Hawaiʻi Health Data Warehouse

Author: Tonya Lowery St. John

2022 Behavioral Risk Factor Surveillance System Data

The 2022 data from the Behavioral Risk Factor Surveillance System (BRFSS) have been released on HHDW.org and HawaiiHealthMatters.org. Explore data on health-related risk behaviors, chronic health conditions, use of preventive services, and more in Hawaiʻi.

This year, explore 18 new indicators on HHDW.org in the topic areas of Access to Health Care, Chronic Diseases and Conditions, Demographics, Health Behaviors, and Screening and Preventive Services. A full list of these indicators is available in the Data Release Notes.

Here are some highlights from the 2022 data:

  • Nearly all adults (97.8%) have health insurance coverage, with the percentage rising with age. For those ages 18-24, the coverage rate is 95.8%, increasing to 99.7% for those ages 75 and older.
  • More than half (55%) of adults walked or rode a bicycle around their neighborhood for at least 10 minutes once or more in the past month, compared to less than a third (27.2%) who walked or biked 15 or more days in the past month.
  • Two-thirds (67.8%) of adults did not have a sunburn in the past 12 months, while 10.1% experienced one sunburn, 8.3% experienced two, and 13.8% experienced three or more. Men were more likely than women to report three or more sunburns (17.4% and 10.3%, respectively).
  • Over a quarter (26.8%) of people ages 18-49 years report having received at least one dose of the HPV vaccine. This is a significant increase since 2018 (16.1%).
  • Over 1 in 10 adults (11.5%) reported they did not have good mental health for at least 14 days in the past 30 days. Rates vary by county from 9.9% in Kauaʻi, 10.7% in Honolulu, 13.2% in Hawaiʻi, to 13.5% in Maui.
  • New indicators reveal that 5.8% of adults report ever having a traumatic brain injury and 6.2% report ever having a spinal cord injury.

The 2022 BRFSS data has also been added to the Community Reports feature on HHDW.org. To learn more about Community Reports, view the short training video here.

New: Leading Causes of Death Report Series

HHDW is pleased to announce a new series of reports on the Leading Causes of Death in Hawaiʻi. The series of three reports uses pie charts and matrices to display the leading causes of death in Hawaiʻi across different demographics. Modeled after the National Vital Statistics System Leading Causes of Death report, the Hawaiʻi reports include the leading causes of death among those aged 1 year and older for the state by year from 2017-2021 and by county, age group and Hawaiʻi-specfic race/ethnicity for the three years from 2019-2021. Two additional reports use 5-year aggregates (2017-2021) to examine the leading causes of death for females ages 15-44 years and the leading causes of death by race/ethnicity and sex.

The Leading Causes of Death in Hawaiʻi reports can be accessed from Death Data Source page and will be updated annually.

Below are some highlights:

  • In 2021, heart disease (20.9%), cancer (20.1%), stroke (7.5%) and COVID-19 (5.2%) were the leading causes of death in Hawaiʻi accounting for 53.7% of all deaths in the state.
  • There were more deaths among males than females from 2019-2021 (18,855 compared to 16,323).
    • Heart disease (23.9%), cancer (20.9%), unintentional injury (6.9%), stroke (5.8%) and chronic lower respiratory disease (3.5%) were the top 5 causes of death among males.
    • Cancer (21.0%), heart disease (18.9%), stroke (8.8%), Alzheimer disease (6.9%), and unintentional injury (3.5%) were the top 5 causes of death among females.
  • Unintentional injury was the number 1 cause of death from 2019-2021 among those ages 1-9 years, 10-24 years, and 25-44 years (28.6%, 34.7%, and 24.2%, respectively), and a leading cause of death in all other age groups.

View the reports here.

2021 Birth Record Data

The 2021 Birth Record data is now available in Build Your Own Report! 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. As part of this update, HHDW has reloaded the 2020 population estimates and loaded the new 2021 estimates, which are now based on the 2020 Census.  While this will not impact the 2021 data, please note that birth rates may differ slightly for 2020, now that the population estimates have been updated.

