Hawaii County health needs revealed

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A national comparison of counties released early this morning reveals troubling news about Hawaii County’s teenagers and young adults.


A national comparison of counties released early this morning reveals troubling news about Hawaii County’s teenagers and young adults.

Seventeen percent of 16- to 24-year-olds in the county are not in school or employed, according to the Robert Wood Johnson Foundation, which funded the report.

The foundation calls such young people “disconnected youth.”

Poor education and lack of employment can lead to lack of access to health care, food, medicine, housing and a host of health-related physical and mental problems.

Comparatively, only about 9 percent of 16- to 24-year-olds are unemployed and not in school in top-performing counties nationally.

“We’re kind of thinking of this as lost potential for the county,” said Justin Rivas, a community coach with the foundation and the state team leader for Hawaii.

Pediatrician Dr. Joseph D’Angelo of Island Pediatrics in Hilo said if there was a boom industry, such as sugar cane, pineapple or, in the future, marijuana production, “a lot of those people would be working.”

But many opportunities already exist.

John Leong, CEO of Kupu, a nonprofit working to encourage new “environmental stewards” and leaders, said “work-based programs like the ones Kupu provides allow young adults to gain the skill sets, mindset, character and experience necessary to move forward in life.”

Sixteen- to 24-year-olds are “an asset to society, not a liability,” Leong said. And they have the “most latent potential to create positive change” despite being one of the most underemployed demographics.

Among his patients, D’Angelo said, those kids who say they’re going to work “are usually those that have solid jobs, like mechanics.” He does not specifically ask kids about their career plans.

But that might be changing.

“I can talk to the kids now, because it’s been brought to my attention,” he said. Once he asks what a patient plans to do, he can offer counseling.

Each year, the Robert Wood Johnson Foundation, which works to improve health and health care, gathers information from multiple sources, including national and state data, to create a county-by-county comparison nationwide.

The foundation reports that Hawaii County needs to work on topics such as adults smoking (18 percent), excess drinking (22 percent), the uninsured (11 percent), unemployment (5.5 percent), children in poverty (25 percent), the high school graduation rate (83 percent) and severe housing problems (29 percent).

Rivas said the foundation works with counties to promote effective solutions that already were proven to work.

He said examples that might be effective in Hawaii County include alternative schools such as the Youth Challenge Academy, summer jobs, internships and training in trade-based skills such as culinary arts and mechanics.

Bill Kunstman, with the state Department of Labor and Industrial Relations, said there already are such programs.

“We do have some federal moneys for that,” he said, noting the U.S. Department of Labor has been emphasizing such programs.

For example, Hawaii in 2016 received a $1.5 million U.S. Department of Labor grant to expand apprenticeships to train women, veterans, Native Hawaiians and people with disabilities in fields such as health care, culinary arts, construction and the hospitality industry.

Rivas said 29 percent of keiki in Hawaii County are impoverished, which is similar to the percentage of people who live in problem housing.

“That’s a pretty high rate of children in poverty,” he said.

Statewide, 15 percent of children are impoverished; nationally, the number is 12 percent.

The county appears to do well in terms of health behavior — people actually exercise here, despite their lack of access to exercise options, sometimes because of rural living.

But Rivas said housing in Hawaii County demonstrates “severe housing problems” for a third of the population — 29 percent.

“Housing and quality of housing is directly related to health outcomes,” he said.

Poor housing can affect the entire family. A severe housing problem is recognized by the foundation’s report as lacking a complete kitchen, overcrowding, poor plumbing and high housing costs.

Rivas recommends counties build partnerships with schools, law enforcement, nonprofits, faith communities, agencies, health agencies and the business community to plan how to improve community health outcomes.

He said the Robert Wood Johnson Foundation will pay for a job coach to work with a county for up to a year at a time to help improve the health of its residents, if the county seeks such assistance.

Should the county do such a thing?

“Yes, absolutely, I think — if it’s not at the taxpayers’ expense, it’s a worthwhile investment,” D’Angelo said.

Counties are guided by the foundation’s coach with evidence-based actions that previously were shown to work.

“We need to be intentional about engaging the next generation in something bigger than self,” Leong said. “When a young adult gives of their time and themselves selflessly to something bigger than themselves, they develop a heart that understands kuleana and what being pono is about.”

A major goal of the foundation is to get community members and counties to take action.

To learn more about how to do so personally, through your organization or via a government initiative locally, go to countyhealthrankings.org and click the “get help” button to talk with a coach.


“It’s really up to the local community to decide what to prioritize and engage in,” Rivas said.

Email Jeff Hansel at jhansel@hawaiitribune-herald.com.

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