Kanaka Maoli (Native Hawaiians) have experienced drastic changes to their way of life and to the demography of their ancestral homeland over two centuries of US occupation. We review 1) the current social status and health status of Kanaka Maoli; 2) the effects of social status on a person’s health status; 3) the major social changes in Hawai‘i affecting Kanaka Maoli social standing and well-being; and 4) the empirical studies suggesting a relationship amongst social, psychological, and physical factors affecting Kanaka Maoli health and well-being. We also examine the issue of social justice for Kanaka Maoli as a public health imperative. The major tenets of this paper are that 1) the drastic and rapid social changes in Hawai‘i and other societal issues have adversely affected the health and well-being of Kanaka Maoli and 2) a complex interaction exists between the social status and health status of Kanaka Maoli.