The purpose of U.S. Senate Bill S. 2243 is to improve the health status of native Hawaiians through the authorization of programs designed to provide a comprehensive health promotion and disease prevention system of services for them. The Select Committee on Indian Affairs reported on the following points, including pertinent statistics: (1) historical background of Hawaii; (2) higher proportion of mental and social problems among native Hawaiians than the overall population in Hawaii; (3) poorer physical health, lower life expectancy, and greater risk of serious illness among native Hawaiians; (4) inaccessible medical services because of financial and cultural barriers; (5) poorer nutrition and dental care; and (6) negative impact on Hawaiians of the western economic, social, political and educational system. The special legal relationship existing between the Federal Government and native Hawaiians is analyzed. A section-by-section analysis of S. 2243 is included. (PS)