maybe rethink your vacation.

Environment

The Coronavirus Crisis

Facing economic devastation, hawaii attempts to revive tourism.

Ryan Finnerty

Hawaiian Airlines jets outside Daniel K. Inouye International Airport in Honolulu. Hawaii has seen a more than 90% reduction in the number of air travelers arriving since the start of the pandemic. Ryan Finnerty/Hawaii Public Radio hide caption

Hawaii has some the highest levels of unemployment in the country. Joblessness rose to Great Depression-levels in the spring following shutdown orders that local authorities issued in March.

In addition to the business closures and restrictions on large gatherings common across the country, Hawaii was also the first state to require out-of-state travelers to quarantine upon arrival.

That, combined with public concerns over the safety of flying, tanked Hawaii's tourism-centric economy.

For seven months, Honolulu's Daniel K. Inouye International Airport has been largely empty. The concourses have been marked by shuttered concessions shops and public address announcements directing people to quarantine.

Tracking the coronavirus around the U.S.: See how your state is doing

Shots - Health News

Coronavirus maps: how severe is your state's outbreak.

The scene represents a stark reversal from the time before COVID-19. Roughly 30,000 people arrived in Hawaii every day during 2019, although the number approached 40,000 during the summer travel season.

That number has declined dramatically since the onset of the pandemic. During the initial lockdowns in the spring, the number of daily arrivals dropped below 500.

The drop coincided with Gov. David Ige's order in March that all travelers arriving from out of state undergo a 14-day self-quarantine upon arrival.

While the measure was initially successful in preventing the spread of the virus, it came at a steep cost. The drop in visitors sent a shockwave through the state's $18 billion tourism industry, which represents the foundation of Hawaii's economy.

Unemployment surged, reaching almost 24% in April and May.

Although the situation has improved somewhat since then, 1 in 6 workers are still out of a job. They are people like Christina Hilfiker, who was a restaurant server in the popular tourist destination of Haleiwa on Oahu's iconic North Shore.

Hilfiker lost her job in March and said she is struggling to get by.

"I'm sort of hanging on by a thread, relying on friends and family. You can get a lot of miles out of a loaf of bread and a jar of peanut butter," she said in an interview.

Coronavirus Live Updates

Air travel high: tsa screens 1 million for 1st time since march.

Hilfiker is one of thousands of Hawaii residents who have experienced lengthy delays in getting approved for jobless benefits.

Like many states, Hawaii's unemployment system has been overwhelmed, saddling applicants with the financial and emotional stress of no income for weeks and even months.

Hawaii's local businesses are also struggling. They have endured not just one, but two full lockdowns — one in the spring and a second later in the summer when the state experienced a surge of new infections.

Many businesses were being sustained by federal benefits from the CARES Act, but those have long since run out.

"It's just really crushing not to get the help," said Melissa Bow, owner of Via Gelato, an ice cream shop in the Honolulu neighborhood of Kaimuki.

She said in an interview that during the second lockdown , many small-business owners were at the end of their rope, struggling to make rent with being able to generate revenue.

"They're just so, so tired," Bow said of her fellow entrepreneurs. "Not sleeping at night, zero income for a long time. No help on the horizon. They're thinking about shuttering their business."

However, help may be on the way. The state of Hawaii recently adjusted its travel rules , allowing incoming passengers who test negative for the coronavirus to skip the quarantine.

That is significant because tourism represents nearly a quarter of Hawaii's economy , according to Sumner La Croix, an economist with the University of Hawaii Economic Research Organization and author of Hawai'i: Eight Hundred Years of Political and Economic Change.

"That's a huge chunk and if that 23% isn't operating, it will look something like depression here," La Croix said.

'Will I Have A Place To Live?' Scrambling To Survive After $600 Benefits End

On the first day of the relaxed travel rules, the number arriving airline passengers more than tripled compared with recent weeks but still represented a fraction of the pre-pandemic level.

Major players in Hawaii's visitor industry hope the relaxed quarantine will help relaunch tourism but are preparing for a slow recovery .

Hawaiian Airlines recently announced layoffs for 30% of its staff. Ahead of the changes, Avi Mannis, the airline's senior vice president of marketing, predicted that the relaxed rules will entice some travelers to fly but many are expected to stay grounded well into 2021.

"How quickly we can put people back to work is going to depend on the success of public health interventions, and testing, and screening that the state is putting in place," Mannis said.

The importance of public health measures has been reiterated by local hoteliers, for whom the lucrative end-of-year holiday season is normally a critical period.

Currently, only around half of the hotels have reopened, according to the Hawaii Lodging and Tourism Association. The group's president, Mufi Hannemann, said it is not yet clear if people will be willing to travel.

"I think October, and how we handle October into November, will be critical in determining what kind of holiday season we have here," he said, adding that a new spike in cases would likely depress travel again.

A winter surge of COVID-19 would be devastating — not just for hotels and other businesses but for the 80,000 Hawaii workers currently out of a job.

public health

We've detected unusual activity from your computer network

To continue, please click the box below to let us know you're not a robot.

Why did this happen?

Please make sure your browser supports JavaScript and cookies and that you are not blocking them from loading. For more information you can review our Terms of Service and Cookie Policy .

For inquiries related to this message please contact our support team and provide the reference ID below.

International edition
Australia edition
Europe edition

Hawaii reopens with coronavirus traveler testing program. Wakiki Beach, Honolulu, on 22 October.

Can Hawaii reset its stressed out tourism industry after the pandemic?

The islands has been feeling the weight of a tourism industry that has ballooned to what many believe is beyond the islands’ capacity

On a recent Sunday morning, Makua Beach looks like the picture of paradise.

A stretch of soft, yellow sand lies on a strip of land between the lush Waianae mountain range and the deep blue Pacific Ocean on the north-west coast of Oahu. Waves crash against rocks along the beach, and a monk seal can be seen swimming near the shore.

While this is a place that would make a striking Instagram post for visitors, it has become a source of sadness for Micah Doane. His grandmother’s family was one of many who were evicted from the area to make way for military training infrastructure during the second world war. Doane grew up taking trips to Makua with his family, including his grandmother’s brother, Ivanhoe Naiwi, who shared the heartache of the family’s displacement and passion for preserving the area with Doane.

“All of our trips down here as youngsters were with him. He kind of raised us out here,” Doane said. “As a kid growing up, we became protective over the place.”

About an hour’s drive from Honolulu, Makua has historically been remote from the bustling crowds of Waikiki. But over the last decade, Doane has seen an influx of visitors coming to Makua Beach, especially as people started tagging the “secret” beach on social media. On this particular Sunday, the parking area outside the beach is packed early with beachgoers, some of whom brought snorkeling gear to catch a glimpse of dolphins.

Doane has long been concerned about the impact snorkelers have on the Hawaiian spinner dolphins, who use the area as a place to sleep.

Makua is also popular for a cave hike, which is illegal, and camping on the beach, also illegal. With no bathrooms nearby, strands of toilet paper can be seen in bushes along the beach along with other trash that accumulates in the area.

A co-founder of Protectors of Paradise, a non-profit that promotes stewardship in the area, Doane and a group of volunteers hold weekly beach cleanups and try to educate visitors on how to respect the area. Yet the group can only cover so much ground.

Huge swell hits Hawaii, Haleiwa, Oahu, in January.

“You see every day these disrespectful people come and do whatever they want … You have your kids that are getting older, and our parents’ generation and our kupuna [elders] that are getting older, and you think it’s sad that they’re not able to enjoy these things,” Doane said. “It’s to the point where it’s kind of hurt an entire community.”

This area on the west side of Oahu is just one of many places throughout the islands that has been feeling the weight of a tourism industry that has ballooned to what many believe is beyond the islands’ capacity.

A rise in vacation rentals, of which there were 23,000 in the islands in 2018, and the growth of social media saw more tourists visiting Hawaii and increasingly going into its more residential and protected areas. In 2019, 10 million visitors came to Hawaii, which has a population of about 1.5 million. It was the highest number of tourists in a single year the islands had seen in its history.

The phenomenon, known as overtourism , has seen travelers overwhelm not just Hawaii but many of the US national parks and has frustrated residents in cities around Europe , like Venice and Barcelona, and elsewhere.

The Covid-19 pandemic delivered an unusual mixture of pain from economic loss and relief to residents of places that have gotten used to crowds of tourists. In Hawaii, locals hiked popular trails and visited beaches that are usually clogged by tourists. Traffic was noticeably lighter, and things in the islands were generally calmer.

Things are already looking much different in 2021. About 30,000 travelers are now flying into Hawaii each day, over 80% of the number of travelers that were flying in during the same time in 2019. Around the islands, it seems that tourism as it was before the pandemic is coming back.

While that means jobs are back, surveys from the Hawaii Tourism Authority (HTA), the state’s tourism agency, have shown local residents are taking on an increasingly negative opinion of tourism, even in light of the pandemic. In 2020, over half of the respondents to the survey agreed that tourism had brought more problems than benefits.

“There’s an understanding, even within the [tourism] industry … based upon our experience in 2019, that tourism shouldn’t come back the way it was – an unmanaged state,” said Frank Haas, a tourism industry expert based at the University of Hawaii (UH). “That in my mind is pretty clear. The question is, who’s going to pick up the torch and develop a good management plan?”

A balancing act

The parking lot of Hanauma Bay nature preserve, a popular beach and snorkeling spot for visitors on the southern tip of Oahu, is completely empty, save for a few employee cars. The spot would typically be open on this Monday and packed with visitors. But after the pandemic, the Honolulu parks department, which manages the beach, closed the beach for an additional day so the bay gets rest two days each week.

“You can see how clear the waters are right now because it’s a closed day. When you come and it’s an open day, it’ll be very milky, [with sand] stirred up by all the visitors,” said Ku’ulei Rodgers, a researcher with the Hawaii Institute of Marine Biology at UH. This sedimentation can affect the health of coral colonies in the preserve, the larger of which have been dying over the last few years.

Rodgers and other researchers at UH have utilized the pandemic as an opportunity to better study the impact visitors have on Hanauma Bay. Along with clearer waters, the researchers noticed schools of larger fish, like jackfish and milkfish, foraging in the bay and even spotted a few monk seals resting on the beach for the first time in years.

While the bay is a beautiful spot to lounge and snorkel for humans, it is an important refuge for fish. A lack of predators in the bay and low impacts from heavy storm surf and freshwater make the bay a uniquely safe place for fish, of which there have been up to 400 species in the preserve.

While impacts from visitors pale in comparison with the effects of climate change, which has caused devastating bleaching events in the bay’s water, Honolulu’s parks department has for years taken on a series of measures to curtail overcrowding at the preserve.

To enter Hanauma Bay, along with paying a $12 fee, visitors must watch a 10-minute education video on the history and importance of the bay as a nature preserve. In December, when the city reopened Hanauma Bay to visitors, it halved the number of people who could watch the video at once, essentially halving the number of visitors who can visit Hanauma Bay each day to just over 1,000.

The parks department is continuously evaluating the bay’s visitor capacity, teaming up with Rodgers and other researchers to find the balance between access to Hanauma Bay and protection of it.

“[The research] is a big tool for us to determine where that sweet spot is, what’s the right number of people visiting where we can get them in and have them enjoy this beautiful natural treasure but at the same time not having a completely detrimental impact on the nature that’s attracting them,” said Nathan Serota, a spokesperson for the Honolulu department of parks and recreation.

Surf breaks on Oahu’s coast. The weight of a tourism industry has ballooned to what many believe is beyond the islands’ capacity.

Hanauma Bay’s reservation system has existed for years, but after the massive number of tourists in recent years, the state is starting to implement similar systems at other popular tourist spots to combat overcrowding.

After severe flooding closed Haena state park on Kauai to visitors in 2018, local residents were treated to empty roads and beaches. The state’s department of land and natural resources (DLNR) worked with the local community to develop a reservation system that caps the number of visitors at the park at 900, down from the 3,000 before the flood.

Along with setting up reservation systems, the state is also turning toward increased fees in an attempt to control crowds. The fee to hike Oahu’s famous Diamond Head volcanic cone have doubled for out-of-state visitors, it now costs $90 to park a vehicle carrying over 26 people. And the state legislature is considering a bill that would implement a $20 “green fee” – which places like Palau and Bhutan have implemented – that would go toward a fund to promote the state’s environmental goals.

“We’re more cognizant of the impacts that tourism has,” Serota said. “You’re starting to see that you can’t just have a policy of let’s bring in as many tourists and possible and reap the benefits. Now we have to look at managing it more effectively to see how we can create an experience and not have a negative impact on the local population as well.”

Destination management

But change isn’t going to be easy. In its last five-year strategic plan, released in 2020 before the pandemic, HTA said that destination management – a term that in recent years has been used to describe the solutions to overtourism – has become a major focus of the agency, which has historically been in charge of the state’s tourism marketing. “The continuous drive to increase visitor numbers has taken its toll on our natural environment and people,” the agency said in its plan .

Over the last few months, HTA has released three action plans for destination management on Kauai, Maui and the Big Island. It expects to release Oahu’s plan later this summer.

The influx of visitors seen at the end of 2019 “was enough to start driving our work in a direction to say how do we transition from a destination marketing organization to a destination management organization?” said Kalani Kaanaana, director of Hawaiian cultural affairs and natural resources at HTA.

Kaanaana was one of 14 Native Hawaiian authors who put out a declaration calling for action toward long-term sustainability in the islands, including managing the relationship between residents and visitors. Nearly 3,000 individuals, community groups and businesses, including HTA, have signed on to the declaration.

Destination management will not be an easy task for HTA as the agency faces limited authority to carry out some of its recommendations. Regulation of short-term vacation rentals, for example, which greatly affects the number of tourists, is handled on a county level. And the state’s legislature recently moved to cut HTA funding and strip the agency of some of its responsibilities, with legislators saying the agency should focus on marketing.

Haas, a former vice-president of HTA, said state leaders, who have been enmeshed in the complicated politics of tourism, need to develop a coordinated plan to address tourism for any long-term change to happen.

“At least in the short term, we don’t have a lot of viable options for tourism as an economic driver,” said Haas. “We really need to figure out how to thoughtfully manage and until we do that, it’s just going to be haphazard.”

Hawaii holidays
Coronavirus

Most viewed

Sunday, April 28, 2024 76° Today's Paper

Hawaii’s overtourism may get worse than ever

By Lebawit Lily Girma Bloomberg News

May 6, 2023

Business Editors' Picks

Share on Facebook
Share by email

CINDY ELLEN RUSSELL / [email protected]

Beachgoers gather on the shores of Waikiki in 2021.

