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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 2010 estimated population of 1,360,301 people – 407,094 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, 24.7% of the state’s population is white, 38.6% is Asian, 10.0% is Native Hawaiian or other Pacific Islander, 1.6% is African American/Black, and 8.9% is of Hispanic/Latino origin (2010).

There are 23 hospitals in Hawaii, 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 (Sept. 2010). There are 2 Rural Health Clinics in Hawaii (Kaiser, 2011), 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, 2008-2008).

According to the Economic Research Service, The average per-capita income in 2009 for residents of Hawaii was $42,152 although rural per-capita income lagged at $34,321. 2010 estimates indicate a poverty rate of 14.8% exists in rural Hawaii, compared to a 9.5% level in urban areas of the state. 2010 ACS data reports that 10.5% of the rural population has not completed high school, compared to 10.1% of urban populations. The unemployment rate in rural Hawaii is 9.0%, while in urban Hawaii it is 5.6% (USDA-ERS, 2010).

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.

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 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 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 Montana, Wyoming, Alaska, Hawaii, American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands.

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.

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

California STD/HIV Prevention Training Center
Web site
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
Web site
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 Data
Web site
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.

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

Hawaii QuickFacts
Web site
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
Web site
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
Web site
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
Web site
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
Web site
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

See also: Resources for All States: 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

See also: Resources for All States: Maps

Funding

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

Gannett Foundation Community Action Grants
Community action grant priorities include education and neighborhood improvement, economic development, youth development, community problem-solving, assistance to disadvantaged people, environmental conservation and cultural enrichment.

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

Rural Community Assistance Corporation Housing Loans
Loan program helps 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

2012 WICHE Workplan: It's All About Outcomes
Sponsoring organization: Western Interstate Commission for Higher Education
Discusses WICHE's focus in 2012 which includes finance, access and success, workforce and society, technology and innovation, and accountability. Highlights students exchange programs in rural and underserved areas, rural healthcare initiatives, and rural primary care clinics.
Date: 09 / 2011

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

Asian/Pacific Islanders and Cardiovascular Diseases: Statistics: 2011 Update
Sponsoring organization: American Heart Association
Outlines the leading causes of death among Asian/Pacific Islander men and women.
Date: 2011

Changing West: A Regional Overview
Author(s): Don E. Albrecht
Sponsoring organization: Western Rural Development Center
Provides baseline data for identifying population changes in the western states for use in advancing rural development.
Date: 2008

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

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

HIV/STD Prevention Guidelines for Native American Communities: American Indians, Alaska Natives, and Native Hawaiians
Sponsoring organization: Rural Center for AIDS/STD Prevention
Provides a framework to create HIV/STD prevention programs tailored to Native Americans, reflecting the unique culture of Native communities and a starting point for program development at the local level.
Date: 2004

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

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.

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: 02 / 2011

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

Student Exchange Programs: Statistical Report, Academic Year 2011-12
Sponsoring organization: Western Interstate Commission for Higher Education
Discusses WICHE's three student exchange programs: Western Undergraduate Exchange (WUE), Western Regional Graduate Program (WRGP), and Professional Student Exchange Program (PSEP). Covers Fall 2011 enrollment, discusses health workforce shortages, and the funds that flow between students' home states and the enrolling institutions in these programs.
Date: 01 / 2012

See also: Resources for All States: 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.

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Page last updated 2/1/2012
Topic last reviewed 04/28/2010

Events
Mar 13 - 15, 2012
2012 9th Annual Hawaii Conference:
Preventing, Assessing & Treating Child, Adolescent & Adult Trauma

Institute on Violence Abuse and Trauma
Ala Moana Hotel
Honolulu, HI
Contact:
  858.527.1860
  ivatconf@alliant.edu


Apr 15 - 17, 2012
2012 86th Annual DETC Conference
Distance Education and Training Council
Wailea Beach Marriott Resort and Spa
Maui, HI
Contact:
  Robert Chalifoux
  202.234.5100 x104
  rob@detc.org


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Funding for this project was supported by Grant Number U56RH05539 from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the funder.