Hawaiʻi Health Data Warehouse

Author: Julia Chosy

State of Obesity 2025: Better Policies for a Healthier America

Our featured content for December is the State of Obesity 2025: Better Policies for a Healthier America. The State of Obesity is an annual report by Trust for America’s Health (TFAH) that looks at key obesity statistics and trends in the United States. TFAH is a non-profit, non-partisan organization that works on various health issues and advocates for prevention and health equity. This year’s edition of the State of Obesity Report includes a special feature that focuses on the science and policy considerations surrounding ultra-processed foods, and how these foods contribute to the obesity crisis in the United States.

Key takeaways from the report include:

  • Nationally, obesity rates are comparatively lower for those with college degrees and for those with higher household incomes, indicating the important role the affordability of healthy foods can have in obesity outcomes (NHANES, 2023).
  • Hawaiʻi had one of the lowest adult obesity rates in the US (27.0%), behind only Colorado which had an obesity rate of 25.0% (BRFSS, 2024).
  • Hawaiʻi’s adult obesity rate has increased from 22.1% in 2014 to 27.0% in 2024, mirroring national trends where the number of states with adult obesity rates over 35% increased from 3 states to 19 states (BRFSS, 2024).
  • In the US, people who live in more rural areas have higher rates of obesity compared to people who live in more urban areas (NHANES, 2023).

A core element of the State of Obesity reports are the policy recommendations that TFAH forms to address obesity in the US. Recommendations from this year’s report include:

  • Retaining funding for the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention (CDC).
  • Undoing funding cuts for nutrition support programs including the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
  • Introducing requirements for front-of-package nutrition labeling so that consumers in the US can make informed purchasing decisions of food
  • Decreasing the advertisement of unhealthy foods to children through the limitation of marketing and pricing strategies

View the full list of recommendations formed by TFAH in the full report. A fact sheet specific to Hawaiʻi is also available.

2022 Birth Record Data

The 2022 Birth Record data is now available in the Hawaiʻi Health Data Warehouse! Build Your Own Report on HHDW.org. The Birth Record data is composed of variables extracted from birth certificates of live births as captured by the Hawai‘i State Department of Health, Office of Health Status Monitoring (OHSM). It provides information about the birth, the infant, and the parents. The population estimates used for population-based birth rates come from the U.S. Census. HHDW has reloaded the 2016-2021 Department of Health (DOH) Race/Ethnicity population estimates and loaded the new 2022 estimates, which are now based on a special 2016-2020 5-year aggregate Census extract. Note that birth rates may differ slightly for 2016-2021, now that the population estimates have been updated.

Below are some highlights:

  • There were 15,570 births in 2022, the fewest number of births in the past 21 years and a decrease of 67 births compared to 2021. The crude birth rate was 10.8 per 1000 persons in 2022 which is unchanged from 2021.
  • 9.8% of babies born in Hawaiʻi were preterm (before 37 weeks gestation). This percentage jumps to 25.4% among women who had no prenatal care.
  • 8.4% of babies born in Hawaiʻi had a low birth weight (less than 2500 grams), which is down slightly from 2021 (at 8.8%). The percentages were highest among those ages 15-19 years (10.9%) and those 40-44 years (9.8%).
  • The teen birth rate continues to decline from 28.1 per 1000 girls ages 15-19 in 2012 to 11.7 per 1000 in 2022. Other Pacific Islander teens had the highest rate (40.9 per 1000) and Filipinos had the lowest (7.1 per 1000).
  • The fertility rate among women of child-bearing age remained steady for 2022 at 58.6 births per 1000 women ages 15-44 years. The rate in 2021 was 59.0 per 1000. In 2022, the rate was highest for Kauai County (63.1 per 1000) and lowest for Maui County (55.6 per 1000).

Check out the latest birth data on HHDW.org!

2021 Youth Risk Behavior Survey Data Released!

Now available! The 2021 Youth Risk Behavior Survey (YRBS) data has been released on HHDW.org and HawaiiHealthMatters.org. Explore the state of Hawaiʻi’s high school and middle school students in 6 categories of health-related behaviors: unintentional injuries and violence, sexual behaviors, alcohol and other drug use, tobacco use, unhealthy dietary behaviors, and inadequate physical activity. Get data at the state and county level for more than 175 indicators of health behavior and risk.

While the 2021 data is highly anticipated, users should be aware that the 2021 data may be different from previous years for a few reasons. 

  • This is the first assessment since the pandemic and students likely had very different experiences in the past two years than previous cohorts. 
  • The survey was administered in the fall instead of the spring. Therefore, the students were younger and earlier in their school year, which may affect their experiences. 
  • When asked about the previous 12 months, it is likely that a good portion of those months involved full or partial online schooling. This difference in environment may also affect their responses.

Highlights from the 2021 YRBS data in Hawaiʻi:

  • More than a quarter (26.6%) of high school students report getting 5 hours or less of sleep on an average school night. This is a decrease from 2019 (29.1%).
  • More than 1 in 3 (34.8%) high school students report depression lasting 2 weeks or more in the past 12 months. There are significant differences by sex with 46.9% of girls reporting depression compared to 23.4% of boys. Self-reported depression has increased among girls from 35.2% in 2011 to 46.9% in 2021. Overall, the rate changed very little from 2019 (34.7%) to 2021 (34.8%).
  • Current alcohol use among high school students decreased from 20.4% in 2019 to 16.6% in 2021. Overall, substance use (alcohol, marijuana, cigarettes, and e-cigarettes) decreased in 2021 compared to 2019.
  • About 1 in 4 (25.8%) middle school students report they have ever hurt themselves on purpose (cutting or burning). Among females, this increases to more than 1 in 3 (36.4%) while males demonstrate a rate of 15.4%.  The measure is similar to that observed in 2019 (25.4%).
  • 78.2% of middle school students report having seen a dentist in the past 12 months. This is a very small decrease from 2019 (80.5%). 
  • Male middle school students were more likely to report having an adult outside of school they can talk to than female students (66.3% vs. 53.2%). Overall, the rate decreased from 2019 (64.9%) to 2021 (59.4%).

