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Hawaii

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Hawaii, the Aloha state, is comprised primarily of eight islands in the Pacific Ocean. Hawaii’s landscape is unique in that it exhibits towering volcanoes, lush valleys, and sandy beaches. It is the only state that has its own official native language. Hawaii covers 6,423 square miles, with a 2012 estimated population of 1,392,313 people – 415,941 living in rural Hawaii (USDA-ERS). Honolulu, the capital, is located on the island of Oahu. The state’s largest cities are Honolulu, Hilo, Kailua, Kaneohe and Waipahu. Hawaii is the most racially and ethnically diverse state in the nation. According to the U.S. Census Bureau, 26.0% of the state’s population is white, 38.5% is Asian, 10.1% is Native Hawaiian or other Pacific Islander, 2.0% is African American/Black, and 9.2% is of Hispanic/Latino origin (2011).

There are 26 hospitals in Hawaii (Kaiser, 2010), 13 of which are located in rural areas (North Carolina Rural Health Research and Policy Analysis Center, Dec. 2008). The state has 9 hospitals identified by the Flex Monitoring Team as Critical Access Hospitals (March 2013). There are 2 Rural Health Clinics in Hawaii (Kaiser, 2012), and 14 Federally Qualified Health Centers provide services at 69 sites in the state (Kaiser, 2010). Most Hawaiians have some form of health insurance coverage, although 8.0% of its residents lack health insurance (Kaiser, 2011).

According to the Economic Research Service, The average per-capita income in 2011 for residents of Hawaii was $42,925 although rural per-capita income lagged at $34,258. Estimates from 2011 indicate a poverty rate of 16.3% exists in rural Hawaii, compared to a 10.3% level in urban areas of the state. 2011 ACS data reports that 10.2% of the rural population has not completed high school, compared to 9.7% of urban populations. The unemployment rate in rural Hawaii is 8.9%, while in urban Hawaii it is 5.7% (USDA-ERS, 2011).

For a national comparison, please see an overview of the United States.


Data Sources
U.S. Census Bureau: State & County QuickFacts; USDA Economic Research Service: State Fact Sheets; North Carolina Rural Health Research and Policy Analysis Center; Kaiser Family Foundation State Health Facts; Flex Monitoring Team: Critical Access Hospital List

State Contacts

Directory of Rural Health Contacts: Hawaii
Contact information for people and organizations in Hawaii with an interest in rural health.

Organizations

Administration for Children and Families: Region 9 (ACF)
Federal government
Dedicated to promoting and enhancing the economic independence and social well-being of children, families, individuals, and communities. ACF Region 9 serves Arizona, California, Hawaii, Nevada, American Samoa, the Federated States of Micronesia, Guam, the Marshall Islands, Republic of Palau, and the Commonwealth of the Northern Mariana Islands.

Asian & Pacific Islander American Health Forum (APIAHF)
National organization
Influences policy, mobilizes communities, and strengthens programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders living in the United States and its jurisdictions.

Atherton Family Foundation
Nonprofit/Foundation
Supports programs and projects that benefit the people of Hawaii. Works in the areas of arts, culture, and humanities; community development; education; environment; health; human services; spiritual development; and youth development.

Hawaii and Pacific Basin Area Health Education Centers (AHECs)
State/regional organization
Works to improve the health of the underserved in Hawaii and the Pacific Basin through training and supporting health professions students and health care providers to serve rural and underserved areas.

Hawaii Community Foundation (HCF)

Manages grant funding for charitable organizations in Hawaii.

Hawaii Department of Education: Special Education
State government
Provide appropriate educational programs and services which will enable all children with disabilities to become a: self directed learner; community contributor; complex thinker; quality producer; effective communicator; and an effective and ethical user of technology.

Hawaii Department of Health: Office of Health Equity
State government
Mission is to increase the capacity of the Hawaii State Department of Health, its health care providers, and racial/ethnic communities to reduce or eliminate disparities among and improve the quality of life of Hawaii’s diverse populations.

Hawaii Department of Human Services (DHS)
State government
Encompasses medical assistance programs, public assistance programs, child welfare and adoption, assistance for needy families, rehabilitation and services for the blind.