JAMM AQUINO / [email protected]

A tour group crosses Kamehameha Highway toward Turtle Beach in Laniakea in 2021.

In early 2021, Hawaii’s tourism board kicked off a trailblazing plan to inject authentic Native Hawaiian culture into every facet of its visitor industry, using it to help protect its communities and fragile places while deepening the tourist experience. Now, just three years in, the “Malama Hawaii” or “Care for Hawaii” initiative to push sustainable tourism may be on its way out.

As a busy summer travel season impends, Hawaii’s legislators have allocated no funds for the state’s 25-year-old tourism office in the proposed state tourism budget bill for fiscal year 2023-2024, which will kick off on July 1. And late in April, lawmakers considered two bills to disband the Hawaii Tourism Authority and replace it with an agency that would focus less on marketing Hawaii to tourists and more on managing the destination’s resources.

The bill was deferred and HTA remains in place, but numerous knowledgeable people who spoke to Bloomberg predict that excluding the agency in the final budget would significantly curtail HTA’s efforts in managing tourism on the islands.

John De Fries, chief executive officer at the Hawaii Tourism Authority, said in a newsletter that without funding, the HTA’s work in destination management, visitor education and brand marketing work will be jeopardized. The HTA, he said, will be “making tough decisions in the coming days” about canceling existing contracts and “ongoing community work.”

Legislators said the tourism office can tap into $30 million in unused funds from the American Rescue Plan Act to continue managing tourism — equal to half the money that the HTA had requested for the upcoming fiscal year.

All this poses an existential threat to the cultural activities, festivals and community-led volunteer opportunities that have recently made Hawaii such a vibrant place to visit — as well as improved crowd control measures protecting the state’s most fragile places.

Tourism tensions

The friction between legislators and Hawaii’s tourism office is not new. It reached a boiling point in 2019, when Hawaii’s 1.5 million residents watched it become a case study in over- tourism amid 10.4 million annual arrivals. Among the side effects of that unregulated industry: garbage littering popular sights, beaches so crowded you’d have a hard time finding space for a towel, coral reefs suffering from bleaching, traffic snarls caused by selfie-snapping tourists, and sacred places being desecrated by graffiti and spray paint.

For many Hawaiians inside and outside the government, HTA was a victim of its own success marketing the state. And for that, HTA began giving itself a major overhaul.

A leadership of largely white executives was replaced with one almost entirely comprising Native Hawaiians; the agency’s goals were refocused on making tourism more sustainable for everyone.

The “Malama Hawaii” campaign took off. It spread responsible tourism messaging to visitors before and during their trips and created sustainable experiences to help visitors be more mindful of the fragility of Hawaii’s beautiful and sacred places. It also helped disperse foot traffic to reduce the harmful impacts of mass tourism.

The changes helped attract more affluent, higher- spending travelers, which explains why in 2023 the state is projected to bring in a record $1 billion in hotel bed taxes. Those guests, in turn, were happy to contribute to educational community-led activities such as beach cleanups in Kauai, tours of a chocolate farm on Oahu and joining cultural walks in Waikiki.

For some Hawaiian legislators that progress was too slow. The government has since reined in the tourism office’s spending powers, cut off its direct line of funding from hotel taxes and began requiring state approval to award contracts and pass annual budgets.

“The Legislature didn’t think (the change) was going fast enough,” says Frank Haas, president of Marketing Management Inc. and a consultant for the HTA’s 2020-25 strategic plan for sustainable tourism development.

Mondy Jamshidi-Kent, a professor of travel management at the University of Hawaii at Manoa, says some legislators have been committed for at least five years to disbanding the HTA, having made up their minds before De Fries could get to work.

“I’m disappointed to have learned that they don’t incorporate the last three years of statistically measured improvement,” she says, arguing that the current discussions are driven more by emotion than data. ”This is a disturbing threat to our democratic process.”

Jamshidi-Kent speculates that this “new way of tourism,” which centers Hawaiian culture in business operations and adds layers of true accountability, may have been perceived as threatening by certain members of the government. “It doesn’t make sense why the Legislature is trying to fix something that’s working.”

Seeds of sustainability

In a short period, HTA had made measurable progress. More than 25% of mainland visitors to Hawaii surveyed during the fourth quarter of 2022 reported seeing messaging before and during their trip about “caring for and respecting Hawaii’s culture, people, and environment.”

On the sustainability front, a growing number of state parks now require reservations; the 4,000-acre ‘Iao Valley State Monument on Maui just became the fourth state park using an advance booking system for out-of-state visitors, as of May 1. The number of community- run volunteer experiences for tourists via HTA-funded pilot programs led by the Native Hawaiian Hospitality Association, in collaboration with nonprofit organization Travel2change, more than doubled, from 30 to about 70, in recent years.

All this helped improve sentiment among residents about tourism, explains Malia Sanders, executive director of NaHAA. A quarterly survey taken in the fall showed that almost half of 1,949 Hawaii residents surveyed statewide said they believed tourism was being better managed than previously; there was little change, however, in the number saying their own island is being run for tourists at the expense of residents.

What comes next

Those calling for the closure of HTA favor building a different kind of tourism office that would focus exclusively on sustainable management of tourism, not marketing to tourists. It would take time to establish, and it will come with costs.

At risk are programs and experiences that are as valuable to travelers as to locals: HTA-sponsored events like the Hawaii Book and Music Festival on Oahu, which celebrates Hawaiian heritage and cultures through storytelling and song; the Hawaii Food & Wine Festival; the Maui Ukulele Festival; and the Big Island Chocolate Festival. These festivals help put Hawaiian artists and culture in the spotlight, giving visitors a richer experience and locals meaningful revenue streams.

Unless Gov. Josh Green vetoes the proposed state budget, many of these programs would probably suffer cuts in the next three to six months.

“To take all that away is terrifying,” says Sanders of the Native Hawaiian Hospitality Association. Also at risk would be the reservations systems and crowd control measures that are currently mitigating over- tourism in Hawaii’s most fragile and beautiful corners.

One solution would involve rethinking the HTA’s place in the government, giving it authority to work collaboratively with such other agencies as the Department of Land and Natural Resources, says tourism marketing veteran Haas. Goodwill to support such a radical restructuring may be lacking.

Outreach should be a part of any future agency’s mission, argues Sanders. Without it, she asks, “How do we attract the right kind of visitor that is willing to be educated while they are here — willing to contribute and be a part of social change?”

Jamshidi-Kent agrees. Marketing, she explains, makes the difference between telling visitors, “Hey, come to Hawaii, lay on the beach, have a mai tai,” to saying, “Hey, we would love you to come, but remember this is our home. You have to take care of this place.”

Subscriber Favorites

David shapiro: discord drives the beat at the heart of hart, missing maui county documents complicate lahaina fire probe, south dakota gov. noem defends executing 14-month-old pet dog, hawaii water polo team wins big west championship, hawaii tourism agency campaign targets u.s. market, more business.

New round of debt forgiveness begins for Hawaii healthcare professionals

U.S. Air Force awards $13B contract to develop next ‘Doomsday’ plane

Biden delays menthol cigarette ban amid pushback

USDA mandates lower salmonella levels in chicken

Looking back.

April 24, 2001: Hawaii public school teachers ratify contract, ending 19-day strike

Today's news
Reviews and deals
Climate change
2024 election
Fall allergies
Health news
Mental health
Sexual health
Family health
So mini ways
Unapologetically
Buying guides

Entertainment

How to Watch
My watchlist
Stock market
Biden economy
Personal finance
Stocks: most active
Stocks: gainers
Stocks: losers
Trending tickers
World indices
US Treasury bonds
Top mutual funds
Highest open interest
Highest implied volatility
Currency converter
Basic materials
Communication services
Consumer cyclical
Consumer defensive
Financial services
Industrials
Real estate
Mutual funds
Credit cards
Balance transfer cards
Cash back cards
Rewards cards
Travel cards
Online checking
High-yield savings
Money market
Home equity loan
Personal loans
Student loans
Options pit
Fantasy football
Pro Pick 'Em
College Pick 'Em
Fantasy baseball
Fantasy hockey
Fantasy basketball
Download the app
Daily fantasy
Scores and schedules
GameChannel
World Baseball Classic
Premier League
CONCACAF League
Champions League
Motorsports
Horse racing
Newsletters

New on Yahoo

Privacy Dashboard

Hawaii’s Overtourism Problem May Get Worse Than Ever

(Bloomberg) -- In early 2021, Hawaii’s tourism board kicked off a trailblazing plan to inject authentic Native Hawaiian culture into every facet of its visitor industry, using it to help protect its communities and fragile places while deepening the tourist experience. Now, just three years in, the “Malama Hawaii” or “Care for Hawaii” initiative to push sustainable tourism may be on its way out.

NFL Draft: Packers fan upset with team's 1st pick, and Lions fans hilariously rubbed it in

Not everyone was thrilled with their team's draft on Thursday night.

Formula 1: Miami Grand Prix sends cease and desist letter to prevent Donald Trump fundraiser during race

Race organizers say they'll revoke a Trump fundraiser's suite license if he holds an event for the former president on Sunday at the race.

NFL Draft: Bears take Iowa punter, who immediately receives funny text from Caleb Williams

There haven't been many punters drafted in the fourth round or higher like Tory Taylor just was. Chicago's No. 1 overall pick welcomed him in unique fashion.

NFL to allow players to wear protective Guardian Caps in games beginning with 2024 season

The NFL will allow players to wear protective Guardian Caps during games beginning with the 2024 season. The caps were previously mandated for practices.

Joel Embiid not happy that Knicks fans took over 76ers home playoff games: It 'pisses me off'

"I don't think that should happen. It's not OK."

The expanded 12-team College Football Playoff is here — and it already has problems

There is cause for excitement around the new playoff format. There's also lots of complaints and criticism to go around.

Cowboys owner Jerry Jones compared his 2024 NFL Draft strategy to robbing a bank

Dallas Cowboys owner Jerry Jones made an amusing analogy when asked why the team selected three offensive lineman in the 2024 NFL Draft.

Korey Cunningham, former NFL lineman, found dead in New Jersey home at age 28

Cunningham played 31 games in the NFL with the Cardinals, Patriots and Giants.

2024 NFL Draft grades: Kansas City Chiefs get even richer with one of the best hauls this year

Yahoo Sports' Charles McDonald breaks down the Chiefs' 2024 draft.

Michael Penix Jr. said Kirk Cousins called him after Falcons' surprising draft selection

Atlanta Falcons first-round draft pick Michael Penix Jr. said quarterback Kirk Cousins called him after he was picked No. 8 overall in one of the 2024 NFL Draft's more puzzling selections.

Panthers owner David Tepper stopped by Charlotte bar that criticized his draft strategy

“Please Let The Coach & GM Pick This Year" read a sign out front.

Falcons ownership endorsed the Michael Penix Jr. pick and put Kirk Cousins on the clock. Now what?

Cousins doesn’t have a track record inside the team. Unlike Alex Smith, Brett Favre and Aaron Rodgers, there are no entrenched locker room soldiers behind him.

2024 NFL Draft grades: Baltimore Ravens do what they do best — let good players fall into their laps

Yahoo Sports' Charles McDonald breaks down the Ravens' 2024 draft.

Legendary basketball star Candace Parker announces her retirement

Candace Parker announces her retirement from women's basketball after 16 seasons in the WNBA and a stellar college career at Tennessee.

2024 NFL Draft grades: Minnesota Vikings risked a lot to get J.J. McCarthy and Dallas Turner

Yahoo Sports' Charles McDonald breaks down the Vikings' 2024 draft.

NBA playoffs: Shorthanded Bucks fall in 3-1 hole to Pacers after losing Bobby Portis to ejection

A shorthanded Bucks roster and red-hot 3-point shooting by the Pacers put Milwaukee on the brink of elimination.

Ford Ranger vs Chevy Colorado: 2024 Comparison

Expert advice comparing the 2024 Chevrolet Colorado and 2024 Ford Ranger's power, towing, mpg, safety, price and specs, including the Raptor and ZR2.

2024 NFL Draft grades: Green Bay Packers' stockpile of picks put to good use

Yahoo Sports' Charles McDonald breaks down the Packers' 2024 draft.

New Bills WR Keon Coleman makes hilarious first impression with Macy's shopping advice and more

If nothing else, the Bills have a player who can recognize a good deal.

Legislation aims to help tourism recover

Share this story

Jamm Aquino / Star-Advertiser

Beachgoers are seen on the sand in Waikiki on Friday, April 26, 2024, in Waikiki. The hotel booking pace for the state is in the red through December, and most months are down by double digits for Maui.

HONOLULU — Hawai‘i’s hotel booking pace is in the red through December, but legislative funding has allowed the Hawai‘i Tourism Authority to support a new multimillion-dollar marketing campaign aimed at U.S. visitors.

The new campaign highlights the local people and places making the Hawaiian Islands an unforgettable destination.

While the Maui fires have created challenges for the visitor industry statewide, other factors also have dampened tourism. They include uncertainty in the U.S. economy, the strength of the dollar against some international currencies, increased competition from other destinations and the community-driven push toward managing rather than growing tourism.

It didn’t help that HTA spent the prior two years defunded by the Legislature and at times fighting not only for money but for its existence. A procurement battle over the awarding of the state’s top U.S. tourism award took energy out of the market.

The importance of the U.S. market to Hawai‘i cannot be understated. In 2023, about 7.42 million visitors came to Hawai‘i from the U.S., which represented about 77 percent of all the visitors that came to Hawai‘i. They spent $15.9 billion, which also was about 77 percent of the $20.7 billion in total visitor spending across all markets.

In the meantime, the Hawai‘i Visitors &Convention Bureau, HTA’s contractor for its top U.S. market, kept running COVID-19-era malama (take care of) Hawai‘i campaigns. Research shows that HVCB’s malama campaigns were effective compared with other campaigns from other destination marketing organizations. Still, industry critics said it grew tired after COVID-19 and the Maui wildfires, and it left some visitors confused about whether Hawai‘i really wanted them to visit.

Now HTA and the messaging in its latest U.S. multimillion dollar marketing campaign is trying to pivot. HTA began the state legislative session tracking 135 measures, including several carryover bills that would have eliminated the organization but have since died.

