Studies have shown that living near certain public works projects like landfills and power plants can have long-term physical health impacts, but less is known about the mental health burden. Makani Tabura, however, sees the strain every day.
Tabura is the director of cultural activities and education at Waianae Coast Comprehensive Health Center and his work in the pain management and substance abuse recovery clinics has revealed to him an identity crisis among his Waianae clientele.
For decades, Westside residents have shouldered the burden of hosting the island’s public utilities and the negative perceptions that come with it. Often seen as a dumping ground, the stereotype of the Westside being dangerous and desolate has permeated the community.
But health professionals and residents say in order for this perception to change, the entire island has to acknowledge the history and impact of the Westside’s sacrifice.
“Sometimes the people of Waianae feel like they have a reputation to uphold, that they have to be tough,” Tabura said.
The Dumping Ground?
Laurel Mei-Singh grew up hearing stereotypes about people from the Waianae Coast, a narrative she explored during her time as an ethnic studies professor at the University of Hawaii Manoa.
“We don’t just dump material waste on the Westside, but we kind of ‘dump on’ that side of the island psychologically,” Mei-Singh said.
Pre-Western contact, Waianae was a lush, sustainable community, with acres of loi kalo, or taro patches, and inland crops as well as many fishponds. All of these were fed by the perennial streams along the Waianae mountain range.
Then came the multiple waves of commercial agriculture. The sandalwood trade of the early 1800s rapidly stripped the land of iliahi for Chinese markets. When sugar plantations boomed in the latter part of that century, Waianae Sugar Co. was the first plantation to open on Oahu. Plantations diverted millions of gallons of water a day, depriving local crops and foodways.
Mei-Singh said this stole both economic and ecological wealth from the area. Followed by a boom in military bases post-World War II and the push to develop and urbanize the Ewa Plain, all of these changes to the land impacted the people who lived there and how the area was understood.
No longer was it a prosperous place to live and work, but an outlier way out west. Too dry, too hot and too far from the hubs of Oahu. These factors made it economically viable to build public works projects such as landfills, waste management sites and power plants on the Westside.
“I know the community I grew up in indirectly benefits from the economic and environmental oppression of people on the Westside,” said Mei-Singh, who was raised near Diamond Head and now teaches environmental justice at the University of Texas.
Up and down the Waianae Coast, there are multiple public utilities that service the entire island of Oahu. The only municipal landfill, Waimanalo Gulch, welcomes drivers into Nanakuli. Next door is Hawaiian Electric’s Kahe Point power plant. PVT, the only construction waste landfill, is a couple of miles down the road. Campbell Industrial Park, with the island’s only waste-to-energy burning facility, sits one town over.
A 2014 report from the U.S. Environmental Survey found these Westside power plants, landfills and industrial parks emitted thousands of tons of pollutants like volatile organic compounds, heavy metals and carbon monoxide.
Current federal regulations only require landfill companies to monitor 62 contaminants. However a recent evaluation from the University of Missouri found 584 contaminants present in landfill leachate, and 322 are known to be highly toxic.
“Regulatory lists are decades old and are not taking into account all of the newer classes of pollutants such as pollutants from electronic waste or pharmaceutical compounds,” said Liz Rogers, a doctoral student at the University of Missouri who is working on a database of common toxins found in landfills.
Some common contaminants found by Chung-Ho Lin, the researcher leading the toxicity project, include a common wood preservative and fire retardant, which can cause neurological problems. He’s most concerned about endocrine disruptors, a class of chemicals that can affect human hormones in very low amounts.
Lin and Rogers said that it’s not enough for regulators to rely on the Environmental Protection Agency’s list of contaminants. Instead they said regulators need to monitor the urine or blood of nearby residents for toxic contaminants and install specific mitigation efforts based on which contaminants are most prevalent.
“We are not anti-landfill because we need these landfills, but we need to develop processes to protect people living near landfills,” Lin said.
Concern for all these physical health effects are the reason why Westside community members pushed for Act 73 to pass in 2020, enforcing buffer zones around landfills to protect nearby residences and schools.
But while studies show how landfills can affect the physical health of a community, the potential toll on behavioral health is not well studied. That includes the mental strain and stress that community members experience when they feel unfairly burdened by public facilities.
Mei-Singh, the environmental justice expert, said that the forces of militarism, colonialism and racism have changed the meaning of land — from something sacred to this “dumping ground” moniker. But she hopes that understanding history can change negative perceptions.
“It’s important for people on the Westside to know this history so they can recuperate and reclaim their mo‘olelo (story),” Mei-Singh said.
The fluctuations in the people’s relationship to land also affect who they are, said Tabura.
“As Hawaiians, if you alter our environment, it changes us as well,” he said.
A lot of factors can influence someone’s mental health, including genetics, personal history and diet. However, the social determinants or the nonmedical conditions that people live and work in can also affect their well-being. Do they have access to clean water and food? Can they get a quality education? According to the U.S. Department of Health and Human Services, one social determinant is a person’s neighborhood and built environment.
Multiple studies have shown that improvements to built environments can positively affect mental health. When people have access to better housing, infrastructure and waste management systems, these “interventions can positively improve mental (and physical) health by reducing risks of stressors, injury and transmission of disease,” according to a World Health Organization report.
Census data shows that the Waianae Coast has the highest concentration of adults suffering from poor mental health on Oahu. According to Dr. Nikki Wright, a clinical psychologist and director at Waianae Coast Comprehensive Center, three of the biggest issues plaguing the behavioral health of their clients are substance abuse disorders, homelessness and poverty.
Another social determinant of health — economic stability — shows that poverty or low socioeconomic status negatively affects mental health. There’s an inverse correlation between socioeconomic status and access to mental health services and healthy foods, which can then trigger depression and anxiety.
These two determinants feeding into each other create a spiral that may be hard for some people to escape.
Wright has worked at the hospital since 2014 and said it saddens her to see the children and grandchildren of her former patients coming in for the same mental health and substance abuse issues. But she’s trying to break those intergenerational cycles.
“Everyone is just in survival mode, so we encourage them to think long term,” Wright said. “We point out their strengths and show them skills for a different path.”
Tabura hopes that Waianae residents can change the perceptions of their home by first transforming themselves. When he works with recovering drug users, he urges them to channel that tough persona into the grit and determination required for their recovery.
“You have to be beyond tough to sit with who you really are,” Tabura said.
Healthy Land, Healthy Mind
When Kealailiahi Ford looked around her high school classroom, she could see her classmates were struggling.
“They didn’t know how to express themselves or ask for help because they were really hurting,” Ford said.
Growing up in Nanakuli, Ford recognized a lot of the labels that people put on the Westside and can understand why some of those labels could be true — sometimes the label of being a dangerous dumping ground protects her home from outsiders.
As a psychology major at UH West Oahu, she thinks environmental issues and mental health go hand in hand and wants to focus on the social determinants to mental health in her studies.
“It’s unfortunate that we have to live around sewers and landfills and all these things that are polluting our lives,” Ford says.
She also noticed that there are more liquor stores near her home than there are health food stores and she knows that her community deals with high rates of diabetes, asthma and cancer. Ford posits that living near so many fast-food chains and industrial complexes doesn’t help residents make healthy choices.
But fixing these problems is going to be hard. As a member of the newly founded Honolulu Youth Commission, her goal is to mitigate the stigmas around mental health first, so it’s easier for her peers to ask for help.
She hopes that her Westside community can be more self-sustainable in the future, to rely on and beautify the land instead of using and polluting it.
“We are so connected to this land that if our environment is healthy, then we can in turn be healthy,” Ford says.