Here is a link to a custom HHM dashboard with all the YRBS indicators by state. Below are links to custom HHM dashboards for YRBS data for each county.

Hawaii County

Honolulu County

Kauai County

Maui County

2021 Death Record Data

Just released! The 2021 Death Record data is now available for building custom reports on HHDW.org.  Death Record data comes from variables extracted from death certificates collected by the Office of Health Status Monitoring (OHSM) in the Hawaiʻi State Department of Health. It includes information about the decedent, including age, sex, race/ethnicity, and cause of death. Data is available by count (number of deaths) and rate (crude and age-adjusted). The population estimates used for population-based death rates come from the Census. HHDW has reloaded the 2020 population estimates and loaded the new 2021 estimates, which are now based on the 2020 Census. Note that death rates may differ slightly for 2020, now that the population estimates have been updated.

Highlights for 2021 Death Record data in Hawaiʻi:

  • There were 12,877 deaths in 2021 with 12,522 of those deaths among residents (97%).
  • The crude death rate was 868.6 per 100,000 in 2021. This was a significant increase from 811.3 per 100,000 in 2020.
  • The age-adjusted death rate was 612.8 per 100,000 in 2021 and ranged from 531.3 per 100,000 in Kauai County to 707.3 per 100,000 in Hawaiʻi County, and from 487.8 per 100,000 among women to 752.0 per 100,000 among men.
  • The highest age-adjusted death rate for 2019-2021 was observed for Other Pacific Islanders (1,865.1 per 100,000) followed by Native Hawaiians (1,117.7 per 100,000) and Blacks (1,007.6 per 100,000).
  • The leading cause of death in 2021 was major cardiovascular diseases (3,882 deaths) followed by malignant neoplasms (2,545 deaths) and unintentional injuries (711).
  • There were 671 deaths from COVID-19 in 2021. The age-adjusted death rate for COVID-19 was significantly higher among males (43.6 per 100,000) than females (25.8 per 100,000).

Haumea- Transforming the Health of Native Hawaiian Women and Empowering Wahine Well-Being

This month’s Featured Content on Hawaii Health Matters comes from the Office of Hawaiian Affairs. Here’s an explanation of the title of this great resource on the health and well-being of Native Hawaiian women:

“Haumea, in particular, is a cherished ancestor to wāhine, as she is the matriarchal supreme being we know as the mother of Pele, Hi‘iaka, and Kapo, and the grandmother of Hāloa, Wailoa, and Waia. Being the procreator of the Hawaiian universe, Haumea birthed the Hawaiian archipelago and everything within it, including the coral, marine resources, land creatures, and kānaka maoli (Native Hawaiians). Lilikalā Kame‘eleihiwa (1999) notes that wāhine literally embody their ancestors through both their biological makeup and lasting ancestral memory. She describes these mechanisms which ultimately express kānaka ‘ōiwi (native bones) values through and across every generation. Wāhine are both the embodiment of their foremothers and of Haumea, with a wondrous body, an eightfold body, four hundred thousand bodies, four thousand bodies (Emerson, 1915) in all their physical and spiritual forms.”

Learn more here!

Haumea image

The State of Mental Health in America, 2017

This month’s featured content on Hawaii Health Matters is in honor of Mental Health Awareness month. The State of Mental Health in America, 2017, is a chart book of data that provides a baseline for answering some questions about how many people in America need and have access to mental health services. It is a companion to an online interactive data site.

See the full report here.

state of mental health

UH Student Climate Survey: Sexual Harassment & Gender-Based Violence

This month, Hawaii Health Matters is featuring the University of Hawaii Student Climate Survey on Sexual Harassment & Gender-Based Violence. The survey assessed the extent of gender-based harassment and violence experienced by students both on-and off-campus, how well UH responds to these experiences, and students’ awareness of services and programs offered by UH. See the report highlights or read the full report.

UH Student Survey on sexual harassment

Street Youth Study, 2018

The featured content for March is the 2018 Street Youth Study, which looks at homeless, runaway, and other street youth on Oahu. Homelessness among youth is a serious and complex problem, with research showing that youth aged 12–17 are at higher risk than adults of becoming homeless. Transition-aged youth between 18 and 24 years are one of the fastest growing homeless populations. Homeless youth often do not receive adequate services. They may not meet shelter admission policies and, at times, there is a lack of bed space for youth. Although homeless young adults can use shelter services, services may not always be a good fit for the needs of this transitioning population.

Learn more from the 2018 Street Youth Study on Hawaii Health Matters.

street youth study for fb

Hawaii State Dept. of Education & Board of Education Strategic Plan, 2017-2020

This month’s featured content is a joint release from the Hawaii State Department of Education and Board of Education. The Strategic Plan, 2017-2020, describes shared objectives for equity and excellence for every child across Hawaii’s nearly 300 public and charter schools. It works to further the mission of helping Hawaii’s students become educated, healthy, and joyful lifelong learners who contribute positively to our community and global society. Check out the report on Hawaii Health Matters!

DOE BOE strategic plan

2017 YRBS Data Now on Hawaii-IBIS!

Results from the 2017 High School and Middle School Youth Risk Behavior Survey (YRBS) are now available on Hawaii-IBIS! Check out the latest data here.

YRBS 2017 on IBIS for FB