The agency is now looking to emerge from this session with an appropriation in House Bill 1800 that funds 30 positions and a $63 million recurring budget, ensuring the agency’s funding will continue without specific legislative approval.

Mufi Hannemann, HTA board chairman and Hawai‘i Lodging &Tourism Association president and CEO, said, “This is a significant, significant achievement for HTA and I want to thank all of you that had a part of this. Yes, there were some of us out there leading the charge, but at the end of the day it required all of you to help us make the case to enable us to get $63 million for an operating budget. We’ve gone through two years of being defunded and gone through some very stormy discussions about if we should even exist anymore. All of that is past us, in my opinion.”

The finance bill goes to a full vote this week, but it’s looking good for HTA since conferees from the Senate and House agreed to fund HTA at the higher of the two levels proposed. That funding would allow the agency to support HVCB’s new campaign called The People. The Place. The Hawaiian Islands.

Jay Talwar, HVCB senior vice president of marketing and chief marketing officer, shared the new campaign with the HTA board Thursday. Funding for the new campaign comes out of HVCB’s total U.S. market budget for 2024, which is more than $18.9 million, including phase two of the Maui Marketing Recovery Plan and grant money from the U.S. Economic Development Administration.

HVCB’s total contract from HTA to market the U.S. is nearly $38.4 million for the initial 2-1/2-year term, with an option for one two-year extension.

The contract came after HVCB, the only agency ever to market the U.S. contract for HTA, initially won an award and then lost it to the Council of Native Hawaiian Advancement, whose contract was eventually also rescinded.

Both entities protested, but those protests ended when the HTA board split the contract and awarded the U.S. branding piece to HVCB and awarded CNHA with a stewardship contract that runs across all markets.The compromise ended the distractions and allowed the contractors to respond to new market conditions.

New campaign

HVCB’s new campaign keeps many of the values of the malama campaign, which was evaluated highly by SMARInsights as part of HVCB’s return on investment in 2023.

Alisha Valentine, SMARInsights vice president, told the HTA board Thursday that for every marketing dollar spent by HVCB in 2023, about $407 was returned to the state.

“This (return on investment) is 43 percent above average. Post-COVID, the average return on investment for state (destination marketing organizations) is $285,” Valentine said. “However, for state offices with paid media investment over $5 million since 2021, the average ROI is $219, making the return on the 2023 media buy 86 percent higher than the average competitor.”

HVCB’s newest campaign is similar to the malama campaign; however, it shifts from the COVID-19-era tone of telling visitors how to act and instead conveys that caring is expected by having locals and visitors model it.

“You can feel a difference. There’s a welcoming here,” Talwar said as he highlighted images and videos from the campaign. “There are people smiling and happy to see you. We are looking to allow the benefits of tourism to reach a broader part of the community — the chefs, the agricultural producers, the farmers, the fisherman, the ranchers, culturalists, musicians, the lei makers, the fashion designers, the artists. (It’s) a large group of people who need support from tourism to allow them to continue their crafts and their lifestyle here on the islands. They are all coming to life in the campaign.”

On Maui, chef Kyle Kawakami of Maui Fresh Streatery is shown feeding and interacting with residents and visitors against the backdrop of the lush greens of upcountry Maui.

On Oahu, Meleana Estes, author of “Lei Aloha,” shares the cultural significance of the lei.

On Kauai, Hanalei Strings, a small music shop owned by Kirk and Tora Smart and their son Eli Smart, shows the magic of the small island where visitors might walk into the store and have an impromptu jam session, then later run into the participants on the beach.

HTA said additional ambassadors are in the pipeline.

“I actually know most of the ambassadors,” said ‘Iwalani Kuali‘i Kaho‘ohanohano, the HTA senior brand manager who has oversight for the U.S. contract. “It’s really special for me to be able to see them sharing their stories in this capacity in the tourism industry to our market and beyond. That’s what I grew up with. That’s what living in Hawai‘i means to me.”

Keith Vieira, principal of KV &Associates, Hospitality Consulting, who was among the industry reviewers on Wednesday, said overall feedback was positive, and those in attendance liked that the campaign highlighted that each island is a separate and special place and has its own beauty.

However, Vieira said, some industry leaders expressed concern that a long-form video of Maui was too focused on the past fire rather than its current recovery. He said some leaders also wanted to see more of Hawai‘i’s beaches and ocean featured.

Josh Hargrove, general manager of the Westin Maui Resort &Spa, said he loved that the upcountry Maui imagery was lush and green because it counteracts the perception that some people have that all of the Valley Island was on fire. He suggested subsequent campaigns could focus on beaches and waterfalls and other parts of Maui.

“We need visitors to come and realize that Maui is as beautiful as it’s ever been,” Hargrove said.

Hannemann said, “We are listening to their feedback and HVCB is making tweaks.” He said the new campaign is expected to roll out soon to address expected shortfalls in bookings not just on Maui but everywhere.

“We have been hearing from the industry that it is going to be a soft summer, so the sooner we get this kind of messaging out the better that we will be,” he said.

Talwar showed the board a slide of the hotel booking pace for all islands and pointed out that as of April 14, the hotel booking pace for Hawaii this month is in the red by single digits for every month except August up until December. Maui was up slightly for April, but is in the red by double digits well into the first quarter of next year, and West Maui is even worse.

“(The numbers) are consistently negative. So we are really appreciative of what’s been going on with the legislative session and your leadership that allowed us to get the funding. It looks very solid,” he said.

Funding wasn’t HTA’s only legislative win this year.

Senate Bill 3006, which would allow the agency to sell or lease naming rights of the Hawai‘i Convention Center facility, stalled. However, House Bill 2563, which started as a bill to develop a mobile app, was passed out of conference with the naming rights provision. Funding for the mobile app, which HTA supported, was taken out of the bill; however, it now exists in House Bill 1800 so the project can move forward.

Your email address will not be published. Required fields are marked *

By participating in online discussions you acknowledge that you have agreed to the TERMS OF SERVICE . An insightful discussion of ideas and viewpoints is encouraged, but comments must be civil and in good taste, with no personal attacks. If your comments are inappropriate, you may be banned from posting. To report comments that you believe do not follow our guidelines, send us an email .

1 Light at the end of the tunnel for Hakalau Beach Park
2 New round of debt forgiveness begins for Hawai‘i health care professionals
3 Obituaries for Monday, April 29, 2024
4 Legislation aims to help tourism recover
5 Missing documents muddle wildfire probe

4 ways Hawaii is coping with a tourist influx as COVID-19 restrictions lift

Jul 14, 2021 • 6 min read

USA, Hawaii, Oahu, Hanauma Bay Nature Preserve, a Nature Preserve and a Marine Life Conservation District inside a volcanic crater

Tourists have been returning to Hawaii in droves © John Seaton Callahan / Getty Images

Hawaii has always been a go-to destination for travelers—and many Hawaiian residents are used to it. But since COVID-19 restrictions were lifted this spring, there's been a rush of tourists that has rattled even the most hardened residents.

Hawaii is currently on track to surpass its 2019 tourism numbers, despite the state only being fully opened since July 8. Since the quarantine restrictions were lifted, Hawaii has seen nearly 200,000 self-described tourists arrive on their shores.

These numbers have led to a host of issues like traffic congestion, more garbage and lack of transportation resources. A lack of rental cars have even led some tourists using U-Hauls to get around . Hawaiian government officials and the tourism boards are scrambling to solve the overtourism issues, which experts claim won’t level off until 2022 .

“We’re working toward more mindful and, ultimately, regenerative tourism where visitors take the time to know each island and the local culture and community," said Kalani Ka‘anā‘anā, chief brand officer of the Hawaii Tourism Authority, via email. “As tourism starts to recover, we encourage travelers to be open-minded and respectful as we believe that when visitors travel mindfully and make a positive impact, they’ll have a more enriching experience.”

Here are four ways Hawaii is dealing with the recent influx of tourism to its islands.

Aerial view of Hanauma Bay Nature Preserve in Hawaii

Increasing fees for out-of-state tourists

Snorkeling the translucent waters of Hanauma Nature Bay now comes with a heftier price tag. According to the Associated Press, the entrance fee for out-of-state visitors has increased from $12 to $25.

The increased entrance fee has nothing to do with punishing tourists and more to do with preserving the natural habit of the area. According to Honolulu conservation groups, the nine-month shutdown led to clearer waters and the return of wildlife to the coasts.

“We saw how dramatically Hanauma Bay healed during the pandemic when access to the public was closed. We want to preserve the healing by minimizing human impacts, while at the same time ensuring that there are sufficient resources to maintain the bay and its facilities,” said Honolulu City Council Chairman Tommy Waters, who represents the district that includes the bay, via the Associated Press .

Read more: How to visit Hawaii without totally destroying it

Currently, Hanauma Bay is closed on Mondays and Tuesdays and has a cap of 1,000 visitors per day on the days it's opened. All reservations must be made online . According to the AP, attendance was roughly around 3,000 visitors daily in 2019.

In Maui , officials are debating implementing a “visitor impact fee” to fund services needed to combat increased visitors' burden on the island.

"Places like the Galapagos, it's expensive to get there. Galapagos, you would have to pay an extra $400 for impact fees if you're visiting the Galapagos," Maui County Councilman Shane Sinenci said during a press conference via ABC7 News .

Hawaii counties are also considering a 3% hotel room tax increase . The current hotel tax is 15%. The increase would make Hawaii one of the most expensive places to visit in the country. Las Vegas has a hotel room tax of 13.35%, while San Francisco charges 14% and New York City 14.75%.

"We feel that visitors can and should contribute to helping to preserve our natural resources, especially those who visit our parks, hiking trails, beaches, etc. while in Hawai‘i," said the Tourism Board of Hawaii. "Tax decisions are made by the governor, mayors, legislators and council members, as the state and counties can determine entrance and parking fees for visitors at parks to help pay for safety, upkeep, and reinvestment in those locations.”

Maui mayor requests tourism pause

Maui County Mayor Michael Victorino is calling for a general pause of tourism to the island. The first-term mayor reportedly met with airline executives to request a brief stoppage of passengers to the overpopulated destination.

"I have been talking with different airlines and … we're asking for just a pause, if you want to use that term," Victorino said during a press conference on June 29. "We don't have the authority to say stop, but we're asking the powers to be to help us …

"I want to remind the visitors that Maui is a community first and a vacation destination second.”

Victorino’s pleas will likely do little to curb the influx of tourists. Based on the state of Hawaii COVID-19 travel portal , nearly 80,000 passengers came via United Airlines, while Hawaiian Airlines flew in over 60,000 and Southwest nearly 50,000 passengers in July alone.

Alex Da Silva, the spokesman for Hawaiian Airlines, said the airline carrier is interested in working in tandem with Hawaiian leaders to find a solution to the tourism concerns.

“As Hawaii’s hometown airline, we both live and work here and are conscious of the strain on our infrastructure, natural resources and communities posed by a rebound in visitor arrivals, especially when businesses still face operational restrictions associated with COVID-19,” Da Silva said in a statement via The Star Advertiser . “But we know that visitors are also the engine of our economic recovery and future diversification.”

Read more: Historic Hawaii: exploring the stories of Moloka‘i and Lana‘i

New shuttle bus service

A new shuttle bus service, subsidized by the Maui Visitors and Convention Bureau and running from the Kahului Airport to big resorts around the island, is being tested.

The two-week pilot program will aim to reduce the number of vehicles on the road and decrease traffic congestion, which has only gotten worse since COVID-19 restrictions were lifted on the islands. The program is slated to end on July 17, but it could run throughout the rest of the summer if successful.

“Our hope is that it becomes so popular with the visitors that we can continue it through the summer and then it will help with the whole community versus visitor relationship too,” said Leanne Pletcher, Maui Visitors and Convention Bureau Director of Public Relations and Marketing to Hawaii News Now .

According to Hawaii News Now, the “Maui Aloha Shuttle” will make three trips each day using coaches provided by Polynesian Adventure Tours. Rates are $50 for a one-way trip to West Maui, $35 for children ages 4-12; $35 to Wailea and $20 for kids 4-12. Children three and younger are free. Shuttle bus tickets can be purchased at the airport.

Read more: Spelunking Kazumura Cave, the world's longest lava tube

The curvy coastal road to Hana cuts through dense rainforest on the Hana Highway

Increased law enforcement on Hana Highway

The 64-mile road to Hana, better known as the Hana Highway, is a major tourist attraction and has only gotten more popular since tourism has resumed. The winding road filled with picturesque views of waterfalls and jagged coastline entices many visitors to stop for a picture. However, here lies the problem.

The Hana Highway is also the main road Maui residents use. High tourist traffic not only leads to congestion but negatively impacts residents trying to live their lives.

“You have 40 to 50 cars piling up at these traffic lights and then embarking bumper to bumper along the Road to Hana, and when these sets of cars come upon the bridges where there are people illegally parked it creates scenarios of full stoppage,” said Hana resident and Hana Highway Regulation Administrator Napua Hueu to KHON2.com . “We have residents who have sent in videos of them being stalled at a bridge for up to 30 minutes.”

In response to resident pleas, the Hawaii Department of Transportation (HDOT) has installed approximately 70 “No Parking” signs along the most popular areas on the Hana Highway.

According to a Hawaii Tourism Authority press release , the signs also warn drivers about the $35 parking fine and $200 surcharge for illegally stopping on a state highway.

Mayor Victorino’s office reported that between June 1 and June 23, the Maui Police Department issued 389 parking citations and 83 warnings to violators on Hana Highway between Haiku and Hana town.

You might also like: When to visit Hawaii 17 best places to visit in Hawaii Circling the island of Hawaii: a pilgrimage to Mother Nature

Explore related stories

Apr 23, 2024 • 7 min read

Everything you need to know about ships, itineraries, and activities – this is how you pick the best cruise in Alaska for you.

Apr 18, 2024 • 7 min read

Mar 28, 2024 • 19 min read

Mar 22, 2024 • 9 min read

Mar 15, 2024 • 10 min read

Mar 7, 2024 • 9 min read

Mar 5, 2024 • 13 min read

Mar 4, 2024 • 8 min read

Feb 21, 2024 • 2 min read

Feb 15, 2024 • 7 min read

Tourists are overcrowding Hawaii. Here's how they're handling it.

On today's episode of the 5 Things podcast:

Hawaii is a small state that's a huge draw for tourists. Maybe it's the beaches, or the phenomenal hiking trails, or the beautiful, rich culture. Maybe it's the 'Aloha spirit' that welcomes you and makes you feel like family. Maybe, it's all of the above.

