How Healthy is Rural Maui?

First the definitionof rural typically used by the US government relies on Census data. If a city has a population over 150,000, then the city and the county where it is located are declared to be a Metropolitan Statistical Area (MSA) and therefore not rural. The definition applied to the County of Maui means that all of county is classified as rural.

When Maui is compared to other rural areas in the US using the same definition, there is an obvious difference in what “rural” means for Maui than for the contiguous rural areas of the rest of the country. First,Hawaii is the only one of our 50 states that is composed only of islands. Second, Maui is the only county in Hawaii that is also composed of several islands. So Maui has a very unique geographical definition of rural. It is the only county that contains three non-contiguous regions comprising its rural definition.

So, how much more rural is Maui and what, if any, health concerns and health care are presented by the populations on the islands of Lana’i, Molokai and Maui?

The data table on the next page shows examples of some of the unusual characteristics of the three isle communities. The town of Hana area is noteworthy because of its geographical isolation from the rest of the general population on the island of Maui. As can be seen from the chart, Maui County exceeds the balance of state (benchmark) in the percentage of Native Hawaiian adults. Hana and Molokai lead the way with 60 plus percent Native Hawaiian. Both Hana and Molokai also exceed the balance of state average (benchmark) with their high levels of adults who are 200% below the Federal Poverty Level. Molokai has the highest rate of obesity and high blood pressure and finally all areas of Maui exceed the State levels on the per cent of adults without health insurance. This one table shows just a few of the dramatic differences of what rural means in Maui when compared to the rest of Hawaii.

Primary Care Needs-Maui County
Census/Areas / Hana / Makawao / Molokai / Wailuku / Lahaina / Lanai / Maui Cnty / State Hawaii
Adult Population / 1,808 / 26,963 / 10451 / 47227 / 13562 / 2,088 / 102,099 / Benchmark %
Adults who are Obese / 20.10% / 17.50% / 27.60% / 20.40% / 23.60% / 16.50% / 20.70% / 20.50%
363 / 4718 / 2884 / 9634 / 3201 / 345 / 21134
Adults with High Blood Pressure / 8.80% / 20.80% / 27.50% / 25.10% / 17.80% / 24.00% / 23.00% / 26.00%
159 / 5608 / 2874 / 11854 / 2414 / 501 / 23483
Adults w/o Health Ins. / 20.60% / 12.00% / 14.10% / 8.80% / 7.50% / 9.10% / 10.20% / 7.60%
372 / 3236 / 1469 / 4156 / 1017 / 190 / 10423
Adults w/o physical activity / 15.40% / 15.50% / 19.80% / 7.20% / 19.90% / 20.30% / 18.40% / 19.20%
278 / 4179 / 2069 / 3400 / 2699 / 424 / 18686
Adults w/o Dental visit last year / 25.90% / 30.10% / 29.20% / 24.90% / 21.00% / 31.10% / 26.30% / 24.40%
468 / 8116 / 3052 / 11760 / 2848 / 649 / 26852
Pop. Native Haw'n (alone/comb) / 62.70% / 19.60% / 61.20% / 28.90% / 18.90% / 19.80% / 26.80% / 23.30%
1134 / 5284 / 6396 / 13684 / 2563 / 2088 / 23891
Pop. over 18 yrs w/o HS Diploma / 14.60% / 11.00% / 22.30% / 19.40% / 16.10% / 29.20% / 16.20% / 15.30%
263 / 2966 / 2330 / 9162 / 2183 / 610 / 16540
Pop.<200 % of Fed. Poverty Level / 40.70% / 23.10% / 42.30% / 24.60% / 21.20% / 24.70% / 25.00% / 25.90%
736 / 6228 / 4421 / 11618 / 2875 / 505 / 25524
Households receiving food stamps / 10.00% / 7.30% / 24.80% / 9.20% / 6.00% / 6.10% / 8.90% / 11.60%
181 / 1968 / 2593 / 4345 / 814
Inadequate prenatal care utilization / 67.60% / 49.40% / 28.80% / 51.90% / 53.60% / 34.30% / 50.30% / 29.20%
Highlighted / data represents populations that exceed benchmark
Sources: Maui County Data Book, U.S. Census, and State of Hawaii Primary Needs Assessment Data Book (2009)
Compiled / 10/16/2010

Capacity of Maui to Provide Services

Although not shown in the table above, the Health Resource and Service Administration (HRSA) data also shows Maui County as having the greatest shortage of dentists, physicians and registered nurses in the State of Hawaii. Further, Hawaii itself ranks in the bottom tier nationally for shortages in these same health fields.

This all points to a very strong need to for Maui to increase its capacity and efficiency in delivering Rural Health programs to the uniquely rural who live in the county of Maui.

One of the organizations that is dedicated to addressing rural health needs in Hawaii is the Hawaii State Rural Health Association (HSRHA). HSRHA actively pursues solutions to the unique issues that are associated with providing robust health services to Hawaii’s rural populations.

HSRHA is organized for advocacy, collaboration, communication, education, and research of issues related to rural health. The objectives of this Corporation are to:

  1. Facilitate a continually improving health network responsive to the needs of people living in rural areas of Hawaii.
  2. Increase communication locally and nationally related to the health needs of rural communities in Hawaii.
  3. Facilitate collaboration between the rural health associations in the State of Hawaii.
  4. Educate the community on rural health issues.
  5. Ensure community participation in health and health care planning.
  6. Educate federal, state, county, and other community agencies, and institutions regarding health policy and allocation of resources.
  7. Provide a forum for exchange of information and ideas.

At the present time there is not a local rural health association affiliated with HSRHA. For those who are interested in joining the State Association (HSRHA) or who wish to start a local Rural Health Association for Maui County please contact: Larry Carter ---larry @mauiagewave.com.