Hawaii Department of Labor and Industrial Relations (DLIR)
State government
The state agency responsible for ensuring and increasing the economic security, well-being, and productivity of Hawaii's workers. Promotes access to employment and strives to alleviate the economic hardship of workers during periods of disability or temporary unemployment; and protect the employment rights of workers and assure a safe and healthy workplace.

Hawaii Health Information Exchange (HHIE)
State/regional organization
Established for the purpose of improving healthcare delivery throughout the State of Hawaii through seamless and safe health information exchange.

Hawaii Health Systems Corporation (HHSC)
State/regional organization
A public benefit corporation governed by a 13-member board of directors whose responsibility is to develop policies, procedures, and rules necessary to plan, operate, and manage the hospitals within Hawaii.

Hawaii Mental Health Division
State government
Seeks to improve the mental health of Hawaii's people by reducing the prevalence of emotional disorders, and mental illness. Services include mental health education, treatment and rehabilitation. Also aims to improve the emotional well-being of children and adolescents, and to preserve and strengthen their families by assuring early access to a child and adolescent-centered, family-focused community-based coordinated system of care.

Hawaii Pacific REC
State/regional organization
Hawaii State Health Information Technology Regional Extension Center (REC) that helps health care providers become meaningful users of electronic health records by providing information and technical assistance.

Hawaii Primary Care Association (HPCA)
State/regional organization
A non-profit organization dedicated to fostering primary health care—basic medical, dental and behavioral health, and health education services—for all Hawaii residents.

Hawaii Public Health Association (HPHA)
State/regional organization
Association of community members, public health professionals and organizations dedicated to improving public health in Hawaii. Serves as a voice for public health professionals and as a repository for information about public health in the Pacific.

Hawaii Public Housing Authority
State government
Provides Hawaii residents with affordable housing and shelter without discrimination. HPHA efforts focus on developing affordable rental and supportive housing, public housing and the efficient and fair delivery of housing services to the people of Hawaii.

Hawaii Rural Health Association (HRHA)
State/regional organization
Also includes three county-based Rural Health Associations: Hawaii Island, Kauai, and Maui. Provides communication, education, and research opportunities related to rural health issues in Hawaii and provides leadership in developing healthy rural communities.

Hawaii State Department of Health (DOH)
State government
State agency working to protect and improve the health and environment for all people in Hawai`i . Philosophy

Hawaii State Department of Health: Developmental Disabilities Division (DD Division)
State government
Provides support and service for persons with developmental disabilities or mental retardation (DD/MR), which includes principles of self-determination and incorporates individualized funding, person-centered planning and community services.

Hawaii State Office of Rural Health
State government
A division of the Hawaii Department of Health. Works closely with the statewide Hawaii Rural Health Association.

Healthcare Association of Hawaii (HAH)
State/regional organization
An advocate for Hawaii health care facilities, their systems and the health care services they provide. The Healthcare Association of Hawaii represents its members in their ongoing efforts to meet the health care needs of the people of Hawaii.

HUD Community Development Block Grants: Hawaii
Federal government
Contact information for the State CDBG program. Provides funding for community development projects.

John A. Burns School of Medicine, University of Hawaii: Manoa (JABSOM)
Academic/Research
Primary mission is to train physicians for Hawaii and the Pacific.

Mountain Pacific Quality Health Foundation
State/regional organization
A Quality Improvement Organization (QIO) working to improve the health of people in Montana, Wyoming, Alaska, Hawaii, American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands.

National Asian Pacific American Families Against Substance Abuse (NAPAFASA)
State/regional organization
Dedicated to addressing the alcohol, tobacco, and other drug issues of Asian American and Pacific Islander (AAPI) populations on the continental U.S., Hawaii, and the six Pacific Island jurisdictions.

National Council of Asian Pacific Islander Physicians (NCAPIP)
National organization
Serves as the voice of Asian American (AA) and Native Hawaiian & Pacific Islander (NHPI) health professionals in advancing the health and well being of these populations and communities.

National Network of Libraries of Medicine, Pacific Southwest Region (NN/LM-PSR)
State/regional organization
Supports collaboration among libraries and information centers that serve health information needs in Arizona, California, Hawaii, Nevada, and the U.S. Territories in the Pacific Basin.

