The hepatitis B virus (HBV) affects the liver, with the potential for causing cirrhosis and primary hepatocellular carcinoma in infected persons. Asian and Pacific Islander (API) Americans historically have a higher infection rate, particularly those born in countries where HBV is endemic. The prevalence of HBV infection in Hawaii, a state with a large population of API and immigrants from countries where HBV is endemic, is not known. The purpose of this study was to test the relationship between prevalence of infection and susceptibility to HBV, as well as vaccination compliance rates, and country of birth. Hepatitis B epidemiology and historical approaches to its detection and prevention form the conceptual framework for the study. A purposeful sample of 1,511 participants were from the Hawaii 3ForLife program, a community-based public health program that offers free hepatitis B screening and vaccination. Chi-squared analysis was used to test the study hypotheses related to the relationships between birth status (foreign born versus United States born) and HBV infected, immune, and susceptible status as well as with vaccination compliance. Significant associations were found between birth status and HBV infection, HBV susceptibility, and compliance in completing vaccination. The prevalence of HBV infection in the sample was 5.8%; for HBV susceptibility, it was 52%. Approximately 40% of those who were HBV susceptible completed the hepatitis B vaccinations. This research contributes to positive social change by providing clarification on the importance of public health intervention programs, such as Hawaii 3ForLife, for reducing the long-term consequences of hepatitis B infection and preventing transmission of the disease, which will reduce the incidence of hepatitis B and related health problems.