In 2021, 600,000 people visited Ho'omaluhia Botanical Garden. That's the tip of the iceberg. But that influx comes with a price for the state's 1.4 million residents. Over tourism has become a buzz word recently, and many Hawaiian's are feeling the burnout. During the COVID-19 pandemic tourism all but stopped and Hawaiian's saw for the fist time what some places were like with no people, and nature had a chance to restore itself.

5 Things Sunday host James Brown sat down with USA TODAY's consumer and travel reporter Kathleen Wong, who is based in Hawaii.

She talks about responsible visitors and what that means to not only the island, but to Hawaiian's and how the state is managing the number of tourists.

For more on respectfully visiting Hawaii:

Take it from Hawaii locals: You won't regret these 8 activities when you visit the islands

Stop throwing coins into hot steam vents, Hawaii Volcanoes National Park asks of 'disrespectful' people

Waipio Valley protestors block access to sacred Hawaiian land after partial reopening

Don't be that tourist: Here's how to respectfully visit Hawaii, have an authentic trip

Honolulu charges the most expensive tourist tax. Here's how that affects your vacation.

Hawaii sees riskier beachgoers: How to safely enjoy the ocean on the islands

Beach closures, damage: What travelers can expect after the 'historic' Hawaii swells

Listen up, tourists: Hawaii locals share what they wish visitors would stop doing

Woman treated for injuries after an encounter with nursing monk seal in Hawaii

Follow James Brown and Kathleen Wong on Twitter.

If you have a comment about the show or a question or topic you'd like us to discuss, send James Brown an email at [email protected] or [email protected]. You can also leave him a voicemail at 585-484-0339. We might have you on the show.

Podcasts: True crime, in-depth interviews and more USA TODAY podcasts right here.

Hit play on the player above to hear the podcast and follow along with the transcript below. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text.

James Brown: Hello and welcome to 5 Things. I'm James Brown. Go, Bills. Every week we take a question, an idea or concept and go deep. If there's something you'd like us to look into or just want to say hello, email me at [email protected] or [email protected]. You can find me anywhere on social media at James Brown TV. We also have a voicemail line. Call us at 585-484-0339. I love reading and listening to all of your messages. One of my goals is to see more of America. I've been to six or seven states, and that's far too few. My hope is to get to all 50 states eventually. That, of course, includes Hawaii, and I'm not alone. That state is in demand. Nearly 600,000 people visited in 2021 alone. That's a ton, especially for a state whose population is only 1.4 million people. With this kind of influx of visitors comes a price that the state is managing. With more on how they're going about it, comes USA Today's Kathleen Wong, who's based in Hawaii. Kathleen Wong, welcome to 5 Things.

Kathleen Wong: Hi, James. Nice to be here.

James Brown: I want to start with a place that may seem a bit off, but I always worry about it. Am I pronouncing Hawaii correctly?

Kathleen Wong: So you could actually say it, there's an okina, which is the thing that kind of looks like a backwards apostrophe between the two Is, so it's like Hawaii.

James Brown: Hawaii.

Kathleen Wong: Or actually you could do even more and the W and Hawaiian actually sounds like a V so it's like Hawaii would be the...

James Brown: Hawaii. Hawaii, am I getting it right?

Kathleen Wong: You're close. Yeah.

James Brown: I'm trying here. No promises, but I know that if someone was pronouncing where I live incorrectly, I would feel a bit strange about it. I'm imagining that happens a lot.

Kathleen Wong: Yeah, I mean you definitely can hear some people say Hawaii, closer to Hawaii or Hawaii or stray pretty far, but I appreciate your curiosity in wanting to pronounce it correctly. I feel like a lot of people don't even realize that it's pronounced differently from Hawaii.

James Brown: Well, are you native to the island?

Kathleen Wong: No, I'm not. So I wouldn't even call myself Hawaiian or Native Hawaiian or anything like that. So I'm Asian and I moved here as a kid, so I would more call myself a local. It's definitely a nuance I think that you get when you spend a lot of time here and understand that. Yeah.

James Brown: Tell me more.

Kathleen Wong: Yeah, I mean there are the Native Hawaiians who came here many, many years ago and their culture is super significant here. And just with the history of Hawaii, I think the colonization and the overthrow of the monarchy, I think a lot of people who end up living here or grow up here definitely want to make that distinction between I'm of Hawaiian blood, or I grew up here and have a deep connection with the place, but I wouldn't want to call myself Hawaiian. So it's definitely a lot of nuances.

James Brown: Why did you decide to stay?

Kathleen Wong: I mean, it's just such a beautiful place, obviously, as everyone knows when they think of Hawaii. But I mean the culture that's here from the Native Hawaiians and also all the different Asian cultures who immigrated here for working on the plantations, the sugar and rice plantations, they've just created a really special culture where everyone's family. There's like this term hanai, which is like when you adopt your neighbor's child and you treat them your own. And there's just a lot of welcoming and aloha spirit and care that I really didn't find anywhere else and it was hard to not want to return to. It's just a really beautiful place both in nature and in spirit and with its people.

James Brown: Aloha spirit.

Kathleen Wong: Yeah.

James Brown: What do you mean by that?

Kathleen Wong: Yeah, I think it's a welcoming, a love, a expect... Or doing things out of kindness, but not expecting things in return. It's just a kind of kindness and generosity that is really fostered here.

James Brown: Interesting. Is that something that is taught? Is it something that you just sort of catch in the ether of just living and growing up in, on the islands?

Kathleen Wong: That's a good question. It's definitely a value I think that comes from Hawaiian culture. I think it is something that when you come here and you experience, you want to share with others yourself and keep it moving forward.

James Brown: I read your piece and it really struck me in a number of different ways, and I think I'd like to start with defining a term, as you see it in your region. What does overtourism mean to you? Mean to other people who are Hawaii residents?

Kathleen Wong: That is definitely kind of a buzzing word, I would say when we think about tourism, which is such a big part of Hawaii's economy, just how Hawaii's seen in the world. Overtourism for me, and maybe a lot of people would be an influx of visitors who are maybe not educated on how to be a responsible visitor. Who maybe don't understand that resources here are finite. I'm not fully blaming a visitor who wants to come. I totally understand why you would want to come. I would want to come too. And definitely responsible visitors are welcome in my opinion, so that they can go home and educate others. But I would say when there aren't enough policies in place or these reservation systems that I explore to kind of manage the amount of people, and also there's local people here who want to use those places too. Go to the gardens, go to different beaches and feel like it's just so crowded or so difficult to be able to visit. And it sucks when that's your home.

James Brown: The only way that I can quite understand it is where I live, there are certain neighborhoods that have big festivals. And for that amount of time, your neighborhood is invaded by these people who are coming from elsewhere. And it's louder. It's at times abrasive. And some people choose to go on vacation when they live in those areas.

Kathleen Wong: Oh, really.

James Brown: But when I think of Hawaii, am I pronouncing it? Did I get it right?

James Brown: I did?

Kathleen Wong: Yeah. And I appreciate the Hawaii residents too. That was good. I like that.

James Brown: But when I think about it, I'm not quite sure if there is a defined season when it happens or are the waves of people coming through at all times of the year?

Kathleen Wong: Yeah, I mean there's definitely a peak in summer and holiday travel, but honestly, you can find hers pretty much all year round. And during, I think the pandemic, when tourism pretty much came to a stop because it was just so hard for people to come in. They had to show negative Covid tests within a certain amount of time. And so it really reduced the amount of people who came and so many places were empty. And that was kind of the moment that people actually got to see what it was like to have nearly no visitors. But otherwise, people are coming all the time.

James Brown: How does life change for residents when tourists come in?

Kathleen Wong: Yeah, I think it just makes it, I mean, as an island, there is just a lot more congestion on the roads. Beaches are more crowded, hikes are more crowded, so maybe it's harder to find parking. The trail has a lot of people on it, which is less enjoyable for everyone. Restaurants are more packed. It's just like the resources stay the same, but the amount of people increase. And yeah, it's a struggle for I think locals and both visitors.

James Brown: What do they, I mean, it's 1.4 million people can't speak for everybody, but what's the common sentiment?

Kathleen Wong: I think it ranges. There are definitely some people who are really against tourism, and I understand why. There are some people who feel it's important to the economy and needs to stay. It's a definitely a gray area. So I really can't speak for everyone, but I do feel as if most people could agree that things need to change in the industry.

James Brown: And I take it you may agree with that.

Kathleen Wong: I do. I definitely do. Just from growing up here as a kid to returning as an adult after college, things have definitely changed. There's way more cars on the road. Places are way more crowded. There's climate change impacting, certain beaches are eroding. So it's almost as if there's less resources in the future, plus the same amount of visitors. So things definitely need to change. I do think so.

James Brown: Well, I think it's a tough problem because on one hand your region is dependent on this influx of people, probably money coming with them, but you don't want to be overrun by these folks at the same time. How is that manageable?

Kathleen Wong: Yeah, I think that's the question that's on everyone's mind. And it's tough coming up with the right solutions. Which is why I think these reservation systems come into play and more places are beginning to implement them as a way to see if that's how they can manage tourism. And also in the piece you may have seen, I mentioned these destination management plans for each county, which is almost each island, but Maui has Malachi and Lanai, and they just talk about the issues related to each island and how they hope to tackle them. And it's in progress and it will take time, like years, I think, before things can change. But things such as the reservation systems could make a big difference.

James Brown: Well, let's take it one by one. Let's start with reservation systems. So where was this idea birthed and where was it enacted?

Kathleen Wong: When I was reporting, it seemed as if the first place where it happened was at Haena State Park on Kauai. They had done renovations and when they reopened in 2019, they decided to implement a reservation system. And then when the pandemic happened, it just kind of, I think gave people the space to think about how to manage tourism once that does return. And I mentioned Hanauma Bay on Oahu, a super popular snorkeling spot. It just got so many people visiting that it was never in great condition. And then in April, 2021 to kind of manage social distancing that came along with Covid, they put in a reservation system and they saw a lot of success in managing the amount of people who go there. Before they even let people back in, they noticed how clear the water was, how there were more fish, more coral growing, and just how when no one's there or less people, significantly less people. Nature had time to kind of restore itself, which is positive. That's an exciting thing. I think.

James Brown: There's got to be some folks that I would think would break those rules. Or are these areas like guarded? How do they know that you have a reservation for these areas?

Kathleen Wong: So a lot of these are done online and you sign up and you pay, and there are guards at the entrance to check and also manage the parking lot situation. So there are park staff that are there to help manage that.

James Brown: So you can't slip in.

Kathleen Wong: No. I think it would be tough to do so. And before they actually didn't even require you to pay online, I believe. And a lot of people would reserve and not show up. So they started making people pre-pay to hold them to actually show up. So things are always being tweaked to make sure they're effective.

James Brown: And how do these systems and destination management systems, as you mentioned earlier, what's the difference between those two?

Kathleen Wong: Destination management plans are kind of the broader vision for each county. And then these reservation systems are a part of these bigger plans. The Hawaiian Tourism Authority, and a lot of other people are really pushing for change.

James Brown: I also wanted to touch on another piece because I do think it doves tails with this idea. You describe what a respectful visit to Hawaii is. What do you mean by that? And for a neophyte like myself, what advice would you give?

Kathleen Wong: I appreciate you asking that question. I've said a few times in this conversation, responsible visitor lines with respectful visitor as well. And I was excited to write that piece because I think what the Hawaii Tourism Authority and a lot of other people are hoping to target when they, with their visitors who come here are people who want to educate themselves past whatever you see on mainstream media and to learn about the real issues and meet real people here and really create a connection to the islands here. And that could be through something like volunteering with a non-profit or supporting local businesses or ethical tour companies. And there are a lot of different ways to do it, but I think it mostly comes with a curiosity and really wanting to educate yourself on what the real Hawaii is like and wanting to bring that back home too.

James Brown: Any famous last words?

Kathleen Wong: I don't think so. I appreciate you wanting to know more about what makes a local versus a native Hawaiian and how to pronounce Hawaii. And I think that's the curiosity where really a lot of people should start with.

James Brown: If you like to show, write us a review on Apple Podcasts or wherever you're listening in, do me a favor, share with a friend. What do you think of the show and what do you think of the concept of respectful tourism? Email me at [email protected] or leave me a message at 585-484-0339. We might have you on the show. Thanks to Kathleen Wong for joining me. And to Alexis Gustin and Shannon Ray Green for their production assistance. Taylor Wilson will be back tomorrow morning. And for all of us at USA Today, thanks for listening. I'm James Brown, and as always, be well.

April 29, 2024

UC Berkeley's only nonpartisan political magazine

After The Fire: Rethinking Tourism Impacts On Hawaii

In the aftermath of a deadly wildfire resulting in over 100 lives lost, Lahaina–a historical whaling town in Maui that was once the centerpiece of the Hawaiian monarchy–begins the difficult task of rebuilding.

While the island grieves what was lost and begins to pick up the pieces, native Hawaiians are urging local governments and individuals to address the systemic issue of tourism that has shaped the indigenous communities’ way of life in Hawaii. While the future of Maui is uncertain following the fires, a revitalization of the effort to preserve and rebuild the culture, land, and history of Hawaii offers a hopeful future to native communities.

In August, a series of high winds from Hurricane Dora, along with low humidity and a drought spell, put Hawaii under warning for conditions that foster wildfires. Shortly afterward, on the morning of August 8th, a devastating fire broke out and forced the evacuation of thousands, displacing the community and ripping through Lahaina. The land was a tinderbox set ablaze–hundreds of acres incinerated from the fires, and a multitude of churches, temples, and cultural sites that represented the history and culture of Hawaii were destroyed. Generations of native Hawaiians watched as their land was stripped from them again, with little to recollect. Lahaina’s 150-year-old Banyan tree , a generational symbol of prosperity and hope, was engulfed in flames as the town burned.

Wildfires on the island, though not uncommon, have never reached such catastrophic levels in the past–but Maui has changed both economically and environmentally . Though the cause of the wildfire is considered unknown, both residents and local officials raised concerns regarding the increased impact of climate change, as what was once a wetland has been struggling with severe drought. Native plants are no longer able to retain nutrients that create a damp and humid environment, where wildfires struggle to spread as quickly. Coupled with the drought is the introduction of non-native plants brought by colonizers that are highly flammable . These concerns about climate change have been brought alongside claims that Hawaiian Electric, the operating company of Maui Electric, did not ensure that proper safety measures and emergency procedures were established ahead of the storm and risk of wildfire. Together, these factors brought about a condition in which the wildfires were able to prosper, devastating the land and the people.