Pacific Basin Telehealth Resource Center
State/regional organization
One of the telehealth resource centers funded by the federal Office for the Advancement of Telehealth. Assists health care organizations, health care networks, and health care providers in the implementation of cost-effective telehealth programs to serve rural and medically underserved areas and populations. Includes Hawaii and the Pacific Basin.

Papa Ola Lōkahi
State/regional organization
A clearinghouse for data and timely information associated with the health status of Native Hawaiians.

Rural Community Assistance Corporation (RCAC)
Nonprofit/Foundation
Helps rural communities in Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming to improve community infrastructure. Offers numerous services including loans for housing and environment.

State of Hawaii Executive Office on Aging (EOA)
State government
Coordinates a comprehensive range of social, health and long-term care services, which are designed to enhance the independence and self-reliance of persons who are no longer able to care for themselves.

State of Hawaii, Department of the Attorney General: Child Support Enforcement Agency (CSEA)
State government
The state agency that works to collect child support from absent parents. CSEA has a staff of support enforcement officers, investigators, accountants, attorneys, paralegals and other personnel who help establish and enforce orders to collect child support.

U.S. Department of Housing and Urban Development: Hawaii
Federal government
Works to increase homeownership, support community development and increase access to affordable housing. The HUD state office provides information about HUD housing programs and local contacts for the state.

University of Hawaii - Hilo, College of Pharmacy (UHH-CoP)
Academic/Research
A center of pharmaceutical research, education, and patient care services in the Asian Pacific Region.

University of Hawaii - Manoa, School of Nursing & Dental Hygiene (UH-SONDH)
Academic/Research
Offers programs to prepare students for careers in nursing and dental hygiene primarily for the state of Hawai‘i and the Pacific Basin.

USDA Rural Development Hawaii State Office
Federal government
Committed to helping improve the economy and quality of life in all of rural America. The Rural Development State Office provides information about Rural Development programs and applications for financial assistance.

Western Rural Development Center (WRDC)
State/regional organization
One of four regional development centers in the nation. Participates in rural development research and extension (outreach) projects cooperatively with universities in the West. Serves a 13 state area in the Western region and 4 U.S. Pacific Territories, which includes WA, UT, WY, NV, ID, HI, CA, AZ, AK, OR, NM, MT, and CO.

Tools

Asian/Pacific Islanders and Cardiovascular Diseases: Statistical Fact Sheet
Website
Outlines the leading causes of death among Asian/Pacific Islander men and women.
Sponsoring organization: American Heart Association

California STD/HIV Prevention Training Center
Website
Provides training courses that are designed to meet the needs of medical, health, and community professionals serving persons and communities impacted by STD and HIV. Service area includes the federal Health and Human Services Region IX: California, Arizona, Nevada, Hawaii, and the following Pacific Islands: American Samoa, the Federated States of Micronesia, Guam, the Northern Mariana Islands, the Republic of the Marshall Islands, and the Republic of Palau.
Sponsoring organization: Centers for Disease Control and Prevention

ERS State Fact Sheet: Hawaii
Website
Lists statistics on population, educational attainment, employment, income, farm characteristics, and farm financial indicators for the state.
Sponsoring organization: USDA Economic Research Service

Hawaii Health Centers Research & Data
Website
Provides access to information on Federally Qualified Health Centers for the state. Includes a map of FQHC locations, as well as information on the populations served by health centers, services provided, staff, patient visits, costs of care, and use of electronic health information.
Sponsoring organization: National Association of Community Health Centers

Hawaii KIDS COUNT Data Center (KCDC)
Website
Provides data on child well-being for the state.
Sponsoring organization: Annie E. Casey Foundation

Hawaii QuickFacts
Website
Basic demographic and economic statistics for the state, with links to county-level data.
Sponsoring organization: U.S. Census Bureau

Hawaii State Health Facts
Database
The latest state-level data on demographics, health, and health policy, including health coverage, access, financing, and state legislation. Individual state profiles and 50-state comparisons.
Sponsoring organization: Kaiser Family Foundation