Below are some highlights:

  • There were 15,637 births in 2021, the fewest number of births in the past 20 years and a decrease of 170 births compared to 2020. The crude birth rate was 10.8 per 1000 persons in 2021 which is unchanged from 2020.
  • 8.8% of babies born to Hawai‘i residents had a low birth weight (less than 2500 grams), and rates were highest among mothers who are Filipino (12.0%) or ages 40-44 (14.1%).
  • The teen birth rate continues to decline from 28.1 per 1000 girls ages 15-19 in 2012 to 12.3 per 1000 in 2021. However, disparities exist by county (from 11.1 per 1000 in Honolulu to 16.0 in Hawai‘i) and race/ethnicity with 43.1 births per 1000 among Other Pacific Islander teens and 20.7 among Native Hawaiians compared to 2.1 and 6.3 among Japanese and Chinese teens, respectively.
  • In 2021, 11.3% of births received late (3rd trimester) or no prenatal care. Late or no prenatal care varied significantly by county (from 5.3% in Maui and 5.7% in Kauai to 10.4% in Hawai‘i and 12.6% in Honolulu) and race/ethnicity (from 5.9% among Whites to 26.3% among Other Pacific Islanders). Late or no prenatal care was associated with very low and low birth weight infants (28.4% and 21.5%, respectively). 
  • Fertility rate remained relatively constant for all DOH race/ethnicities from 2020 to 2021. In 2021, the average fertility rate for all race/ethnicities was 58.5 per 1000, compared to 71.1 per 1000 in 2012.

To learn how to build your own report using the 2021 Birth Record Data, register here to attend our 30-minute Coffee Break webinar on at our March 7th at 11 am.

Kūpuna Food Security Coalition After Action Report

The Kūpuna Food Security Coalition (“KSFC” or “Coalition”) is a cross-sectoral partnership formed at the onset of the COVID-19 pandemic to address food insecurity needs of O’ahu’s kūpuna. While their founding began as an emergency response to kūpuna food needs, they are shifting towards long-term food system solutions and sustainability.

The Kūpuna Food Security Coalition After Action Report serves as a planning tool and reference guide for stakeholders, policy makers, funders, and businesses who work with kūpuna health and wellbeing. The report describes the Coalition’s structure and organization, documents data and trends of their program, and highlights lessons learned and future recommendations.

From March 2020 to December 2020, the Coalition:

  • Distributed over 1.2 million meals for up to 8,000 kūpuna each week
  • Provided education to 2,500 seniors around SNAP* and other food program options
  • Provided 30,000 wrap-around health and social services

Some recommendations include:

  • Sustain critical food security and nutrition services
  • Provide additional technical assistance and resources to coalition members
  • Foster creativity and innovation in addressing kūpuna food security
  • Broaden awareness and recognition of coalition member efforts

*Supplemental Nutrition Assistance Program

Hawaiʻi Tobacco Prevention & Control Plan 2030

The Hawai‘i Tobacco Prevention and Control (TPC) 2030 Tracker is now available on Hawai‘i Health Matters! Stay updated on Hawai‘i state tobacco prevention progress compared to other states and territories, Hawai‘i’s Prior Values, TPC Plan Targets and HP 2030 Targets.

The Hawai‘i Tobacco Prevention and Control (TPC) Plan 2030 is a ten-year strategic plan for achieving a tobacco-free Hawai‘i and provides guidance for tobacco prevention, education, and cessation services through program implementation, legislative action, and community empowerment. It focuses on the goals established by the Centers for Disease Control and Prevention for comprehensive tobacco control programs:

  • Identify and eliminate tobacco-related disparities
  • Prevent initiation of commercial tobacco use among youth and young adults.
  • Promote quitting tobacco among young people and adults.
  • Eliminate exposure to secondhand smoke. 

Here are examples of some data you can find with this tracker: 

View the tracker here. Learn how to use the tracker by viewing this video.

NEW Population-Based Death Rate Data

Population-based Death Rate Data now available in HHDW!