As the Banyan tree begins to sprout again and turn over a new leaf in the conversation of who owns Hawaii, the entirety of Lahaina faces the deadly consequences caused by destruction from the fires. The aftermath has spread roots of uncertainty all throughout the island, with natives struggling to conceptualize the loss and the local government pleading with visitors to reconsider their vacation plans . Hotels were converted to shelters for residents who were evacuated and displaced, with an estimated 46,000 individuals flying out of Maui on the day the fires broke out. Maui halted most visitors from entering, with many local Hawaiians stating that the island needs time to recover and grieve the lives and communities that were lost. The road to repair is lighting a spark in natives emboldened by the loss to regain control over the land. Maui’s wildfires and the devastation that impacted Lahaina are reigniting the conversation about the exploitative nature that Hawaii’s tourism industry has fostered.

Since the establishment of Hawaii as a state in 1959, the land has been used to support its tourism industry, which has grown exponentially. Since then, the impacts of the human footprint and climate change have in turn exploited its natural environment. Visitors to the island reach numbers in the millions every year. As hotels, resorts, and businesses owned by large-scale corporations continue to drive up housing prices and pay poor wages, residents have become unable to afford their homes and are forced to abandon their land, which is then often bought by billionaires like Oprah Winfrey and Jeff Bezos . These issues didn’t arise overnight–they stem from the structured gentrification of Hawaii that financially and physically displaced the native population while portraying it as a way to economically benefit the island’s communities.

When Hawaii was harvested for its rich agricultural resources, particularly sugar, the island and its natives began to lose independence as a nation. The result was a drift towards a for-profit economy bolstered by white settlers that profited from colonialism enacted against native peoples and their land. After the overthrow of the monarchy and annexation of the island, the result was a series of political and economic leverages used against the native community, backed by powerful sugar lobbyists who were instrumental in taking control of the land. As indigenous communities were regarded with suspicion and tasked with proving loyalty to the United States during World War II, colonialism flourished and grew exponentially. The result was stripping away indigenous communities’ self-determination and capitalizing off the obstacles natives faced in order to develop and maintain Hawaii’s economic advantage through the tourism industry.

Maui, in particular, has been a hotspot for tourism–its economy relies on the tourism industry for more than 80% of its wealth, and resorts welcome as many as 8,000 individuals per day. Taxes and revenue from the hotel industry are fed right back to supporting the expanding service industry. This creates a repetitive and vicious cycle of consumption culture , where the indigenous society is buried under the weight of tourism. Following the relaxation of pandemic restrictions, local infrastructure has suffered from the surge in visitors that heavily burden public services, including roads, businesses, and the natural landscape. Streets are closed because of overcrowding, natives face egregious fines for basic water consumption, and profit-driven pollution has compromised the environment.

Visitors often leave long-lasting impacts on the land through extreme water usage at hotels and luxury golf courses built by distant investors. Investment in Hawaii would be better aimed at environmental impact mitigation and housing solutions, such as the Hawaii Tourism Authority’s hope to reinvest 2.7 million dollars into the culture and community.

Decades of colonialism in partnership with tourism and over-development have marginalized and disregarded the indigenous communities in Maui, promoting an unethical economy that is detrimental to Hawaii’s future in the aftermath of the fires. As described by Kaniela Ing , a seventh-generation Native Hawaiian from Maui, “black, brown, and low-income communities. . . have contributed the least to climate change, but have suffered the most”. As demonstrated by this longstanding exploitation, the balance between the ethical enjoyment of Hawaii and the preservation of its history has become increasingly hard to manage. While Maui relies on its tourism infrastructure and the use of natural resources to generate revenue, native Hawaiians are begging for the island to shift in a direction Ing describes as “redefining what Hawaii stands for”.

Visiting Hawaii should be more than just an aesthetic experience treated like a “paradise” when the people and communities do not share these benefits. A continuous effort has been made to educate tourists and individuals about the tangible impacts of the tourism industry. Groups like DeTours have been operating since 2004, allowing visitors to tour the island through the perspective of local Hawaiians and their communities. The group is part of a larger movement in acknowledging the turbulent relationship between the tourism industry and Hawaii, allowing people to visit old neighborhoods, the Hawaiian royal residence, and Pearl Harbor. By visiting these locations, people are able to understand the larger context of historical colonialism and its abuses while learning about the significance of their impact as tourists.

Repeated exploitation has fostered a reliance on tourism throughout the island. Hawaiian businesses, employment opportunities, housing, and infrastructure are all aimed at the preservation of tourism. Lahaina and its community, in the days following the fires, have begun to imagine a life outside of the realm of an industry that has shackled Hawaii to its colonialist history. To some, the fires provided a wake-up call to the direction that non-native Hawaiian opportunists have been running in–favoring the island’s profit over its people.

Investors and the service industry should no longer be building the framework of Hawaii. Rather than investing in golf courses, resorts, and attractions that ruin the land and foster consumption culture, we should encourage a new sense of leadership and drive in the restoration of Maui. Despite the imminent need for resident housing, Hawaii continues to favor short-term rentals designed for vacation-goers. The burden of this is placed entirely on natives, who spend an average of 23 years waiting for housing through the Department of Hawaiian Home Lands. As a result, natives are twice as likely to be homeless, forcing many to leave the state and abandon their land. Housing should be developed for long-term residents and have immediate results for locals whose land has been taken from them. The wildlife and island should be protected and preserved, with indigenous communities at the forefront of this conversation, receiving help and support from both federal and local governments. The same concerns were raised when the development of a telescope on Mauna Kea sparked criticism from local Hawaiians. Through advocacy and engagement with organizations like the Hawaii Land Trust (HILT), individuals and communities are able to participate in reducing the impact of climate change through wildlife conservation, coastline protection, and outreach in educating people about the land. Since the beginning of HILT, the organization has conserved thousands of acres of land, all through their volunteer program which is aimed at engaging and assisting the native population in their effort to reclaim land. Community-oriented spaces and projects like HILT promote the construction of public services and preserve culture, allowing Maui to be restored to what it once was before–a home.

As the island begins to heal and the leaves of the sacred Banyan tree flush out the ash created through decades of occupation and colonialism, now more than ever individuals should acknowledge and educate themselves on the impact that tourism has had on Hawaii.

There’s hope that in the aftermath of the fires, tourists and locals will embrace collective responsibility. After the detrimental effects of an unethical economy, Hawaii is beginning to break free from historical exploitation, sprouting hope and opportunity for the natives. A future in which Hawaii is constructed by indigenous culture and history can uproot the deep-seated issues of colonialism that have followed the natives and their land, allowing indigenous communities to grow and flourish after decades of economic and social suffocation caused by tourism. It’s evident that tourism has negatively impacted Hawaii both socially and environmentally, and the fires are a pivotal point in restoring and reclaiming native lands. While the future of Maui is uncertain following the fires, a revitalization of the effort to preserve and rebuild the culture, land, and history of Hawaii offers a hopeful future to native communities.

Featured Image Source: CNN

Published in United States

climate change
United States

Comments are closed.

Community Voice

Hawaii’s Unhealthy Relationship With Tourism

It’s time to shift focus and invest in our own communities, residents and industries.

By Kayte Jones

July 24, 2020 · 6 min read

About the Author

Kayte Jones

Growing up on the windward side of Oahu, I was used to crowds of tourists. I saw a few tourists increase to busloads of tourists over the years.

In the last few years, my family made the decision to move to Big Island, for many reasons. Although it is not the primary reason, I can’t deny that being “priced out” of Oahu was a contributing factor. We moved to the windward side of the island, since that is my comfort zone, where we have found a new home and community that we love.

I couldn’t help but notice the difference in services and infrastructure. I saw the lack of public transportation. There’s a bus system here on Big Island, made up of retired tour buses and City and County of Honolulu buses, that doesn’t run that often or go to most residential areas.

Manini Beach KealaKekua Bay Kona Hawaii island1

Well, that’s funny. This island is huge. Public transportation would be so beneficial to the residents. Not only would a better bus system create more jobs, it would connect people with more job opportunities in different areas.

I shared my thoughts with a friend who told me, “Well, the county of Hawaii has less tourism, so therefore has less money. What did you expect?”

Abundance Of Opportunity

Recently, I took a trip to the Kona side, which is filled with hotels, strip malls, golf courses, just like Oahu. As I walked through a perfectly manicured strip mall, I felt myself becoming angry and resentful. All of a sudden I felt this boiling resentment. No one invests in locals, the people that actually live here. We only build nice things for tourists.

My “bold and creative” solution for the future of Hawaii is to shift our focus from tourism and invest in our own communities, our own residents and our own industries. Tourism has been profitable for our state. However, the impacts of COVID-19 on tourism highlighted just how completely dependent our state is on tourism — and it’s an unhealthy relationship.

We should continue to attract tourists and profit from it, but we should not be completely dependent on it. It’s time to shift our focus.

Don’t we have more to offer than the exploitation of our land, people and culture? Couldn’t we be a model of sustainability for the future through research of our unique ecosystem and climate? Through developments in agriculture and green energy like solar power, wind power, algae farms and geothermal energy? Couldn’t we be an educational destination through investment and development into our university system?

I recently read an article about opportunity zones in Civil Beat, which stated, “More than two years after Congress created opportunity zones as part of the 2017 Tax Cuts and Jobs Act, business advocates on Hawaii island say there’s frustration among local entrepreneurs about a perceived lack of movement from the state to bring new investment into the island’s economically disadvantaged communities.”

I followed the link and clicked my way to the Factsheets section where there was a handy-dandy break down of “Investment Drivers” for each area there are Opportunity Zones, including Hilo, Kona, Honolulu, Kahului and Molokai. On the factsheet for Hilo, I found multiple “investment drivers” listed: economic, health care, government, education and research, ports and cultural, along with areas, institutions and businesses ripe for investment in each category.

Apparently, there is an abundance of opportunity out there. Imagine my surprise to see all of this opportunity in my own community, listed so neatly on this factsheet.

Hawaii has more to offer than hotels, luaus and Instagram-worthy photos. Our tropical climate and fertile land are ideal for agricultural development, yet we import most of our food. Investing in our agricultural industry would not only shift our focus from tourism and support local farms, but would also help Hawaii to be less dependent on exports for food.

Hawaii’s climate also creates a unique opportunity for our state to be a model of sustainability via research and development into sustainable sources of energy, such as solar power, wind farms, geothermal and algae farms. The University of Hawaii is a land-, sea- and space- grant institution recognized as a research university. Investing in research and education can make Hawaii an educational destination.

Lastly, and most importantly, we can shift our focus from tourism to our people here at home through infrastructure investments. That means that even areas with low tourism rates get nice things too. Why should we expect outside investors to come in and invest in areas of our state that we don’t invest in ourselves?

Not only would strengthening agricultural infrastructure help Hawaii become less dependent on exports, it will keep our money in the state. Every time there is a crisis, or a natural disaster, residents of Hawaii worry about whether or not cargo ships will make it into our harbors. We worry because most of us are accurately aware of our state’s dependence on exports.

I’m not OK with accepting that my new home has less infrastructure because we have less tourists.

While I loved living on Oahu, I love living on Big Island for different reasons. But this move has shown me the differences between an island catered to and funded by tourism and an island sustained by residents. I have no problem going to the post office to get my mail because we don’t have mail service.

I don’t mind that county water isn’t available in many areas. I enjoy living off the water grid and utilizing a catchment system because I want to live sustainably. I don’t mind some unpaved roads. A poor bus system doesn’t bother me, because I have a car.

What I’m not OK with is accepting that my new home has less infrastructure because we have less tourists.

A community’s value is not determined by its average number of tourists. Our state is more than a tourist destination. Our culture is not meant to be marketed and sold. The people of Hawaii are worthy of investments that improve residents’ standard of living, and not just projects that attract more tourists.

We’ve known for decades that we need to diversify our economy to be less reliant on tourism. It’s time to shift our focus to a more sustainable future for Hawaii.

--> Sign up for our FREE morning newsletter and face each day more informed. --> Sign up for our FREE morning newsletter and face each day more informed.

Community Voices aims to encourage broad discussion on many topics of community interest. It’s kind of a cross between Letters to the Editor and op-eds. This is your space to talk about important issues or interesting people who are making a difference in our world. Column lengths should be no more than 800 words and we need a photo of the author and a bio. We welcome video commentary and other multimedia formats. Send to [email protected] . The opinions and information expressed in Community Voices are solely those of the authors and not Civil Beat.

Read this next:

Pritchett: Excess Baggage

By John Pritchett · July 26, 2020 · 0 min read

Local reporting when you need it most

Support timely, accurate, independent journalism.

Honolulu Civil Beat is a nonprofit organization, and your donation helps us produce local reporting that serves all of Hawaii.

Kayte Jones, originally from Oahu, is a resident of the Big Island where she works in the mental health field.

Latest Comments (0)

This article makes a great point but the author forgets that many people today are against progress unless it's progress to build new stores. The NIMBYs and CAVE people do their best to stop progress. They are against geothermal energy, carbon neutral energy, space exploration(from telescopes to space ports), and any other form of progress that would give Big Island a step away from relying on tourism. We sit between a rock and a hard place. Whomever figures out this problem and gets everyone on board will be in the running for the Nobel Prize.

hawaiianreyes · 3 years ago

PLEASE send this thoughtful, well written article to Governor Ige, Lt. Governor Green and all county Mayors!

Jimmy · 3 years ago

Mahalo for this piece.I totally agree we need to move towards self-sustainablilty and protecting this beautiful culture, people and land.

Judy · 3 years ago

About IDEAS

IDEAS is the place you'll find essays, analysis and opinion on every aspect of life and public affairs in Hawaii. We want to showcase smart ideas about the future of Hawaii, from the state's sharpest thinkers, to stretch our collective thinking about a problem or an issue. Email [email protected] to submit an idea.

You're officially signed up for our daily newsletter, the Morning Beat. A confirmation email will arrive shortly.

In the meantime, we have other newsletters that you might enjoy. Check the boxes for emails you'd like to receive.

Breaking News Alerts What's this? Be the first to hear about important news stories with these occasional emails.
Special Projects & Investigations What's this? You'll hear from us whenever Civil Beat publishes a major project or investigation.
Environment What's this? Get our latest environmental news on a monthly basis, including updates on Nathan Eagle's 'Hawaii 2040' series.
Ideas What's this? Get occasional emails highlighting essays, analysis and opinion from IDEAS, Civil Beat's commentary section.

