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We are excited to debut the Primary Care Needs Assessment (PCNA) Tracker in Hawaii Health Matters! The PCNA Tracker is a digital version of the PCNA Data Book produced by the Hawai‘i Department of Health Family Health Services Division. This tool allows users to compare common health statistics across 35 primary care service areas in Hawai‘i, and houses over 45 indicators of population characteristics and health status. The tracker provides information like trend and subgroup data, and interactive maps/charts that was previously not available in the Data Book.  Here are some highlights from the 2021 PCNA Tracker: 

• 4.1% of people in the state of Hawai‘i do not have health insurance. Although this does not reach the Healthy People 2020 target of 0%, it is lower compared to the nation (9.4%) and shows significant decrease overtime.

• Linguistic Isolation is highest in the primary care service areas of Downtown – Kalihi (27.5%), followed by Lana’i (13.4%) and Ala Moana – Nu’uanu (11.7%). Language barriers prevent households from receiving health services that are available to only fluent English speakers.

• 12 primary care service areas in the state of Hawai‘i have significantly worse rates of adults with prediabetes compared to the state value of 14%.  In the lead is Hawai‘i kai – Kaimuki (16.9%), Downtown – Kalihi (16.6%), and Wailuku (16.5%).

The National Youth Tobacco Survey (NYTS) is a collaboration between the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration. It is a cross-sectional, voluntary, school-based, self-administered electronic survey of U.S. middle and high school students. The survey provides nationally representative data about middle and high school student’s tobacco-related beliefs, attitudes, behaviors, access and exposure to pro- and anti-tobacco influences. It also serves as a baseline for comparing progress toward meeting seven Healthy People 2030 goals for reducing tobacco use among youth. Here are some highlights from the 2020 NYTS:

• 1.8 million fewer U.S. youth are currently using e-cigarettes compared to last year, but an alarming 3.6 million youths are still using e-cigarettes.
• 19.6% of high school students (3.02 million) and 4.7% of middle school students (550,000) reported current e-cigarette use.
• 22.5% of high school users and 9.4% of middle school users reported daily use.
• Among all current e-cigarette users, 82.9% used flavored e-cigarettes, including 84.7% of high school users and 73.9% of middle school users.
• Similar to 2019, prefilled pods or cartridges were the most commonly used device type in 2020; however, disposable e-cigarette use increased approximately 1,000% (from 2.4% to 26.5%) among high school current users and 400% (from 3.0% to 15.2%) among middle school current users between 2019 and 2020.
• Among current users of flavored prefilled pods or cartridges, the most commonly used flavor types were fruit (66.0%); mint (57.5%); menthol (44.5%); and candy, desserts, or other sweets (35.6%).
• Among current users of flavored disposable e-cigarettes, the most commonly used flavor types were fruit (82.7%); mint (51.9%); candy, desserts, or other sweets (41.7%); and menthol (23.3%).

Source: Wang TW, Neff LJ, Park-Lee E, Ren C, Cullen KA, King BA. E-cigarette Use Among Middle and High School Students — United States, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1310–1312. DOI: http://dx.doi.org/10.15585/mmwr.mm6937e1

Updated: 01/7/2020

The HIV/AIDS Surveillance Program administered by the Hawai‘i State Department of Health collects, analyzes, interprets, and shares information about new and existing cases of HIV and AIDS infection in Hawai‘i. It serves as the primary source for monitoring trends in HIV infection in Hawai‘i, and maintains a network with medical facilities and HIV/AIDS surveillance programs nationwide to promote accurate and timely reporting of diagnosed HIV and AIDS cases.  The program releases an annual report with non-identifiable data which includes the population rates of HIV diagnoses, the number of people living with HIV, and the number of people who are receiving HIV medical care. Here are some highlights from the 2019 report:

• A total 4,831 Hawai‘i residents have been diagnosed with HIV from 1983-2019, including 3,546 with stage 3 (AIDS).
• There have been 2,281 known deaths from HIV/AIDS.
• The 5-year HIV infection average diagnosed rate was 5.8/ 100,000 population for the State of Hawaii (2015-2019), and ranged from 3.6 in Maui County to 6.5 in Honolulu County.
• 91% of residents diagnosed with AIDS (stage 3) in 2019 were male, and male-to-male sex was the highest risk factor (65%).
• Of the 2,347 persons diagnosed with HIV by 2017 and living in Hawaii during 2018,  83.2% received HIV medical care, 58.0% were still receiving HIV medical care and 76.4% achieved viral suppression.
• 76.8% of the newly diagnosed cases in 2018 (69 persons) were linked with HIV medical care within one month of diagnosis.

Updated: 12/9/2020

Since 1990, the Annie E. Casey Foundation has ranked states annually on overall child well-being using an index of key indicators. The KIDS COUNT index captures what children need most to thrive, using four domains:

(1) Economic Well-Being
(2) Education
(3) Health
(4) Family and Community.

Each domain includes four indicators, for a total of 16. These indicators represent the best available data to measure the status of child well-being at the state and national levels. The 31st edition of the Annie E. Casey Foundation’s KIDS COUNT Data Book ranks Hawaiʻi 17th among all states for child well-being.

• All 4 indicators under Economic Wellbeing improved in Hawaiʻi, including children in poverty, children whose parents lack secure employment, children living in households with a high housing cost burden, teens not in school and not working.
• All but 1 indicator under Education improved in Hawaiʻi. The percentage of young children (ages 3 and 4) not in school increased from 44% in 2009-2011 to 53% in 2016-2018, which is higher than the overall nation percentage.
• All but 1 indicator under Health improved in Hawaiʻi. The percentage of low birth-weight babies remained at 8.3% between 2010 and 2018.
• All but 1 indicator under Family and Community improved in Hawaiʻi. The percentage of children in single-parent families remained at 30% between 2010 and 2018.

Updated: 10/30/2020

The County Health Rankings & Roadmaps (CHR&R) program is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The program provides data, evidence, guidance, and examples to help identify factors that impact health, and supports community leaders working to increase health equity. Ranking the health of nearly every county in the nation, CHR&R illustrates what is currently known when it comes to what is keeping people healthy or making them sick and shows what can be done to create a healthier community. This report highlights how health outcomes and health factors differ by place within the state of Hawaii and illustrates how health differs among racial/ethnic groups in the state.

• 12% of Hawaii children are living in poverty, which is lower than the national average of 18%.
• Maui County ranks the highest in health outcomes (length and quality of life), followed by Honolulu County, Kauai County, and Hawaii County.
• Honolulu County ranks the highest in health factors, followed by Kauai County, Maui County and Hawaii County coming in last. Health factors represent what can be changed to improve health for all, and are divided into Health Behaviors, Clinical Care, Social and Economic Factors, and Physical Environment (see image).
• Hawaii County had the highest percentage of adults who stated that their physical health, which includes physical illness and injury and that their mental health (including stress, depression, and emotional problems) was not good for 14 or more of the past 30 days.
•  Kauai County has the lowest primary care provider (including physicians in general practice medicine, family medicine, internal medicine and pediatrics) rate per 100,000 population.
• Life expectancy is highest in Maui County (83 years) and lowest in Hawaii County (80.5 years).
• Honolulu County has the highest percentage of households with at least one of the following housing problems: overcrowding, high housing costs, lack of kitchen, or lack of plumbing facilities.
• Alcohol-Impaired Driving Deaths are lowest in Honolulu County (25.5%)  and highest in Maui County (48.5%).

