On the rural Hawaiian Islands he serves, Dr. Landon Opunui uses culture as a clinical tool that blends lifestyle medicine with Indigenous healing, storytelling, and traditional foods to support whole-person health. His work highlights how culturally grounded care can help rebuild trust, improve engagement, and confront some of the most enduring inequities in health.
Landon Opunui, ND, DipACLM, doesn’t just care for patients– he tells stories.
The executive director and medical director of Nā Puʻuwai, one of five federally recognized Native Hawaiian Health Care Systems established under the Native Hawaiian Health Care Act, cares for patients on the islands of Molokaʻi and Lānaʻi.
These rural communities are home to more deer than people, and individuals who do live there have disproportionate rates of coronary heart disease, type 2 diabetes, obesity, and cancer. They are also more likely to be food insecure.
Rather than focusing solely on deficits and disparities, Dr. Opunui emphasizes strengths, resilience, and the cultural assets that have sustained Native Hawaiian communities for generations. He believes the path to indigenous healing requires shifting the narrative from the question of “what is wrong with you” to “what is important to you,” while honoring cultural knowledge, family systems, and connection to land.
This focus on community-driven care is reflected in Dr. Opunui’s selection as a recipient of a 2023 Health Equity Achieved Through Lifestyle Medicine (HEAL) scholarship, which supports leaders working to reduce health disparities in historically underserved communities across the United States.
“As a clinician, I often use my time with patients to share stories and reminders of who we are as a people and where we come from,” he said. “While colonization disrupted many cultural practices and interrupted the transmission of our indigenous wisdom, our communities continue to carry tremendous strength and wisdom. Reconnecting with the brilliance, innovation, strength, and resilience of our ancestors, and recognizing that those same qualities live within us today, can itself be healing.”
A healthy and living environment
Native Hawaiians have a history of extraordinary resilience. Before Western contact, Hawaiians were expert ocean navigators, governed sophisticated social systems, and sustained robust health through strong community care and land stewardship.
Land dispossession, foreign diseases, cultural suppression and more have created the conditions that underlie today’s disparities and healthcare access barriers, he said. Healthcare for Native Hawaiians has not always felt safe or effective, and the consequences are lower rates of health screenings and delays in seeking medical care.
Dr. Opunui often quotes the Hawaiian proverb Mohala i ka wai ka maka o ka pua—“Flowers thrive where the conditions for life are abundant.”
“Health does not emerge in isolation,” he said. “It is shaped by the environments that surround us. These environments include not only our homes and communities, but also our relationships, culture, connection to ʻāina (land), access to food, shelter and opportunity, and the systems and institutions we encounter, including our healthcare ecosystem. If we want healthier communities, we must create the conditions that allow health to flourish.”
Integrating lifestyle medicine and indigenous healing
Nā Puʻuwai is not a Federally Qualified Health Center, but receives federal funding under the 1988 Native Hawaiian Health Care Act to improve access to provide primary health, disease prevention, and health promotion services to island communities.
At Nā Puʻuwai, an interdisciplinary team works collaboratively across primary care, behavioral health, nutrition, fitness, health education, and traditional Hawaiian healing to support whole-person well-being while offering many access points to care. The health system offers culturally adapted programs to improve health literacy and promotes health through a number of community resources, such as a fitness center right outside the doors of exam rooms.
“Lifestyle medicine has become a powerful bridge between evidence-based medicine and Indigenous ways of knowing,” Dr. Opunui said. “Many of its pillars align naturally with values our communities have long understood—healthy food, movement, connection, stress management, purpose, and relationships. In many ways, these are not new ideas; they are reminders.”
Food as medicine
Nā Puʻuwai also integrates ʻai pono—the traditional Hawaiian practice of food as medicine—into its clinical practice and diabetes and weight‑management programs.
Long before the phrase “food is medicine” entered mainstream healthcare, Native Hawaiians understood the intimate relationship between food, land, and health, he said. Rather than beginning with foods that may feel unfamiliar or inaccessible, health educators emphasize traditional, plant-predominant staples that are culturally meaningful, nutritionally dense, and locally available.
“We begin with the foods, flavors, and traditions that are already woven into people’s lives and communities,” he said. “By meeting people where they are, we can translate evidence-based nutrition science into guidance that is practical, relevant, and resonant with culture and place.
A diverse, well-trained team
No single intervention reduces complex health disparities. Diabetes cannot be addressed effectively without addressing food insecurity, housing instability, mental health, stress, and the many upstream drivers of health, he said.
“The broader lesson extends far beyond our small, humble rural community health center,” Dr. Opunui said. “Health challenges rarely exist in isolation, and neither should our strategies to address them. We need diverse teams equipped to address the physical, emotional, social, cultural, and spiritual dimensions of health.
“When we care for the whole person and the systems that surround them, we advance the possibility for healing that extends far beyond clinic walls.”
Take the next step
Join the HEAL Initiative
Through the HEAL Initiative, ACLM members collaborate to develop and scale models of culturally responsive lifestyle medicine—like the work highlighted here.