Inbox overcrowded? Don't worry, you can unsubscribe or update your preferences at any time.

This is how tourists are destroying coral reefs in Hawaii

The less people at a certain site, the more coral there are, the research found.

The millions of tourists who flock to the shores of Hawaii every year are wreaking havoc on its natural environment -- especially the coral reefs, which are at risk all over the world, a new study said.

The most popular coral reefs on the Hawaiian islands are likely being degraded by the very visitors they attract, according to a study published Monday in Nature Sustainability .

MORE: World Oceans Day 2022: How climate change and warming waters are affecting the health of the oceans

Researchers from Princeton University combed through more than 250,000 geotagged Instagram posts from 2018 to 2021 by tourists visiting Hawaiian reefs and compared them with flyover maps of live coral cover. They then used artificial intelligence to analyze reef map images at about a 2-meter resolution, or about 6.5 feet, and 16-meter, or 52.5-feet, depth, according to the study.

PHOTO: Fish pass over a coral reef at Hanauma Bay, Jan. 15, 2005 in Honolulu.

Bing Lin, a PhD candidate in science, technology and environmental policy at Princeton University's School of Public and International Affairs and the lead author of the study, got the idea to use social media for the research after doing fieldwork in Hawaii in 2021 and realizing that one of the first things people do when they visit a site is to take a photo and post it to Instagram, he told ABC News.

"They take pictures of the beaches, and they post on social media," he said. "Instagram is by far the main platform through which social media presence is documented, and so I came up with the idea of using Instagram to get a sense of a large-scale representation of where people are distributed in Hawaii."

MORE: More coral bleaching at Great Barrier Reef, Australia confirms

The scientists found that the accessible sites with more live coral cover were visited more often, but that at the popular sites, coral covers were more degraded compared to those at less popular sites, the paper states.

"We were able to find that coral reefs not only played a really significant role in attracting tourism, but also that the tourism subsequently seemed to suppress live coral coverage at the sites in which tourism was most concentrated," Lin said.

PHOTO: Both tourists and locals enjoy the day at Waikiki beach, Aug. 22, 2018, in Honolulu.

While tourism is mostly concentrated on the shoreline, with lots of activity on the beach, many tourists end up on excursions in which they venture further into the ocean for snorkeling or scuba diving, Lin said.

Using keywords included in captions and hashtags, such as "#scubadiving," Lin was also able to determine a certain degree of interaction with the reefs. Corals tended to thrive farther out into the water, where there are less people, Lin said.

MORE: Discovery of 'pristine' coral reef near Tahiti could help save dying coral reefs around the world, scientist says

The degradation can happen in the form of diver contact, when divers intentionally or accidentally come in contact with the reefs, as well as elevated pollution in areas that tourists frequent, Lin said.

Places in Oahu in Honolulu County, such as Waikiki Beach, Waimea Bay, Lanikai Beach and Shark's Cove, were among the biggest spots for degraded reefs, Lin said. Areas on the Big Island were also among the sites with the most degraded coral, he added.

PHOTO: FILE - A school of manini fish pass over a coral reef at Hanauma Bay, Jan. 15, 2005 in Honolulu.

Coral reefs are vulnerable all over the world due to ocean water warming and pollution. A study published in the Proceedings of the National Academy of Sciences in 2021 found that coral reefs could stop growing in 10 years unless greenhouse gases are significantly reduced.

Key moments from Trump's SCOTUS immunity hearing

Apr 25, 3:18 PM

Tornadoes leave trail of destruction in Heartland

Apr 28, 8:47 AM

Man kills wife, 3 kids in mass shooting: Police

Apr 23, 12:35 PM

Coral bleaching, a process that occurs when water is too warm and the algae the corals expel from their tissues cause them to turn completely white, is inundating reefs all over the world, including the Great Barrier Reef in Australia.

MORE: Coral reefs could stop growing in 10 years unless greenhouse gases are significantly reduced, new study says

In addition to their biodiversity and beauty, coral reefs serve as vital ecosystems, nurture fisheries and protect coasts.

Included in the reef tourism industry should be a method to incentivize conservation by generating funds and supporting local livelihoods focused on protecting the reefs. The United Nations' 2030 Agenda for Sustainable Development has set goals to promote sustainable use of marine and coastal resources, but tourists can harm live corals directly or indirectly, such as by polluting the surrounding sea.

"The impacts of tourism is detectable across hundreds of sites," Lin said.

New docs shed light on Mar-a-Lago storage room

Apr 27, 10:26 AM

Climber dead after falling 1,000 feet off mountain

Apr 27, 6:54 PM

ABC News Live

24/7 coverage of breaking news and live events

Smart Living

Native Hawaiians Are Asking For a Reduction in Tourism, and We Should Listen

Published on 9/2/2021 at 3:35 PM

Scenic views of Kauai from above. Keâ??e Beach is at the end of the road on the North Shore.

In 2014, my family traveled to the island of Oahu in Hawaii. I fondly recall climbing the dormant volcano Diamond Head, attending my first luau, and searching for a humuhumunukunukuapua'a while snorkeling in Hanauma Bay. All things considered, we were a typical "tourist family" seeking both adventure and knowledge as we navigated the island's hotspots.

Five years later, we were privileged enough to return, and this time we attempted to broaden our horizons and look for beaches , trails, and restaurants that were frequented by more locals than tourists. This approach to traveling has become an increasingly popular option for travelers today. Though this may seem harmless, there's been mounting concern among Native Hawaiians and locals about the ethics and sustainability of these tourism trends, and those feelings have only been exacerbated by the pandemic.

According to the 2021 Hawaii Tourism Authority's Resident Sentiment Survey, only 53 percent of Hawaiians feel that tourism has been more beneficial than harmful . "It's the lowest measure since we started taking the survey in 1988," Chris Kam, the president and COO of Omnitrak, told the Honolulu Star-Advertiser . Kam explained that some of the primary issues residents are facing include overcrowding, damage to the environment, and higher cost of living. Compounded together, it makes sense that attitudes toward tourism have become more and more negative, hence the calls for a decrease in travel.

According to the 2021 Hawaii Tourism Authority's Resident Sentiment Survey, only 53 percent of Hawaiians feel that tourism has been more beneficial than harmful.

In 2019, a record 10 million tourists visited Hawaii , a group of islands with a population of 1.5 million. A year after the pandemic halted travel, 2021's numbers are quickly approaching — and even surpassing — that rate, creating issues with overcrowding.

This summer, for example, the islands experienced a rental-car crisis . Companies like Hertz and Avis had sold portions of their fleets during the pandemic to save cash, decreasing the number of cars available by more than 40 percent , according to the Hawaii Tourism Authority (HTA). Then, as travel resurged, the issue of supply and demand created astronomical rental prices that were capping at $700 per day, compared to the prepandemic $50.

Shocked, some tourists began renting U-Hauls instead. This transportation loophole left a number of offices unable to provide equipment to locals who needed to move, prompting the HTA to release a statement saying they "[do] not condone visitors renting moving trucks and vans for leisure purposes."

The displacement of Native Hawaiian people has been a harmful runoff effect of overcrowding for years. Micah Doane, cofounder of the beach-cleaning nonprofit Protectors of Paradise, told The Guardian that his grandmother's family was evicted from the Makua Beach area during World War II so a military training facility could be built. Similarly, the building of luxury hotels has also been used to displace locals. Today, places like Makua Beach are frequented by resort guests who disregard the rules and leave behind excess waste. "You see every day these disrespectful people come and do whatever they want . . . It's to the point where it's kind of hurt an entire community," Doane said.

The pandemic had returned a sort of peace to the islands in which nature and wildlife were able to thrive. Without the usual influx of tourists, researchers from the University of Hawaii were able to see clearer waters, schools of larger fish, and monk seals at Hanauma Bay for the first time in years. Kyle Kajihiro, an activist and lecturer at the University of Hawaii at Manoa, told The New York Times that tourists tend to treat the islands like a "play land" and ignore their history and the residents' social-justice and environmental concerns. That's why we too often see trash left on beaches , coral reefs damaged by unapproved sunscreens, and sacred sites disrespected.

If not for the fact that countless endangered and threatened plant and animal species call the islands home, tourists should care about and respect the environment simply because Natives and locals are asking them to. Resorts are often owned and run by non-Hawaiians, whose interest in purchasing property (commercial or otherwise) is largely responsible for the state's high cost of living. Meanwhile, Native Hawaiians are disproportionately employed by the tourism industry in low-paying service jobs.

During an interview with Hawaii News Now , Lawrence Boyd, an economist and associate specialist with the University of Hawaii Center for Labor Education, touched on the rampant economic inequality in Hawaii. "Basically what Hawaii has become is a preferred place for the international 1 percent to buy property ," he said. Today, the median price for a single-family home in Honolulu sits at $992,500 , while the median household income in Honolulu is $87,470 .

Together, it's easy to see how these conditions have led to Hawaii having the highest rate of homelessness per capita in the nation , with Native Hawaiians being disproportionately affected. "There historically hasn't been enough consideration for how tourism and tourists can contribute to making life sustainable and really livable for the locals who serve them here," Bryant de Venecia, a communications organizer for the workers' union in Honolulu, Unite Here Local 5, told The New York Times .

It's important to remember that as tourists, we get to experience the best our destination has to offer without dealing with the realities and stresses of everyday life for those who call Hawaii home. So before jumping on the next plane to experience your own White Lotus -style vacation , take some time to reflect on the role you would play on the islands and how that would affect the Native population and environment. As tourism continues to evolve based on people's needs, one of the best things we can do as visitors is respect the wishes of the locals who want to preserve their community, culture, and environment.

United States
Summer Travel

Open access
Published: 24 April 2024

Cancer care coordination in rural Hawaii: a focus group study

Shin Chang 1 , 2 ,
Michelle Liu 2 ,
Christa Braun-Inglis 2 ,
Randall Holcombe 2 , 3 &
Izumi Okado 2

BMC Health Services Research volume 24 , Article number: 518 ( 2024 ) Cite this article

79 Accesses

Metrics details

Rural populations consistently experience a disproportionate burden of cancer, including higher incidence and mortality rates, compared to the urban populations. Factors that are thought to contribute to these disparities include limited or lack of access to care and challenges with care coordination (CC). In Hawaii, many patients residing in rural areas experience unique challenges with CC as they require inter-island travel for their cancer treatment. In this focus group study, we explored the specific challenges and positive experiences that impact the CC in rural Hawaii cancer patients.

We conducted two semi-structured focus group interviews with cancer patients receiving active treatment for any type of cancer ( n = 8). The participants were recruited from the rural areas of Hawaii, specifically the Hawaii county and Kauai. Rural was defined using the Rural-Urban Commuting Area Codes (RUCA; rural ≥ 4). The focus group discussions were facilitated using open-ended questions to explore patients’ experiences with CC.

Content analysis revealed that 47% of the discussions were related to CC-related challenges, including access to care (27.3%), insurance (9.1%), inter-island travel (6.1%), and medical literacy (4.5%). Other major themes from the discussions focused on facilitators of CC (30.3%), including the use of electronic patient portal (12.1%), team-based approach (9.1%), family caregiver support (4.5%), and local clinic staff (4.5%).

Our findings indicate that there are notable challenges in rural patients’ experiences regarding their cancer care coordination. Specific factors such as the lack of oncologist and oncology services, fragmented system, and the lack of local general medical providers contribute to problems with access to care. However, there are also positive factors found through the help of facilitators of CC, notability the use of electronic patient portal, team-based approach, family caregiver support, and local clinic staff. These findings highlight potential targets of interventions to improve cancer care delivery for rural patients.

Trial Registration

Not required.

Peer Review reports

Rural populations have higher cancer mortality rates compared to urban populations [ 1 , 2 ]. Rural-urban disparities in cancer health outcomes are partly attributed to challenges with cancer care delivery, specifically care coordination (CC) in rural areas [ 1 , 3 ]. Cancer CC is essential to high-quality cancer care [ 4 ], and since cancer CC in rural areas is affected by challenges such as limited access to providers and health services [ 5 ], it is important to gain further understanding of rural patients’ perceptions of cancer CC.

There are notable CC challenges in rural areas including limited access to specialty medical services and long travel distances to care. According to a 2022 data published by the American Society of Clinical Oncology (ASCO), only 10.5% of active oncologists practiced in rural areas, making oncologist shortage an obstacle to care access for rural cancer patients. Beyond challenges in accessing oncologists, there are other barriers to access to cancer care including the scarcity of hospitals in rural areas, limited access to health information sources, and longer travel distances needed to access health services [ 6 , 7 , 8 ]. There are also other notable disadvantages faced by rural populations compared with urban populations. Studies have shown that rural populations have higher poverty and unemployment rates, a greater number of uninsured residents, and lower educational attainment and health literacy [ 9 , 10 , 11 ]. These disadvantages, along with the lack care of access, may contribute to the higher cancer mortality rates found in rural populations.

Limited prior studies have compared the differences in cancer CC between rural and urban populations [ 5 , 12 , 13 , 14 , 15 , 16 ]. Some studies reported more challenges with CC in rural communities compared with the urban due to the limited access to health care providers and community services, fewer providers of specialized care, and lack of effective communication between specialist and primary care [ 5 , 13 ]. In contrast, studies by Mollica et al. reported more positive perceptions of CC among rural patients getting care quickly compared to urban patients [ 14 , 15 ]. Some potential explanations regarding their results of more positive CC experience among rural patients include different expectations to care access in rural residents compared to urban residents, longer wait times for urban residents, and selection bias in Medicare beneficiaries. Overall, research regarding cancer CC in rural populations is limited, and there are major gaps in understanding the perceptions of CC among rural cancer patients.

Our study addresses the knowledge gap of cancer CC in rural patients, specifically in rural Hawaii, by exploring the perceptions of CC through a qualitative study. Rural Hawaii patients face challenges in seeking care such as physician shortages [ 17 ] and lack of specialty care in local clinics. Assessments on the Hawaii physician workforce prior to the COVID-19 pandemic showed that there was a high percentage of physician shortage in Hawaii, especially on the islands that are mostly rural [ 18 ]. Moreover, recent reports also estimated that 10% of providers have retired or closed their practices since the start of the pandemic [ 17 ]. With locum physicians providing oncology care in many rural areas in Hawaii, the limited medical resources and specialty cancer care in rural Hawaii mean that many cancer patients residing on the more rural islands have to travel by air to the more urban Oahu island to obtain cancer treatment. The lack of available health professionals and need for air-travel present as some of the unique barriers for rural patients in Hawaii. However, there is no prior research on how these barriers are perceived by these patients.

