Across the board, Oahu residents have fewer preventable deaths than the rest of the state — especially compared to Hawaii County.


It’s partially because people in the City and County of Honolulu residents have better access to resources that encourage good health than Big Island residents do, according to a study of county-level data, some of which dates back to 2007.

The report was released Wednesday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

Doctors are the top earners when it comes to state employees in Hawaii.
People have better access to doctors on Oahu than they do on the Big Island. Olja Latinovic/

Compared to other island counties, Honolulu ranked highest for length of life, healthy behaviors, clinical care accessibility and socioeconomic factors conducive to better health.

In those same areas, Hawaii County fared the worst, while Kauai County came in second and Maui County third.

Big Island residents had the lowest quality of life too, according to the report. One factor considered in quality of life is the self-reported health of respondents.

When asked to rate their health as “excellent, very good, good, fair, or poor,” 17 percent of respondents rated their health as fair or poor, compared to 13 percent in Honolulu, Maui and Kauai counties. Nationwide, 18 percent of people chose the bottom two health categories.

On average, Hawaii County residents reported having one more day per month where they experienced poor health than Honolulu did, according to the report. Obesity on the Big Island (24 percent) was also 2 percent higher than on Oahu, but still well below the national median of 31 percent.

Hawaii County had the highest percentage of residents lacking health insurance at 11 percent, compared to seven percent in Honolulu, according to the report. Nine percent of the population in both Maui and Kauai counties were uninsured.

In Hawaii, 39 percent of car crashes are a result of drunken driving – eight percent higher than the U.S. median.

While the study showed that 13 percent of Honolulu, Maui and Kauai county populations smoke, 18 percent of Big Island residents smoke, which is right on par with the national median. Hawaii County residents also scored about 30 points lower (64 percent) than those counties when it comes to accessibility to parks or exercise facilities such as recreation centers, gyms, or pools — still above the U.S. median of 62 percent.

Compared to Honolulu, Hawaii County has 14 percent more drunken driving deaths as well, according to the report.

The study found that rural counties nationwide had higher premature death rates, which have risen over the last decade.

Where Hawaii Excelled

Hawaii was close to the national median for most factors the report looked into, and the state emerged as a leader in many areas.

Compared to the U.S. median, Hawaii residents had on average:

  • 2,000 fewer deaths before age 75 per 100,000 people
  • Four percent fewer adult smokers
  • Nine percent fewer obese adults
  • Nine percent fewer adults without health insurance
  • Seven less births per 1,000 15- to 19-year-olds

But Hawaii didn’t perform as well when it came to some socioeconomic factors – including amount of education or violent crime offenses – that can impact the availability of health care, according to the report. Compared to the U.S. median, Hawaii had four percent more heavy or binge drinkers, eight percent more drunken driving deaths and 189 more infections from sexually transmitted diseases per 100,000 people.

Fourteen percent more residents in Hawaii had housing problems such as high costs, crowded living arrangements, or poor kitchens or plumbing — all of which can impact an individual’s health, according to the report.

Mariners Ridge. Hawaii Kai houses. 8 april 2015. photograph Cory Lum/Civil Beat
High housing costs and overcrowding can impact an individual’s health, according to the report — and it’s not cheap to live in Hawaii. Cory Lum/Civil Beat

Gaps In Available Resources

The 2016 report pointed to another from 2015 compiled by the same groups to better explain the health disparities within Hawaii’s population.

The report looked at the highest-performing Hawaii county in categories like obesity and smoking, and determined how many people would be helped if all residents had the same opportunities and resources:

  • 7,700 less adult smokers
  • 11,000 less obese adults
  • 8,200 less binge drinkers
  • 8,600 less uninsured people
  • 6,900 less children in poverty
  • 84,000 less houses with major problems

Statewide, one in 10 deaths of Hawaii residents under age 75 could have been avoided  – or more than 400 deaths – according to the study.

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