Healthy Hawaii Data Warehouse
Website
Provides documents, reports and statistics to promote health and prevent disease among the people of the United States particularly Hawaii.
Sponsoring organization: Hawaii State Department of Health

National Healthcare Quality Report State Snapshot: Hawaii
Website
Health care quality report for the state, based on the National Healthcare Quality Report.
Sponsoring organization: Agency for Healthcare Research and Quality

NN/LM Pacific Southwest Region: Hawaii Resources
Website
Overview of the state, with links to state agencies, health associations, and other resources for Hawaii.
Sponsoring organization: National Network of Libraries of Medicine, Pacific Southwest Region

Office of Minority Health & Health Disparities (OMHD): Native Hawaiian & Other Pacific Islander (NHOPI) Populations
Website
Provides information on health issues of Native Hawaiian and Other Pacific Islanders (NHOPIs), including peoples of Hawaii, Guam, Samoa, and other Pacific Islands.
Sponsoring organization: Centers for Disease Control and Prevention

Provider's Guide to Quality & Culture: Pacific Islanders
Website
Designed to help health care professionals better understand and more effectively respond to the growing needs of Pacific Islanders in the United States. Includes resources on cultural competency, challenges to health and well-being, and the population's strengths and protective factors.
Sponsoring organization: U.S. Department of Health and Human Services

Rural Utilities Service Implementation of the SUTA Initiative
Website
Describes and offers additional links to information on the Substantially Underserved Trust Area (SUTA) provisions of the Food, Conservation & Energy Act of 2008 (2008 Farm Bill), which works to assist tribes in meeting their unique utility infrastructure needs and improve economic development and quality of life.
Sponsoring organization: USDA Rural Development

See also: State-by-State Resources: Tools

Maps & Map Collections

Hawaii Rural Definition Maps
Geographic coverage: Hawaii
Set of maps showing the geographic coverage provided by 9 different rural definitions for the state.
Sponsoring organization: USDA Economic Research Service
Date: 2000

See also: State-by-State Resources: Maps

Funding

Atherton Family Foundation Grants
Offers grants for projects and programs in Hawaii in the areas of arts, culture, and humanities; community development; education; environment; health; human services; spiritual development; and youth development.

Community Facility Loans
Loans to help create and improve essential community facilities in the rural West.

Environmental Infrastructure Loans
Loans to finance water and waste facility projects in the rural West.

Gannett Foundation Community Action Grants
Supports local organizations with funding priority given to programs that focus on education and neighborhood improvement, economic development, youth development, community problem-solving, assistance to disadvantaged people, environmental conservation, and cultural enrichment.

NIMH Outreach Partnership Program
Funding for becoming an NIMH Outreach Partner to conduct statewide, science-based mental health outreach and education efforts.

Rural Community Assistance Corporation Housing Loans
Offers loans to create, improve, or expand the supply of affordable housing for communities in the rural West.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this state that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Documents, Reports and Other Publications

Aiming Higher for Health System Performance: A Profile of Seven States That Perform Well on the Commonwealth Fund’s 2009 State Scorecard
Author(s): Greg Moody, Sharon Silow-Carroll
Sponsoring organization: Commonwealth Fund
Demonstrates that high levels of health system performance are achievable and sustainable, and provides useful examples of policies and practices in Vermont, Hawaii, Iowa, Minnesota, Massachusetts, Wisconsin, and Delaware that may be associated with health system improvement.
Date: 10 / 2009

Compacts of Free Association: Improvements Needed to Assess and Address Growing Migration
Sponsoring organization: Government Accountability Office
Describes compact migration, reviews enumeration approaches, evaluates impact reporting, and reviews Interior grants related to the impact on compacts with the freely associated states, the U.S. territories, and Hawaii.
Date: 11 / 2011

Demographic and Economic Profile: Hawaii
Sponsoring organization: Rural Policy Research Institute
Presents demographics, economics, and research on Hawaii. Includes statistics, data, maps, charts, and graphs.
Date: 02 / 2009

Education: A Regional Overview
Author(s): Don E. Albrecht
Sponsoring organization: Western Rural Development Center
Explores education characteristics in the western states and examines how it impacts rural development.
Date: 2008