In this qualitative study, we explored the specific challenges and positive experiences that impact the CC in rural Hawaii cancer patients. Rural populations in Hawaii are often excluded in US population-based studies, and this study contributes new knowledge in an understudied population. These findings can be used to further improve CC in rural areas in the future.

Participants

In this study, we conducted two semi-structured focus group interviews with a subset of patients ( n = 8) from a previous care coordination survey study. The care coordination study has been described elsewhere [ 19 ]. Participants were recruited from rural areas of Hawaii, specifically the Hawaii county and Kauai, and were receiving active treatment for any type of cancer. Rural was defined using the Rural-Urban Commuting Area Codes (RUCA; rural ≥ 4). The focus group participants were identified through a supplemental questionnaire in the previous study that probed for interest in focus group participation. The study was approved by the University of Hawaii Institutional Review Board.

Study design

The research team coordinated two focus groups ( n = 4 each) based on the times and days convenient to the participants. Prior to the start of the focus group discussions, verbal consent was again obtained from all participants. The interviews were conducted virtually over zoom (R.F.H., C.B., and I.O.) due to the pandemic and to allow remote participation. The interview questions were developed by the research team prior to focus groups and encompassed open-ended questions designed to explore care coordination (see supplement for the discussion guide). All focus group discussions were audiotaped and transcribed verbatim, with each participant’s comment anonymously attributed.

Qualitative analysis

Analysis of the focus group interviews was conducted using content analysis. First, the researchers independently coded the transcripts to identify important aspects across the two focus group discussions. Next, the team compared, analyzed, and refined the codes until the main themes were identified. The themes were discussed until a consensus was reached. Subthemes were also identified, with the hierarchy determined and named appropriately. Any discrepancies were resolved by discussion (S.C., M.L., and I.O.).

Demographic characteristics of the participants are presented in Table 1 . A majority of the participants were female (87.5%) and the mean age was 62.3. The participants were racially diverse, with 62.5% any Asian, 37.5% any White, 12.5% any Native Hawaiian, and 12.5% others. Half of the participants were breast cancer patients, while the remaining half consisted of GI and other cancer patients. There was representation across all cancer stages, with 75% of the participants in the early stages and 25% in Stage IV.

The content analysis (Fig. 1 ) revealed that almost half (47.0%) of the discussions were connected to CC-related challenges. Within CC-related challenges, access to care was the most common subtheme (27.3%), with the lack of oncologists and oncology services identified as the major contributing factor (61.1%). Multiple participants described having to be seen by several different oncologists throughout their treatment, almost to the point of having a “revolving door” of physicians (See Table 2 ). They mentioned that it was difficult having to be treated by physicians who did not know them well, especially because every physician has a different process and approach to care. Other contributing factors that limited access to care included delays in treatment and diagnosis (16.7%), the fragmented system (11.1%), for which patients had to undergo care across multiple healthcare organizations, and the lack of local general medical providers (11.1%). The participants discussed how the long wait times for appointments, different provider networks, and difficulty accessing local general medical providers contributed to their worries about cancer progression.

A & B Themes and subthemes, shown by proportions of focus group discussion

Besides access to care, other subthemes within CC-related challenges included insurance (9.1%), travel (6.1%), and medical literacy (4.5%). Some participants described issues with getting insurance-approval for treatment and inter-island travel, which either caused delays in treatment or led to high out-of-pocket costs. For other participants, the inter-island travel was difficult beyond its costs due to troubles coordinating appointment times and the time commitment required. Medical literacy may also have been a challenge, as some patients discussed their confusion regarding the roles of oncologists. These participants commented that it was strange that they were mostly visiting their oncologists rather than their primary care providers (PCPs), and questioned why their PCPs were not more involved in their cancer care.

Facilitators of CC was another major theme (30.3%) from the focus group discussions. The use of electronic patient portal (12.1%) was helpful for the 3 participants who had access to it. These participants highlighted that the portal allowed them to keep track of their health records and more easily communicate with the healthcare team. In another part of the discussion, team-based approach (9.1%) seemed to have led to a strongly positive cancer treatment experience. Other facilitators of CC included family caregiver support (4.5%), which involved patients having family members to help communicate with the care team, and local clinic staff (4.5%), especially the regular staff that are part of the clinics and infusion centers. Participants described these local staff as members of the care team who are “constant” in their care journeys and who became like family members to them.

At the end of each focus group discussion, the research team asked the participants about suggestions or advice for improving care coordination. Most participants emphasized the need for more full-time, permanent oncologists that can serve on the islands, specifically in rural areas. Besides the challenges of having a different new oncologist for nearly every visit, they mentioned that it was difficult to be kept in the dark as to why the oncologists kept leaving. They thought that it would be helpful if the medical systems were more transparent regarding physician changes, so that they could identify the local physicians with whom they could work with longer. Multiple participants also commented about the importance of self-advocacy, highlighting it as an essential component that improved and sped-up their treatment process. They described self-advocacy as asking questions, proactively reaching out to the providers for help, and keeping the care team updated, which together helped to reduce delays to care and improve their outcomes.

The remaining discussion contained other themes (15.1%). Some participants shared personal history (12.1%) regarding their cancer diagnoses, symptoms, and treatment process. Others described COVID-19 related challenges (3.0%), such as feeling isolated during COVID and having to travel under COVID-restrictions. Quotes from the focus group participants are shown in Table 2 , supporting the qualitative analysis.

In this focus group study, we explored the specific challenges and positive experiences that impact the CC in rural Hawaii cancer patients. Overall, our findings illuminate challenges such as limited access to care, inter-island travel, and insurance-related issues as described by rural cancer patients regarding their CC. Our findings also suggest that there are facilitators of CC such as electronic patient portals, family caregiver support, and local clinic staff, along with the use of a team-based approach, that contribute to more positive experiences that may help to mitigate some of these challenges.

Our results demonstrate that access to care was a major component of CC-related challenges, with the lack of oncologists and oncology services found as the most frequently mentioned contributing factor. These findings are consistent with previous research that reported fewer practicing oncologists and general medical providers in rural areas [ 20 , 21 , 22 ], highlighting the need for more permanent oncologists and providers in rural areas. It is also interesting to note that the high turnover of oncologists was mentioned by the participants. Similar to suggestions made by the participants, further studies are needed to illuminate and address the factors that contribute to oncologist shortages in rural Hawaii.

Other access-related challenges included the lack of local general medical providers and the fragmented care system. Given that previous studies indicate that primary care physicians play a vital role in cancer CC by managing comorbid conditions [ 23 ], the pandemic is likely to have further exacerbated the high-turnover and challenges with finding general medical providers felt by the participants. Furthermore, other studies have also shown that fragmented cancer care results in longer time to treatment and increased mortality while potentiating existing socioeconomic disparities [ 24 , 25 ]. Some of the participants were worried about these delays because they feared further cancer progression. Their worries are not unwarranted, as previous studies have shown a significant association between cancer care delays and increased mortality [ 26 ].

In addition to limited access to care, other subthemes found under CC-related challenges include travel and insurance-related issues. Many participants faced limited cancer care on their islands, were not able to get the care they required, and therefore had to travel inter-island to access the specialized treatment they needed. However, inter-island travel presented with its own unique challenges. For participants whose insurance did not cover the travel costs, the costs for travel were significant, as they needed to pay out of pocket for airfare, and air travel is the only mode of inter-island travel in Hawaii. Utilizing inter-island travels for care also meant extended time commitments and time off from work for those who were employed. Overall, these travel challenges likely further increased barriers to cancer care for rural patients. These results were supported in prior research that showed the association of increased travel burden with decreased care access for lung, breast, and colon cancer patients [ 27 , 28 , 29 ]. Travel distance is also associated with increased financial barriers, especially for those with lower socioeconomic status and inadequate insurance coverage in the rural population [ 30 , 31 ]. Altogether, the longer travel distances faced by rural patients present as a critical health barrier for rural patients. Beyond the financial difficulties, it is important to note that cancer treatment costs can often lead to catastrophic financial burden on the patients, regardless of rural and urban residence, causing what is often termed “financial toxicity” [ 30 , 31 ]. Further interventions are needed to address these financial disparities faced by cancer patients.

Lastly, patients’ lack of understanding of CC processes and the people involved in oncology care was also found as a source of challenge. Some participants did not understand why they were referred to oncologists rather than continuing care with their general providers. Further communication and explanation from the general providers about the roles of oncologists could have alleviated these confusions for patients and ensured a smoother transition in their care.

Although many specific challenges hinder rural cancer patients’ experiences with CC, our findings also revealed the strong positive impact of facilitators on patients’ CC experience. First, the participants who had access to electronic patient portals found that they could easily access their health information and communicate with care team members. By asking questions and keeping their care team up to date through the portals, they were able to better self-advocate. This suggests that electronic patient portals may help to mitigate some of the challenges caused by the long distance between rural cancer patients and their cancer care provider. However, limitations exist because the portals were not available to all our participants due to the differing locations they were at. Similarly, not all of the clinics have these systems.

Second, our findings suggest that team-based approach seemed to have led to a positive experience. It is imperative to note, however, that the comments about the team-based approach came from only one participant, the only one who was receiving an HMO-based care. Although this result may not by generalizable, a systemic review showed that team-based care may improve patient satisfaction [ 32 ]. Third, the presence of local clinic staff also contributed to positive cancer care experiences for the participants. Given the “revolving door” of oncologists, the responses given by the participants suggest that having stable and long-term relationships with the local clinic staff made participants feel like they have constant team members who will keep being a part of their cancer journeys. This is in strong contrast with the long list of oncologists they’ve seen, most of whom they can barely remember the name of. Finally, consistent with prior research, family caregivers’ support also helped improve the cancer CC experience for patients [ 33 ]. This is likely because family caregivers can help to alleviate the emotional toll of cancer on patients while also helping to manage the health care needs and CC-related tasks for patients.

There are some limitations to this study. Firstly, the participants for the focus groups were selected based on voluntary participation. It cannot be ruled out that positive or negative experiences may have prompted these participants to be more willing to participate in this study. Secondly, this study is composed of two focus groups, with an overall sample size of 8 participants. It should be noted that the study was originally composed of three focus groups. However, the third focus group could not be conducted because many participants called in sick or were otherwise unavailable. While the sample size was small, participant comments generally echoed similar concerns and suggestions, and rural residents of Hawaii share similar care coordination-related issues as other rural areas including long travel distance to care, higher proportions of residents with lower socioeconomic status, and limited access to specialty oncology services. Lastly, the focus group interviews were all conducted virtually to allow participants to join remotely, due to the pandemic and to avoid the need for inter-island travel. This could mean limited information about nonverbal cues such as body language and eye contact that may have been more discernible from a traditional in-person interview.

Despite certain limitations, our study is significant because there are limited prior studies about how specific CC processes impact rural cancer care. Furthermore, this is the first focus group study regarding CC conducted with the rural Hawaii population. Hawaii is often excluded in US population-based studies, and this study provides insights into unique challenges with cancer care coordination for rural Hawaii patients. This study can help inform areas of improvements for cancer CC needed to help decrease disparities and increase survival in rural cancer patients.

Conclusions

Our findings explored the challenges in rural Hawaii cancer patients’ CC experiences. Access to care presented as a major challenge due to the lack of oncologist and oncology services, limited local general medical providers, and the fragmented care system. Other challenges that influenced the cancer CC experience include travel issues and insurance-related troubles. We also identified facilitators of CC that are likely to provide positive CC experiences, including the use of electronic patient portals, team-based approach to care, support from family caregivers, and the presence of local clinic staff. Overall, our findings highlight potential targets of interventions to improve cancer care delivery for rural patients.

Data availability

The data collected and analyzed during this study are available from the corresponding author on reasonable request. Any information made available will be fully de-identified.

Abbreviations

Rural-Urban Commuting Area Codes

Care Coordination

Primary Care Providers

Henley SJ, Anderson RN, Thomas CC, Massetti GM, Peaker B, Richardson LC, Invasive Cancer I. 2004–2013, and deaths, 2006–2015, in Nonmetropolitan and Metropolitan counties — United States. MMWR Surveill Summ. 2017;66(14):1–13.

Article PubMed PubMed Central Google Scholar

Henley SJ, Jemal A. Rural cancer control: bridging the chasm in geographic health inequity. Cancer Epidemiol Biomarkers Prev. 2018;27(11):1248–51.

Blake KD, Moss JL, Gaysynsky A, Srinivasan S, Croyle RT. Making the case for investment in Rural Cancer Control: an analysis of Rural Cancer incidence, mortality, and Funding trends. Cancer Epidemiol Biomarkers Prev. 2017;26(7):992–7.

McDonald KM, Sundaram V, Bravata DM, Lewis R, Lin N, Kraft SA et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 7: Care Coordination) [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007 [cited 2023 Jun 18]. (AHRQ Technical Reviews). http://www.ncbi.nlm.nih.gov/books/NBK44015/ .

Walsh J, Harrison JD, Young JM, Butow PN, Solomon MJ, Masya L. What are the current barriers to effective cancer care coordination? A qualitative study. BMC Health Serv Res. 2010;10(1):132.

Douthit N, Kiv S, Dwolatzky T, Biswas S. Exposing some important barriers to health care access in the rural USA. Public Health. 2015;129(6):611–20.

Article CAS PubMed Google Scholar

Chen X, Orom H, Hay JL, Waters EA, Schofield E, Li Y, et al. Differences in Rural and Urban Health Information Access and Use. J Rural Health. 2019;35(3):405–17.

Article PubMed Google Scholar

Chan L, Hart LG, Goodman DC. Geographic Access to Health Care for Rural Medicare beneficiaries. J Rural Health. 2006;22(2):140–6.

Blumenthal SJ, Kagen J. The effects of Socioeconomic Status on Health in Rural and Urban America. JAMA. 2002;287(1):109.

Popat S. The 2014 Update of the Rural-Urban Chartbook. 2014.

USDA ERS -. Rural Education [Internet]. [cited 2023 May 25]. https://www.ers.usda.gov/topics/rural-economy-population/employment-education/rural-education/ .

