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Colonial epidemic disease in Hawai‘i has greatly threatened the Native Hawaiian population since its introduction to the islands over a hundred years ago. Beginning with the first colonizers led by Captain Cook that arrived in the islands in 1778, all the way up until today, foreign disease has been present in Native Hawaiians. Because Hawai'i was so secluded and contained a population of only the Hawaiian people, the islands were considered a “virgin population." This meant that once foreigners arrived, the Native Hawaiian population was decimated by these illnesses while Europeans remained healthy. Some of these diseases included gonorrhea, syphilis, influenza, cholera, tuberculosis, the mumps, measles, smallpox, and leprosy. While each disease brought a different outcome, they all contributed to the reduction of the Native Hawaiian population as they collectively caused more than 100,000 deaths.

These illnesses wreaked havoc on the Hawaiian islands and they killed almost all of the Native population. By 1840, only 62 years after Cook brought the first diseases, the number of Native Hawaiians may have fallen by up to 84%. The U.S. Census of 1920 declared that there were only 24,000 Native Hawaiians — a number down from hundreds of thousands. As of 2015, only 26% of Hawai'i residents have Hawaiian ancestry. This effect on the population from outsiders was at first an unwanted mistake, as Captain Cook himself had tried to keep his diseased men away from Native women, but was later used as a way to discriminate against the Hawaiian people. The number of deaths caused by the interaction with outsiders is comparable to death rates of recognized genocides. While the initial population is contested, it is believed that the Native Hawaiian population lay somewhere between 300,000 and one million. As stated above, this number was down to 24,000 by 1920, after many colonial diseases had spread through the islands. Since then the population has returned to about 560,000 people nationwide that identify with Native Hawaiian ancestry.

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