Employment, Income and Poverty: A Regional Overview
Author(s): Don E. Albrecht
Sponsoring organization: Western Rural Development Center
Examines and compares employment and income in western states with both rural and urban data.
Date: 2008

Financing Long-term Care in Hawaii: A Survey of Residents 18 and Older
Author(s): Jennifer H. Sauer
Sponsoring organization: AARP
A report that documents the results of a state-wide survey done in February 2005 to gauge the need for financing long-term care services in Hawaii.
Date: 03 / 2006

Hawaii: Cancer and Asian Americans, Native Hawaiians & Pacific Islanders
Sponsoring organization: Asian & Pacific Islander American Health Forum
Outlines statistics related to the incidence of certain cancers in Hawaii by gender, race and ethnicity.
Date: 06 / 2010

Health and Longevity: A Regional Overview
Author(s): Don E. Albrecht
Sponsoring organization: Western Rural Development Center
Examines health and longevity for states in the western region.
Date: 2008

Land Use and Resources: A Regional Overview
Author(s): Don E. Albrecht
Sponsoring organization: Western Rural Development Center
Examines land use and resources in the western states.
Date: 2008

Maternal and Child Health of Asian Americans, Native Hawaiians, and Pacific Islanders
Sponsoring organization: Asian & Pacific Islander American Health Forum
Describes indicators of maternal and child health, including prenatal care, low birth weight, and infant mortality, within AA and NHPI (Asian American, Native Hawaiian, and Pacific Islander) populations in the United States and Pacific Islands.
Date: 05 / 2012

Native American Lands
Describes issues faced by people living on American Indian Area, Alaska Native Area, Hawaiian Homeland Area (AIANHH) lands, such as poverty, housing deficiencies, and social and health-related problems. Information is based on the 2000 Census.

Native Hawaiian and Pacific Islander Health Disparities
Author(s): Wom Kim Cook, Corina Chung, Taunu'u Ve'e
Sponsoring organization: Asian & Pacific Islander American Health Forum
Provides an overview of NHPA (Native Hawaiian and Pacific Islander) health in the United States. Where possible, this health brief also includes data on the health status of NHPAs living in the USAPI (U.S.-Affiliated Pacific Islands.)
Date: 08 / 2010

Profiles of State Innovation: Roadmap for Managing Long-Term Supports and Services
Author(s): Alice Link, Suzanne Gore, Lindsay Barnette, Stephen Somers
Sponsoring organization: Center for Health Care Strategies
Identifies five states that demonstrate expertise in managed care approaches for individuals with long-term care needs. States included are Arizona, Hawaii, Tennessee, Texas, and Wisconsin.
Date: 11 / 2010

Small Business Profile: Hawaii
Sponsoring organization: Small Business Administration
Profile of the state's economy, covering the number of firms, industry composition, small business income, banking, women and minority business ownership, and employment.
Date: 2 / 2013

State of Hawaii Primary Care Needs Assessment Data Book 2012
Sponsoring organization: Hawaii State Department of Health
A source of comparative health statistics on primary care service areas in the State of Hawai‘i.
Date: 07 / 2012

State of Hawaii: Population Brief
Author(s): Don E. Albrecht
Sponsoring organization: Western Rural Development Center
Access baseline information for the advancement of rural development that examines population changes and characteristics within Hawaii. Files are available for each county or as a statewide overview.
Date: 2008

See also: State-by-State Resources: Documents

Success Stories

Angel Flight West: A Higher Level of Kindness
Angel Flight West provides free, private air transportation for people with medical and other needs.

Kokua Program
The primary objectives of this consortium of six area health service providers, agencies, and universities were to reach and educate local women on breast and cervical cancer, and provide health screenings using culturally appropriate methods that reduce fear and anxiety.

Adolescent Behavioral Health Project
This project was designed to provide adolescents with an employment experience at the health center to help build self-esteem, develop healthy decisionmaking capabilities, and prevent the onset of chronic health problems. The medical center provided a range of behavioral health services to students at the two local schools, those participating in the employment program, and young children at home.

Page last updated 6/10/2013
Topic last reviewed 5/1/2013

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