Big Island of Hawaii, has the highest percentage of Native Hawaiians 4 and demonstrates the unique housing challenges faced by rural Native Hawaiians in the rapidly modernizing and tourist-heavy state. In Hawai'i County, three factors drive Native Hawaiian housing insecurity: 1) high cost of living, 5 2) insufficient economic opportunities, 6 and 3) the historical underfunding and belated assignment of home lands. 7 This widespread housing unaffordability among Native Hawaiians in Hawai'i County has a detrimental impact on Native Hawaiian health. Native Hawaiians who face threat of eviction are more likely to experience increased depression, high blood pressure, childhood lifetime hospitalization, and poor child health. 8 Additionally, Hawaii has the nation's highest utility costs, 9 displacing funds from food and medical needs. When faced with housing unaffordability, many households resort to overcrowding, which Native Hawaiian families report at a higher rate. 10 Overcrowding has been found to