This chapter focuses on Kānaka ‘Ōiwi, the indigenous people of Hawai’i. Kānaka ‘Ōiwi continue to experience a greater health burden compared to the overall U.S. population. In order to comprehensively understand Kānaka ‘Ōiwi health disparities, it is important to understand the broader historical and sociopolitical framework that has led to their existence. The chapter first provides a post-Western contact, historical overview of Kānaka ‘Ōiwi, because their history is often overlooked in U.S. history and thus unfamiliar to most people in the United States, especially as it relates to the emphasis of this book on achieving health equity. It then describes emerging health disparities and inequities among Kānaka ‘Ōiwi. The chapter discusses culturally responsive programs and case studies that have been successfully implemented in the efforts to achieve health equity for Kānaka ‘Ōiwi. Finally, it concludes with recommendations and best-practices for health equity work.