Vision – Adults have meaningful work, family–sustaining incomes and healthy lifestyles
Desired Outcome – Reduce the impact of chronic disease and support achievement of vision for adults
Though our hopes are for adults to have healthy lifestyles, the reality is that there are many barriers to healthy lifestyles and there is room for improvement in several categories. Improvement will likely require interventions at multiple levels, including systems and policy levels as well as at the individual level.
Primary Indicators
Hawaii County has higher diabetes hospitalization and higher death rates for heart attacks and stroke.
Related Indicators
Hawaii County has higher unemployment, higher levels of population in poverty and the state has high rates of adults working multiple jobs.
Socioeconomic
Access to Healthcare
Hawaii County has a relatively high uninsured population like the neighbor islands compared to the City and County of Honolulu and fewer physicians per population.
Lifestyle Factors
Hawaii County has higher smoking rates than the state and residents who are of Hawaiian ethnicity have much higher smoking rates. Hawaii County has relatively high rates of alcohol consumption, which exceeds recommendations compared to the state. Hawaii County population meeting recommendations for physical activity and nutrition are actually slightly better than the state.
- Percent smoking, Hawaii compared to state (chart)
- Percent smoking by ethnicity (chart)
- Percent exceeding recommendations for alcohol consumption ( chart)
- Percent meeting exercise recommendations (chart)
- Percent meeting nutrition recommendations (chart)
Modifiable Risk Factors for Chronic Disease
Hawaii County has higher rates of overweight and obesity compared to the state and similar rates of high blood pressure.
Death Rates from Chronic Disease
Hawaii County has higher death rates from heart attacks and stroke.
Partners with a Role to Play
Local:
Schools, Employers, Hamakua Health Center, Tutu’s House, and Five Mountains Hawaii-Live Well Project
County:
Hawaii Island Beacon Community, Department of Health, American Heart Association, American Cancer Society, Hawaii County Office of Aging, Senior Centers, Kona-Kohala Chamber of Commerce
State:
Department of Health-Chronic Disease Prevention, Department of Health-Healthy Hawaii Initiative and Diabetes Network, Office of the Governor, HMSA, Kaiser Permanente, and American Heart Association
National:
Health and Human Services, Healthy Communities Programs, Association of Community Health Improvement
Academic:
JABSOM – UH School of Medicine, UC Berkley School of Nutrition
What Works Best
Patient and Community Engagement
- School-based health education integrated into curriculum, practices and polices such as requiring physical eduction.
- Business-based support for workforce wellness and healthy behaviors including nutrition, physical activity and smoking cessation support.
- Business development of healthy lifestyle support businesses (i.e, Gyms, healthy restaurants)
- Multiple interventions including policy change such as smoke free workplace, incentives to exercise and quit smoking.
- Culturally relevant lifestyle change programs.
- Increasing access to affordable fruits and vegetables
- Chronic disease self management curriculum.
Transforming Health Care
- Shift from acute care model to chronic disease model of medical care.
- Physician reimbursement for smoking cessation counseling and lifestyle modification counseling.
What is Being Done
Patient and Community Engagement
- How’s Your Health website at www.howsyourhealth.com available free to all Hawaii County residents to support informed and prepared patients, as well as self management.
- Weight Watchers
- Department of Health Tobacco Prevention and Education program
- The Kohala Center facilitates island wide collaboration on school gardens, and reducing cost of produce through farm to table distribution. Mala’ai – The Culinary Garden of Waimea Middle School.
- Get Fit Hawaii Physical Activity and Nutrition Coalition
Transforming Health Care
- Beacon Programs to transform healthcare.
- Chronic disease self management program in Hawaii County Office of Aging.
Suggested Strategies
Increase Awareness:
- Increase employers awareness of the cost of employee chronic disease.
- Increase awareness of impact of lifestyle on chronic disease.
- Increase awareness of local resources to support healthy lifestyles. Develop resource inventory.
- Increase awareness of patient activation as a predictor of chronic disease outcomes. See Health Services Research.
Obtain Additional Data:
- Increase awareness of Hawaii County relatively high annual hospital utilization rates.
Inventory and Build Existing Resources:
- Develop and share resource inventory of patient education, support and lifestyle change programs, in each region of Hawaii County.
Increase Organizational Links:
- Link with DOH Tobacco Prevention and Education 1-800 QUIT NOW (1-800-784-8669).
- Link with DOH Start Living Health Program and Chamber of Commerce to bring effective models of employee wellness to Hawaii County.
- Partnerships with local employer’s to link with local prevention resources.
Promote Effective Programs:
- Systems approach linking social and environment to health (See CDC the Community Guide).
- Expand employee health through web-based confidential health survey, How’s Your Health
Promote Effective Practices:
- Support use of self management of chronic disease. See Stanford Curriculum for Self Management.
Promote Effective Policies:
- Systems approach to increase safe walking and biking trails and professional education about lifestyle management, and patient activities.
- Provide healthy food options for school lunches, vending machines and employee meals.
Improve Health Systems:
- Integrate a chronic care and prevention model into primary care.
- Improve access to primary care. See Hawaii Healthcare Alliance