The Death Query Module has been expanded to include population denominator data! Now you can calculate crude and age-adjusted death rates using Census Race or DOH Race/Ethnicity. Population-based rates are available for state and county level geographies, by age and sex. The Census rate data is available from 2000-2019 and the DOH Race/Ethnicity rates are available from 2010-2019.

Cause of death can be analyzed using your own ICD-10 codes or the 16 leading causes of death, or the 39 or 113 selected causes of death defined by the National Center of Health Statistics (NCHS).

Here are some highlights in the area of cancer. Click here to run your own queries.

  • The age-adjusted death rate for cancer (malignant neoplasms) has decreased from 136.7 per 100,000 in 2010 to 123.4 per 100,000 in 2019.
  • In 2019, the cancer of the trachea, bronchus and lung was leading cause of cancer death in Hawai‘i (26.3 per 100,000, age-adjusted) for the population as a whole followed by colorectal cancer (12.4 per 100,000), pancreatic cancer (10.5 per 100,000) and breast cancer (10.2 per 100,000).
  • The leading causes of cancer among men were cancer of the trachea bronchus and lung (31.9 per 100,000), colorectal cancer (14.5 per 100,000), pancreatic cancer (12.0 per 100,000) and prostate cancer (11.9 per 100,000).
  • The leading causes of cancer among women were cancer of the trachea bronchus and lung (23.2 per 100,000), breast cancer (19.2 per 100,000), cervical, ovarian or uterine cancer (11.3 per 100,000), and colorectal cancer (10.6 per 100,000).
  • Age-adjusted death rates by DOH Race/Ethnicity show significant differences in cancer mortality. Cancer deaths among Other Pacific Islanders in 2019 was 310.4 per 100,000 or 1.4 times higher than Native Hawaiians and 2.2 times higher than Caucasians (225.0 and 143.2 per 100,000, respectively).

NEW Population-Based Birth Rate Data

The Birth Query Module in Hawaii-IBIS has grown! We’ve added new customizable reports on infant birth weight, prenatal care and preterm births and new rate reports for birth, fertility and teen births by Census race and DOH Race/Ethnicity.

Here are some highlights. Click on the hyperlinks to modify the default report to create your own custom report. Click here to see the Coffee Break video for more information.

  • Low birth weight babies comprised 8.4% of all births in 2019 with 1.2% of births having very low birth weight. Low birth rate varied by mothers’ race/ethnicity from 4.9% among Caucasians to 10.1% among Filipinas. Babies born as part of multiple births were were almost 8 times more likely to have low birth weight as single birth babies (53.3% and 6.8%, respectively).
  • 5.2% of births received no prenatal care in 2019 compared to 3.3% of births in 2017. Teen mothers (age 15-19) were about twice as likely to receive no prenatal care (10.1%) compared to mothers age 20-44 (.
  • The crude birth rate was 12.5 per 1000 persons in 2019 and the fertility rate was 62.9 per 1000 women age 15-44 . The fertility rate has decreased significantly from 70.9 per 1000 women age 15-44 in 2010. Fertility rate varied dramatically by race/ethnicity from 12.3 among Others to 124.9 among Other Pacific Islanders.

2019 PRAMS Data Has Arrived!

The 2019 Pregnancy Risk Assessment and Monitoring Survey (PRAMS) data are now available in Hawaii-IBIS. The PRAMS is an annual mixed mode survey of women who have recently given birth in Hawai‘i. PRAMS provides population-based data on maternal attitudes and experiences before, during and shortly after pregnancy.  Use the Hawaii-IBIS PRAMS data tool to explore over 90 health indicators of state and county level. Data can be viewed by 13 different dimensions.

