Reduce the impact of chronic disease.

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• Hospital utilization rate for diabetes (Chart).
• Hospital utilization rate for congestive heart failure (Chart).
• Hospital utilization rate for coronary heart disease (Chart).
• Hospital utilization rate for stroke.

• % uninsured (Chart).
• % sedentary behavior (Chart).
• % smoking (Chart).
• % obesity (Chart).
• % overweight (Chart).
• % high blood pressure (Chart).
• Death rate for coronary heart disease (Chart).
• Death rate for stroke (Chart).
• Poverty rate (Chart).
• % households with income < 200% of poverty (Chart).
• % working more than one job (Chart).

• North Hawaii and Hawaii County have a high and increasing cost of living and high housing costs.
• North Hawaii and Hawaii County have a relatively high percent of the population with household income below 185% of federal poverty level (Chart).
• Hawaii County has a high percent of the population working more than one job.
• Hawaii County has 12.3% uninsured. Surveys often under estimate uninsured.  Actual uninsured rate may be higher (Chart).
• 46% of residents in North Hawaii drive more than 30 minutes to work (Chart).
• Many employees have time barriers to getting recommended exercise.
• Hawaiians are at higher risk for diabetes.
• Higher cost for fruits and vegetables compared to most simple carbohydrates and fast food.

Local:            

Schools, Employers, Kona-Kohala Resort Association, NHCH-Diabetes Wellness Center, Hamakua Health Center, Tutu’s House, Five Mountains Hawaii-Live Well project.

County:       

Department of Health, American Heart Association, American Cancer Society, County Office of Aging, Senior Centers, Kona-Kohala Chamber of Commerce.

State:          

Department of Health-Chronic Disease Prevention, Department of Health-Healthy Hawaii Initiative and Diabetes network, Hawaii Outcomes Institute, Governors Office, HMSA, Kaiser, and American Heart Association.

 

National:     

Health and Human Services:  Steps to a Healthier U.S., Association of Community Health Improvement.

• School-based health education integrated into curriculum, practices and policies.
• Business-based support for healthy behaviors including nutrition, exercise and smoking cessation support.
• Shift from acute care model to chronic disease model of medical care.
• Business development of healthy lifestyle support businesses (i.e. Curves, Subway).
• Multiple interventions including policy change such as smoke free workplace, incentives to exercise and quit smoking.
• Culturally relevant life-style change programs.
• Physician reimbursement for smoking cessation counseling and lifestyle modification counseling.

• Hawaii Heart Brain Center at North Hawaii Community Hospital – Community Partnership for Prevention Committee working on increasing awareness of stroke and its risk factors, increasing blood pressure screening and stroke screening.
• How’s Your Health website www.howsyourhealth.com, to support informed and prepared patients, as well as self management.
• Weight Watchers.
• Department of Health Smoking Cessation program.
• Work Place Wellness proposal to develop health champions training.
• Mala‘ai, The Culinary Gardens of Waimea School.
• Tutu’s House – nutrition education and diabetes self-management classes.
• Labman promoting school physical activity.
• YMCA – after school activities.

Increase Awareness:

• Increase employer’s awareness of the cost of employee chronic disease.
• Increase awareness of contribution to chronic disease of life style risk factors.
• Increase awareness of local resources to support healthy lifestyles.

Obtain Additional Data:

• Annual hospital utilization rates.

Inventory and Build Existing Resources:

• Resource inventory of patient education, support and lifestyle change programs in North Hawaii.

Increase Organizational Links:

• Link with DOH-Smoking Cessation Project – 1-800-QUIT NOW (1-800-784-8669).
• Link with DOH, Start Living Healthy Program and Chamber of Commerce to bring effective models of employee wellness to Hawaii County.
• Partnership with local employer’s to link with local prevention resources.

Promote Effective Programs:

• Systems approach linking social and environment to Health (See CDC the Community Guide)
• Expand employee health through web-based confidential health survey, How’s Your Health.

Promote Effective Practices:

• Support self management.

Promote Effective Policies:

• Systems approach to increase safe walking and biking trails and professional education.
• Provide healthy food option for school lunches, vending machines and employee meals.

Improve Health Systems:

• Integrate a chronic care and prevention model.