Updated: 10/8/2020

ALICE is an acronym for Asset Limited, Income Constrained, Employed. In Hawaii, there are 148,771 ALICE households (33 %), while another 41,619 households (9 %) live below the poverty level. In total, 42% of Hawaii households are ALICE and below. Aloha United Way commissioned ALICE: A Study of Financial Hardship in Hawai‘i to identify those who are struggling to make ends meet, and to understand the obstacles these families and individuals face.  The latest report has more local variation, variation by household size, and better reflection of household composition. It has also measured a separate Senior Survival Budget and included an ALICE Essentials Index. We have compiled some highlights from the latest HI ALICE Report – take a look!

• The cost of living is increasing for ALICE households. Cost of essentials increased at an average rate of 3.4% annually nationwide over the past decade, while rate of inflation was 1.8%.
• While unemployment reached near record lows in 2018, the number of low-wage jobs grew, wage increases were minimal, and job hours, schedules and benefits fluctuated more often. In Hawaii, 53% of workers were paid by the hour, and 51% of jobs paid less than $20/hr.
• There were more ALICE households than households in poverty , and, as a result of rising costs and stagnant wages, ALICE households rose from 22% in 2017 to 33% in 2018.
• Households living in poverty remained at around 9% through 2017-2018, most likely because the Federal Poverty Line (FPL) underestimates the number of households that cannot afford to live and work in the modern economy.
• Asian households and single or cohabiting households made up he largest number of households below ALICE Threshold.  Among families with children, married-parent families were the largest subgroup and accounted 53% of  families with children living below the threshold.
• Hispanic and Native Hawaiian households (51% and 54% respectively) are the two groups that showed a disproportionately high percentage of households below the threshold.
• From 1979-2016, the average income for the top 1% increased over five times more than that of the middle 60%, and over three times more than that of the bottom fifth.
• Among households headed by adults under the age of 25, 87% were  below the ALICE threshold, 50% of University of Hawai‘i at Manoa undergraduates have experienced food insecurity, and 37% reported experiencing moderate to severe hunger.
• Life expectancy is highest in Honolulu County (82.6 years) where 40% of households are below the threshold, and lowest in Hawai‘i County (80.9 years) where 48% of households are below the threshold.

This report was sponsored United for ALICE and Aloha United Way with support from the Bank of Hawaii Foundation, the Hawai‘i Community Foundation and Kamehameha Schools. The report is available on Hawaii Health Matters and additional information can be found at UnitedforALICE.org.

The Research and Economic Analysis Division of the Hawaii Department of Business, Economic Development, and Tourism (DBEDT) released a new report Quality of Life in Hawaii: 2019 Update. This report is an update from their 2009 report, and examines quality of life across six broad domains: economic, education, environment, health, housing & transportation, and social. Each domain has four dimensions and there are at least two indicators per dimension; for example, education is sub-divided into attainment, performance, readiness, and participation in higher education and there are 10 indicators presented. There are 69 indicators in total and the report includes state and county data, compares Hawaii to itself over time, and to the nation as whole. User-friendly symbols help the reader to see how we are doing as a state.

Here are some highlights from the 2019 report which was released in May:

• The overall quality of life in HI has improved since the 2009 report, but the economic, housing and transportation and social domains have gotten worse. The overall improvement is attributed to the improvements in education and health.
• Economic indicators have gotten worse since 2009. While per capita income and median earnings have increased, poverty rate and income inequality have swelled. Hawai‘i County regularly had the highest poverty rate among the counties, exceeding the national poverty rate.
• Education indicators have improved and are higher than the US. A higher percentage of people have received high school and college degrees, more students are meeting standard in math and reading and more students are graduating from high school on-time. T Honolulu County had the lowest percentage of people with a high school degree, but the highest percentage of people with at least a bachelor’s degree.
• Environment indicators have improved. Hawaii has fewer toxic releases but more unhealthy air quality days compared to the nation due to volcanic activity.
• Health indicators have improved; however, while life expectancy has improved, health status has declined. Hawaii has a higher percentage of adults who binge drink and lower percentage of children who are fully immunized compared to the nation.
• Housing & Transportation indicators have gotten worse since 2009. Hawaii housing was rated worse than the nation for all the indicators in the affordable housing and unmet housing needs section. Hawaii had a lower percentage of workers who drove alone to work (67.1%) compared to the nation (76.4%), but are more likely to travel an hour or more to get to work (10.1% and 8.9%, respectively).
• Social indicators have declined since 2009. Hawaii is generally better than the nation in terms of public safety and family relationships, but does worse in community connectedness and social participation. Hawaii had lower rates of violent crime; accidents, homicides, and suicide death rates; and drug related arrests compared to the nation.

