Hawaii ranked among the top 10 states for high health rankings, according to a recently released report by the United Health Foundation.
Hawaii ranked eighth-best among states in key health measures, according to America’s Health Rankings 2024 Annual Report — a drop from sixth place in 2023.
While the state got the top ranking for its low rates of adults avoiding care due to cost, it ranked in the bottom half for other factors, including No. 34 for the number of primary care providers and No. 36 in the economic hardship index.
“For many key indicators of public health, the data show that Hawaii performs exceptionally well,” said Dr. Kenneth Fink, Hawaii Department of Health director, in a news release. “However, in certain areas — primarily economic factors and certain personal behaviors — there are opportunities for improvement.”
The report is the longest- running annual assessment of the nation’s health on a state-by-state basis, according to the foundation. The 2024 report ranked states based on 88 measures spanning five categories of health and well-being.
Hawaii ranked No. 1 for health outcomes, due in part to recording the lowest rates in the nation for frequent mental distress reported among adults (13%) and racial disparities in premature death; the second- lowest rate of adult obesity (26%); and the third-lowest rate of adults with multiple chronic conditions (7.7%).
Cases of frequent mental distress among adults, however, jumped 54% from 2014 to 2023.
For clinical care, Hawaii ranked No. 7 due in part to recording the lowest rates in the nation for avoided care due to cost (6.7%) and No. 2 for the second-lowest percentage of population uninsured (3.2%).
Hawaii ranked lower for categories that looked at social and economic factors affecting public health.
The state ranked 36th on a scale of 1 to 100 for the Economic Hardship Index, which factors in crowded housing, per capita income, and poverty and unemployment rates.
Socially, Hawaii also ranked low for voter participation, at 34th, and volunteerism, at 45th.
Hawaii ranked high for number of dental care providers, at No. 4, but in the bottom half for number of mental health providers, at No. 28, and number of primary care providers, at No. 34.
The state offered a mixed bag in the category of physical environment — a top ranking for low rates of air pollution and drinking water violations, on one hand, but a bottom ranking for water fluoridation, on the other hand.
Hawaii does not add fluoride to its public drinking water system to help battle cavities and tooth decay. The Honolulu City Council in 2004 voted to ban fluoride from being added to Oahu’s public water supply.
The state’s legislative efforts to change the ban have so far been unsuccessful.
Hawaii residents also ranked No. 44 for percentage of adults that use e-cigarettes (10%) and drink excessively (20%) — and at the bottom, No. 50, for percentage of adults with insufficient sleep (45.6%).
The report also found that drug deaths increased 74%, from 11.3 to 19.7 deaths per 100,000 people between 2013 and 2022.
In overall ranking, New Hampshire ranked first, Vermont second, and Massachusetts third. Louisiana was 50th, at the bottom of the overall ranking.
Monitoring state’s health
Where Hawaii ranked:
>> Overall rank: 8th
>> Health outcomes: 1st
>> Clinical care: 7th
>> Social & Economic Factors: 14th
>> Behaviors: 17th
>> Physical environment: 27th
A closer look
>> Premature death racial disparity: 1st
>> Obesity among adults: 2nd
>> Percent of population uninsured: 2nd
>> Multiple chronic conditions among adults: 3rd
>> Dental visits among adults: 3rd
>> Premature deaths: 6th
>> 4th grade reading proficiency: 8th
>> Childhood immunizations: 17th
>> Fruit and vegetable consumption: 19th
>> Mental health providers (per 100,000): 28th
>> Primary care providers (per 100,000): 34th
>> Voter participation: 34th
>> Economic hardship index: 36th
>> E-cigarette use among adults: 44th
>> Excessive drinking among adults: 44th
>> Volunteerism: 45th
>> Severe housing problems: 50th
>> Sleep health: 50th
>> Water fluoridation: 50th
Key findings
>> Drug deaths increased 74% (from 2013 to 2022)
>> Frequent mental distress increased 54% (from 2014 to 2023)
>> Teen births dropped 53% (from 2013 to 2022)
>> Uninsured declined 40% (from 2014 to 2023)
Source: America’s Health Rankings 2024 Annual Report
