Births decline: Several factors contribute to drop in Hawaii-born babies

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OKINAKA
Tribune-Herald file photo In this 2019 file photo, kindergarteners at Kua O Ka La New Century Public Charter School get excited about recess. Births are on the decline in Hawaii, and people 65 and older now account for nearly 20% of the state's population.
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Birth rates have declined in Hawaii by 14% since 2016, the sixth largest drop of any state in the nation.

While 18,059 births were reported in 2016, just 15,565 were reported in 2021 by the U.S. Centers for Disease Control and Prevention’s National Vital Statistics System.

“It’s probably a combination of many factors,” said Alton Okinaka, professor of sociology at the University of Hawaii at Hilo. “One is the increased access to birth control technology, another is simply the economics of how much it costs to raise kids, so more people are waiting longer to get established career-wise first, then having fewer kids.”

As a result, fertility rates — or the number of births per 1,000 women aged 15-44 — also dropped in Hawaii.

In 2010, the state averaged 72 births for every 1,000 women in that age group. But in 2021, that number fell to 61.1. That was still higher than the national average in 2020 of 56 births per 1,000 women, which was the lowest rate on record.

Despite the statewide decline, births at Hilo Medical Center have remained stable in recent years, with 919 births recorded in 2019, 952 in 2020, 933 in 2021 and 932 in 2022.

“I’ve been at the hospital for 16 and a half years, and back then, we used to have just about 100 births a month,” said HMC spokesperson Elena Cabatu. “So, there has been a decline, but it has been over many years, and in recent years, it’s been flat.”

Back in 2020, some predicted a “baby boom” would result from the work-from-home transition during the COVID-19 pandemic. Instead, birth rates declined nationwide. In Hawaii in 2020, there were just 15,780 births, down 16% compared to the decade before.

Along with declining birth rates, an increasing number of people are moving out of the state.

From July 2020 to July 2021, Hawaii reported the fourth-largest population decrease among all U.S. states, losing a total of 10,358 residents. The state’s population has declined each year since 2017.

One report from the state Department of Business, Economic Development and Tourism found that of all Hawaii-born residents moving to the mainland, nearly two-thirds were 24 or younger.

“We are not just looking at decreased birth rates, but more locals leaving for career and job opportunities as the housing market is pricing them out,” Okinaka said. “Jobs are not paying enough to afford housing.”

But as those born in Hawaii continue to move to the mainland, many from the mainland are moving to Hawaii County.

In 2010, an estimated 185,079 people lived in Hawaii County, but that number jumped to 200,629 in 2020.

“Recently, the island has had relatively large population growth, but it has come mainly from people moving here, not from local births, and I don’t see that changing soon,” Okinaka said. “While real estate is expensive by local standards, for those looking to move here, we offer some of the cheapest land in the state, which means more people moving here. Look at the growth in lower Puna, for example. We have been seeing growth in other areas like Waikoloa and Waimea, as well, even though those are not cheap by local standards.”

Another likely factor behind the decrease in birth rates may also be the increase in the average age of first marriages in Hawaii.

In 1990, the average age for first marriages in Hawaii was 27 for men and 25 for women. But in 2020, that age jumped to 28.2 for women and 28.1 for men, according to data from the U.S. Census Bureau.

“We are also seeing more marriages break up, and remarry, so step children and parents and other disruptions may make people more reluctant to have kids as life becomes too uncertain,” Okinaka said.

Hawaii’s population also is getting older. In 2010, those 65 and older made up 14% of the population, but in 2020, those 65 and older account for closer to 20%.

Lower birth rates could impact this aging group when it comes to demand for hospice workers, care givers, and other support systems needed as residents get older.

“We are seeing some aging of the population, and we can expect an increase in demand for care homes and assisted living facilities and programs,” Okinaka said. “Much of the care needed for the elderly we are already in short supply of, such as health care and social workers. Without increases in pay for these jobs, the shortage is likely to get worse.”

Several state House and Senate bills are being introduced this year that might sway some residents who on the fence about having children. These include 12-week paid family leave for state and county employees for the birth of a child, a refundable monthly state child tax credit, and a child care income tax credit for certain employers.

“If we want increased birth rates, there needs to be incentives,” Okinaka said. “When I look at my family, my grandparents had eight and nine kids on each side. In my parent’s generation, the most anyone in the family had was three.”

Email Grant Phillips at gphillips@hawaiitribune-herald.com.