The Quality of Life in Hawaii: 2019 Update by DBEDT is this month’s featured content on Hawaii Health Matters.

Updated: 08/14/2020

The Hawaii Governor’s Coordinator on Homelessness just released the results of the Hawaii Point in Time (PIT) Counts for 2020. PIT is an annual street and shelter count that determines the number of people experiencing homelessness in Hawaii on a single night in January each year. It is an important source of data on homelessness that is required by the US Department of Housing and Urban Development.  The PIT Count provides the community and homeless assistance providers with data needed to understand the number and characteristics of persons who are homeless, and it provides policy makers with data needed to effectively allocate resources aimed at ending and preventing homelessness. Two service providers coordinate this survey in Hawaii: Partners in Care in Oahu on January 22 and Bridging the Gap in Hawaii, Kauai and Maui Counties on January 26.

Overall, there were 6,458 people experiencing homelessness in Hawaii on one night and about 57% of those individuals were unsheltered. The statewide homelessness rate for 2020 was about the same as 2019, but has decreased since 2016. The most common self-reported primary causes of homelessness by surveyed adults were inability to pay rent, job loss, and alcohol/drug use.

Oahu PIT Count:

• The total number of people experiencing homelessness (sheltered and unsheltered) was 4,448. The sheltered count rose by 4%, and the unsheltered count declined by 2%.
• 881 (24%) adults were chronically homeless.
• 51% of the overall PIT Count identified NHPI as either their only race or part of their multiracial background. NHPIs were over-represented by 210%. For comparison, Caucasians and Asians were underrepresented by -24% and -81% respectively.
• 1 in 4 homeless adults surveyed reported at least one mental health problem, and 1 in 10 were veterans.

Updated: 07/16/2020

The 2019 edition of the  Native Hawaiian Data Book has arrived!  This fully digital publication is a must-have, in-depth reference for statistical data concerning Hawaii and Native Hawaiian people.  The Data Book is divided into 10 topics: Population, Housing, Labor and Employment, Income, Land, Water and Air, Education, Health and Vital Statistics, Human Services, Crime, and Legacy Data. The publication includes maps, tables and data links for further information. You can find the online Data Book in the resource library of our Hawaii Health Matters (HHM) website and at www.OHAdatabook.com. 

The Native Hawaiian Data Book is a periodic publication of the Office of Hawaiian Affairs (OHA) which  was established during the 1978 Constitutional Convention to serve as the principal public agency in the State of Hawaii responsible for the performance, development, and coordination of programs relating to Native Hawaiians. The first hard copy edition of the Native Hawaiian Data Book was published in 1994, and the first online edition in 1996. Starting in 2011, hard copies of the Data Book were discontinued and switched entirely to a digital format. The digital format provides greater flexibility in disseminating current data, and can be updated in a timelier manner. For example, the Health and Vital Statistics  and Human Services tables were updated in January and March of 2020, respectively.

The Hawaii State Department of Health’s weekly COVID-19 Community Bulletin updates are now available to read on our Hawaii Health Matters (HHM) website. Information on the state of COVID-19 in Hawaii, what local organizations are doing, and what you can do to help can be found in the Community Bulletin. The latest issue will be posted every Thursday on the Featured Content section of the HHM homepage. All past and current issues can be found in the Reports and Publication section under Resources & Tools . Read the most recent Issue 4 here.