Here are some highlights from the 2019 Hawaii PRAMS:

  • 32% of women reported getting a flu shot in the 12 months before delivery, a significant increase from 19% in 2012.  Flu shots given during pregnancy help protect both the mother and her baby from flu. Vaccination has been shown to reduce the risk of flu-associated acute respiratory infection in pregnant women by up to one-half.
  • About 50% of women reported taking prenatal vitamins, multivitamins or a folic acid vitamin in the month before they got pregnant.  Regular vitamin use before pregnancy has steadily increased from 34% in 2011 to 43% in 2019.  Taking prenatal vitamins with folic acid decreases the risk of brain and spinal cord birth defects.
  • Overall, 47% of women had their teeth cleaned by a dentist or dental hygienist during their pregnancy; however, the only 33% of new mothers in Hawaii County received a teeth cleaning compared to 50% of new mothers in Honolulu County.   Since pregnancy increases the risk of gum disease and cavities, oral health is an important part of prenatal care. 
  • 94% of infants were offered breast milk at any point after birth, 81% were still breastfeeding at 8 weeks (any),  and 55% of babies were still breastfeeding exclusively at 8 weeks. Breast milk is the most complete nutrition for a new baby, provides protection against many early-life diseases, and is associated with health benefits to mothers as well. 
  • When it is time to sleep, 84% of infants were laid on their backs, the rest were laid on the side (9%), stomach (5%) or more than one positions. Putting infants to sleep on their stomach or side, rather than their back increased their risk of suffocation and is a major preventable risk factor for sudden infant death syndrome (SIDS).

PRAMS is conducted by the Hawai‘i State Department of Health in conjunction with the Centers for Disease Control and Prevention (CDC). Due to extenuating circumstances, data collection was suspended in 2017 and 2018 and resumed in 2019.  The 2019 survey participants were recruited from July to December 2019. Because of the smaller sample size, some indicators may not be reportable in 2019. In these cases, users can aggregate years to increase the sample size.

Updated: 04/27/2021

2019 National Youth Tobacco Survey Results Are Available

The 2019 National Youth Tobacco Survey (NYTS) report is this month’s featured content on Hawaii Health Matters.  Tobacco use is the leading cause of preventable disease, disability and death in the United States and most people start using tobacco in their teens.

The 2019 report shows:

  • 1 in 4 high school and 1 in 8 middle school students (6.2 million total) in the U.S. used some type of tobacco product in the last 30 days.
  • E-cigarettes were the most commonly used tobacco product among both middle (10.5%) and high (27.5%) school students for the sixth year in a row.
  • E-cigarette use continues to rise among middle and high school students. Current use jumped from about 3.6 million users in 2018 to a whopping 5 million students using an e-cigarette in the past 30 days in 2019.
  • Unlike cigarettes, girls are equally as likely to use e-cigarettes as boys.
  • Many students who use tobacco products report using products with flavors such as menthol, alcohol, candy, fruit, chocolate or other sweets, including:
    • 69.6% of any tobacco product users
    • 68.8% of e-cigarette users
    • 46.7% of cigarette smokers
    • 41.9% of cigar smokers

NYTS is a cross-sectional, school based, self-administered survey of U.S. middle and high school students. The 2019 NYTS sampling frame consisted of all regular public and private schools with students enrolled in grades 6-12 across all 50 states and the District of Columbia. The NYTS has traditionally been conducted as a pen and paper survey, periodically from 1999-2009 and annually since; however, 2019 was the first time the NYTS administered in schools using tablet computers.  The 2019 NYTS Methodology report can be found here.

Results from the 2019 Hawaii Youth Tobacco Survey will be available later this year.

The Updated Hawaii Injury Prevention Plan 2018-2023 Is Now on HHM

The latest updated version of the Hawaii Injury Prevention Plan 2018-2023 is this month’s featured content on Hawaii Health Matters.  Injuries are the leading cause of death among Hawaii residents from 1 to 40 years old, and they are a leading cause of disability among people of all ages.

During the average week in Hawaii

  • 15 residents die from an injury
  • 103 are hospitalized
  • over 1600 are treated in emergency departments

The plan focuses on drowning prevention, fall prevention among older adults, suicide prevention and traffic safety. Poison prevention (including drug overdose), sports-related traumatic brain injury prevention, child injury prevention and violence and abuse are also covered as special and emerging areas of focus.