In a large pot, add the ham shank or hock and broth. Bring to a boil, then reduce heat to a simmer. Cover and let it simmer for 1–1.5 hours until the meat is tender and the broth is flavorful. Skim off any foam.
Slice and add the sausage and cubed ham to the pot. Let it cook for 10–15 minutes to release flavor.
Toss in the pot: garlic, onions, carrots, celery, potatoes, cabbage, crushed tomatoes and sauce, kidney beans, and bay leaves. Simmer for 30–40 minutes until everything is tender.
Remove the ham shank or hock, shred or dice the meat, discard the bone, and return meat to the pot.
Add elbow macaroni in the last 10–12 minutes of cooking. Season to taste with salt and pepper.