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In order to understand health trends in Hawai'i, it is necessary to understand the interrelationships among demographics, health, and the health care delivery system. This section on demographics highlights Hawai'i's overall population growth, distribution, births, deaths, and ethnicity and describes the interrelationships, including:
  • Population growth will drive health care demand for the foreseeable future. Growth influences the number, type, and geographic distribution of health care resources required to meet population need.

  • Age is the single most important factor in understanding health status and the need and demand for health care resources. For the elderly, there is a clear relationship between age and mortality, prevalence of chronic conditions, and level of disability. Similarly, the elderly are the heaviest users of health care resources.

  • Ethnicity is related to utilization of certain types of health services. To a limited extent, differences in utilization may be traced to differences in the types of health problems experienced. However, many of the differences reflect variations in lifestyle patterns and cultural preferences.
Among the key findings from this chapter is that Neighbor Island populations are growing at a faster pace than that of Honolulu. Hawai'i's total resident population has grown at varying rates since statehood and is now estimated at 1.4 million. Projections from the Department of Business, Economic Development and Tourism (DBEDT) suggest that Hawai'i's population will grow by about 140,000 every ten years between 2000 and 2030, with over 40 percent of that growth taking place on the Neighbor Islands.

The structure of Hawai'i's population reflects an aging population, with decreasing birth rates and increasing death rates. Of concern are marked differences among ethnic groups in age at death. In particular, Hawaiians/part-Hawaiians, are dying at much younger ages than members of other ethnic groups. In 2011, the latest year for which complete data are available, 70 percent of deaths among Japanese in Hawai'i occurred at age 80 years or older, compared to only 28 percent of the Hawaiians/part-Hawaiians. 21 percent of deaths among Hawaiians/part-Hawaiians in 2010 occurred before age 55, --almost 2 times higher than any other specific group.

Hawai'i continues to be ethnically diverse, as are its counties. The county of Hawai'i has the largest proportion of Hawaiians/part-Hawaiians (29 percent) as well as the largest portion of Caucasians (28 percent). Honolulu has the largest proportion of Japanese (19 percent), Mixed (22 percent), and Chinese (4 percent). Kaua'i has the largest proportion of Filipinos (14 percent).

> Greater Need For Services
> Distribution and Expansion
> Working Age Population
> Consistent Differences
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