Durcinoska I, Young JM, Solomon MJ. Patterns and predictors of colorectal cancer care coordination: a population-based survey of Australian patients. Cancer. 2017;123(2):319–26.

Street TD, Somoray K, Richards GC, Lacey SJ. Continuity of care for patients with chronic conditions from rural or remote Australia: a systematic review. Aust J Rural Health. 2019;27(3):196–202.

Mollica MA, Buckenmaier SS, Halpern MT, McNeel TS, Weaver SJ, Doose M, et al. Perceptions of care coordination among older adult cancer survivors: a SEER-CAHPS study. J Geriatr Oncol. 2021;12(3):446–52.

Mollica MA, Weaver KE, McNeel TS, Kent EE. Examining urban and rural differences in perceived timeliness of care among cancer patients: a SEER-CAHPS study. Cancer. 2018;124(15):3257–65.

Powell RE, Doty A, Casten RJ, Rovner BW, Rising KL. A qualitative analysis of interprofessional healthcare team members’ perceptions of patient barriers to healthcare engagement. BMC Health Serv Res. 2016;16:493.

Withy K, Joo K, Potter C. Hawai‘i Physician Workforce Assessment 2020. Hawaii J Health Soc Welf. 2022;81(4 Suppl 2):4–10.

PubMed PubMed Central Google Scholar

Withy K. Annual Report on Findings from the Hawai’i Physician Workforce Assessment Project. 2019.

Okado I, Liu-Duerr M, Hewitt T, Elhajj C, Nishiyama S, Holcombe RF. Perceptions of cancer care coordination among rural patients in Hawaii. JCO. 2022;40(16suppl):e18553–18553.

Article Google Scholar

Hung P, Deng S, Zahnd WE, Adams SA, Olatosi B, Crouch EL, et al. Geographic disparities in residential proximity to colorectal and cervical cancer care providers. Cancer. 2020;126(5):1068–76.

Levit LA, Byatt L, Lyss AP, Paskett ED, Levit K, Kirkwood K, et al. Closing the Rural Cancer Care Gap: three institutional approaches. JCO Oncol Pract. 2020;16(7):422–30.

Kirkwood MK, Bruinooge SS, Goldstein MA, Bajorin DF, Kosty MP. Enhancing the American Society of Clinical Oncology workforce information system with geographic distribution of oncologists and comparison of data sources for the number of practicing oncologists. J Oncol Pract. 2014;10(1):32–8.

Klabunde CN, Ambs A, Keating NL, He Y, Doucette WR, Tisnado D, et al. The role of Primary Care Physicians in Cancer Care. J Gen Intern Med. 2009;24(9):1029–36.

Hester CA, Karbhari N, Rich NE, Augustine M, Mansour JC, Polanco PM, et al. Effect of fragmentation of cancer care on treatment use and survival in hepatocellular carcinoma. Cancer. 2019;125(19):3428–36.

Choi DW, Kim SJ, Kim DJ, Chang YJ, Kim DW, Han KT. Does fragmented cancer care affect survival? Analysis of gastric cancer patients using national insurance claim data. BMC Health Serv Res. 2022;22(1):1566.

Hanna TP, King WD, Thibodeau S, Jalink M, Paulin GA, Harvey-Jones E, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020;371:m4087.

Longacre CF, Neprash HT, Shippee ND, Tuttle TM, Virnig BA, Travel. Treatment Choice, and survival among breast Cancer patients: a Population-based analysis. Women’s Health Rep. 2021;2(1):1–10.

Obrochta CA Jr, Murphy HP, Nara JD, Trinidad A, Araneta D MR (Happy), editors. The impact of patient travel time on disparities in treatment for early stage lung cancer in California. PLOS ONE. 2022;17(10):e0272076.

Massarweh NN, Chiang YJ, Xing Y, Chang GJ, Haynes AB, You YN, et al. Association between Travel Distance and metastatic disease at diagnosis among patients with Colon cancer. J Clin Oncol. 2014;32(9):942–8.

Yousuf Zafar S. Financial toxicity of Cancer Care: it’s time to Intervene. JNCI: J Natl Cancer Inst. 2016;108(5):djv370.

Carrera PM, Kantarjian HM, Blinder VS. The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment. Cancer J Clin. 2018;68(2):153–65.

Will KK, Johnson ML, Lamb G. Team-based care and patient satisfaction in the hospital setting: a systematic review. J Patient Cent Res Rev. 2019;6(2):158–71.

Okado I, Cassel K, Pagano I, Holcombe RF. Assessing patients’ perceptions of Cancer Care Coordination in a community-based setting. JCO Oncol Pract. 2020;16(8):e726–33.

Download references

Acknowledgements

Not applicable.

This project was funded in part by F32HS027286-01A1 (PI: Okado) from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human. Services (HHS) and the UH Cancer Center.

Author information

Authors and affiliations.

John A Burns School of Medicine, University of Hawaiʻi at Mānoa, 651 Ilalo St, 96813, Honolulu, HI, USA

University of Hawai‘i Cancer Center, 701 Ilalo St. 6th Floor, 96813, Honolulu, HI, USA

Shin Chang, Michelle Liu, Christa Braun-Inglis, Randall Holcombe & Izumi Okado

University of Vermont Cancer Center, 149 Beaumont Av. Burlington, 05405, VT, USA

Randall Holcombe

You can also search for this author in PubMed Google Scholar

Contributions

R.H. and I.O. designed the focus group studies presented in the manuscript. R.H., C.B. and I.O. conducted the focus group interviews. S.C., M.L. and I.O. analyzed the qualitative data from the focus groups. S.C. drafted the full manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Izumi Okado .

Ethics declarations

Ethics approval and consent to participate.

All procedures performed in our studies involving human participants were in accordance with the ethical standards of the institutional research committees and with the 1964 Helskinki declaration and its later amendments or comparable ethical standards. The studies were reviewed and approved by the University of Hawaii Institutional Review Board. The focus group interviews were conducted online, and verbal informed consent was obtained from all individuals included in the study. This study was conducted in 2021, during the COVID-19 pandemic; based on the safety requirements that were in place at the time of data collection, the Institutional Review Board approved the use of verbal consent for this study.

Consent for publication

Competing interests.

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Chang, S., Liu, M., Braun-Inglis, C. et al. Cancer care coordination in rural Hawaii: a focus group study. BMC Health Serv Res 24 , 518 (2024). https://doi.org/10.1186/s12913-024-10916-1

Download citation

Received : 10 August 2023

Accepted : 27 March 2024

Published : 24 April 2024

DOI : https://doi.org/10.1186/s12913-024-10916-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Care coordination
Qualitative study
Focus group
Rural Hawaii

BMC Health Services Research

ISSN: 1472-6963

General enquiries: [email protected]

IMAGES

Effects of tourism on Hawaii by Carlos Morales on Prezi
Hawaii struggles with overtourism
Can Voluntourism Offset the Environmental Impacts of Hawaiʻi's Growing
Hawaii’s over-tourism problem may get worse than ever. Here's why
Hawaii Tourism Statistics
Hawaii Tourism Statistics

COMMENTS

Hawaii overtourism: Residents beg tourists to stop visiting amid post
The island state is burdened by overtourism - and it's becoming a big problem. Last year, tens of thousands of extra US tourists left Hawai'i in turmoil as it struggled to cope with unprecedented ...
Hawaii Is a Paradise, but Whose?
Tourism is the biggest driver of Hawaii's economy, accounting for 21 percent of jobs. Nearly 10 million people visited the state in 2018 and in 2019, guest arrivals were expected to surpass that ...
Tourists continue to visit Hawaii's Haiku Stairs even as it gets
This increase in tourism - and the bad behavior that came with it - was among the reasons cited when Honolulu's city council voted to remove the stairs in 2021.
Have visitors finally overstayed their welcome in Hawaii?
John Locher/AP. The consequences of Hawaii's drive for tourists. 1 of 11. CNN —. The world-famous Ha'ikū Stairs along Oahu's Ko'olau mountain range, known as the "Stairway to Heaven ...
The Case for Caps: Overtourism in Hawaii
Researchers from the University of Hawaii at Mānoa found that at one point, hotels and their guests consumed around 60 percent of Hawaii's fuel and electricity. Even facing the challenges to the tourism sector during the coronavirus pandemic, in 2020, hotels alone were responsible for 8.7 percent of electricity consumption on the island of Oahu.
Here's Why It's So Hard To Reshape Hawaii's Tourism Industry
And resident sentiment toward the industry only worsened. By late 2020, 57% of residents who responded to a Hawaii Tourism Authority survey in September and October completely or strongly agreed ...
How a vacation to Hawaii can be relaxing for tourists
Hawaii's reliance on tourism has resulted in Native Hawaiians getting priced out of their homes and havoc on the natural landscape. Activists say if visitors to Hawaii decenter themselves and ...
Studied To Death? Some Say Hawaii Doesn't Need More Data Before Acting
So do hotel executives, who say tourism is at risk if the stress of hosting too many people erodes Hawaii's natural and cultural resources and aloha spirit to a point that tourists don't want ...
Facing Economic Devastation, Hawaii Attempts To Revive Tourism
The tourist economy in Hawaii has been decimated by the pandemic, with 1 in 6 people there unemployed. Now, the state hopes new traveler testing protocols will help bring visitors back to its beaches.
Hawaii Is Rethinking Tourism. Here's What That Means for You
In 2019, the state of 1.5 million people hosted a record 10.4 million visitors—unsustainable figures that had residents feeling sour. Though tourism netted $2.07 billion in tax revenue that year ...
Can Hawaii reset its stressed out tourism industry after the pandemic
In Hawaii, locals hiked popular trails and visited beaches that are usually clogged by tourists. Traffic was noticeably lighter, and things in the islands were generally calmer. Things are already ...
Hawaii's overtourism may get worse than ever
It reached a boiling point in 2019, when Hawaii's 1.5 million residents watched it become a case study in over- tourism amid 10.4 million annual arrivals. Among the side effects of that ...
Hawaii's Overtourism Problem May Get Worse Than Ever
(Bloomberg) -- In early 2021, Hawaii's tourism board kicked off a trailblazing plan to inject authentic Native Hawaiian culture into every facet of its visitor industry, using it to help protect its communities and fragile places while deepening the tourist experience. Now, just three years in, the "Malama Hawaii" or "Care for Hawaii" initiative to push sustainable tourism may be on ...
Hawaii Tourism Officials Are Seeking 'Mindful, Respectful And High
The Hawaii Tourism Authority is trying to change Hawaii's brand from that of simply a tropical playground. Cory Lum/Civil Beat/2022. Another $14.4 million would be spent to support HTA's ...
Legislation aims to help tourism recover
HONOLULU — Hawai'i's hotel booking pace is in the red through December, but legislative funding has allowed the Hawai'i Tourism Authority to support a new multimillion-dollar marketing ...
4 ways Hawaii is coping with an influx of tourists
Hawaii has always been a go-to destination for travelers—and many Hawaiian residents are used to it. But since COVID-19 restrictions were lifted this spring, there's been a rush of tourists that has rattled even the most hardened residents. Hawaii is currently on track to surpass its 2019 tourism numbers, despite the state only being fully opened since July 8.
Hawaii's 'overtourism' becomes growing debate as West Maui reopens for
In 2022 alone, Hawaii saw nearly 10 million visitors, according to the state Department of Business, Economic Development & Tourism. In 2020, amid the COVID-19 pandemic, the Islands saw roughly 2. ...
Tourists are overcrowding Hawaii. Here's how they're handling it
Hawaii is a small state that's a huge draw for tourists. Maybe it's the beaches, or the phenomenal hiking trails, or the beautiful, rich culture. Maybe it's the 'Aloha spirit' that welcomes you ...
Hawaii Tourism: Opposite of a Paradise for Locals
Once Hawaii became a U.S. state in 1959, it became a tourist hotspot during the 1960s. Although tourism is a major industry in Hawaii's economy, it comes with problems affecting their environment, economy, and residents. Tourism has caused environmental damage to the land and water sources, which has led to the ongoing water crisis in Hawaii.
After The Fire: Rethinking Tourism Impacts On Hawaii
These issues didn't arise overnight-they stem from the structured gentrification of Hawaii that financially and physically displaced the native population while portraying it as a way to economically benefit the island's communities. ... such as the Hawaii Tourism Authority's hope to reinvest 2.7 million dollars into the culture and ...
Hawaii's Unhealthy Relationship With Tourism
Tourism has been profitable for our state. However, the impacts of COVID-19 on tourism highlighted just how completely dependent our state is on tourism — and it's an unhealthy relationship ...
This is how tourists are destroying coral reefs in Hawaii
The millions of tourists who flock to the shores of Hawaii every year are wreaking havoc on its natural environment -- especially the coral reefs, which are at risk all over the world, a new study ...
The Damage Done by the Tourism Industry in Hawai'i
Donate. Thinking Through Writing. Aug 29. Aug 29 Paradise Lost - The Damage Done by the Tourism Industry in Hawai'i. Drew Pagaduan. Macroeconomic Policy. For decades, people from the mainland U.S. and abroad have seen Hawai'i as an island paradise of beautiful beaches, local generosity, and stunning vistas.
How Tourism Is Negatively Impacting Native Hawaiians
Compounded together, it makes sense that attitudes toward tourism have become more and more negative, hence the calls for a decrease in travel. According to the 2021 Hawaii Tourism Authority's ...
Maui wildfires: 'If you want to help, keep your trip,' Hawaii tourism
On August 18, Hawaii Gov. Josh Green declared a "tourism emergency" as visitors to the island have dropped significantly in the wake of the devastating wildfires.
Hawaii once saw 1.5M visitors from Japan. Many aren't returning
However, Eric Takahata, the managing director for Hawaii Tourism Japan, feels differently. The agency is responsible for marketing the Hawaii brand to Japan and inspiring visitors to travel to the ...
Revealing Aspects of Hawai'i Tourism Using Situated ...
In this position paper, we present a process artifact that aims to bring awareness to historical context, contemporary issues, and identity harm inflicted by tourism in Hawaii. First, we introduce the historical background and how the work is informed by the positionality of the authors. We discuss how related augmented reality work can inform strategy for building augmented reality ...
Cancer care coordination in rural Hawaii: a focus group study
Besides access to care, other subthemes within CC-related challenges included insurance (9.1%), travel (6.1%), and medical literacy (4.5%). Some participants described issues with getting insurance-approval for treatment and inter-island travel, which either caused delays in treatment or led to high out-of-pocket costs.