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Why is Hawaii so healthy?

Hawaii is one of the healthiest states in the United States. With its tropical climate, active lifestyle, cultural values around food, and emphasis on community, Hawaii fosters health and longevity among its residents.

Health Rankings

According to America’s Health Rankings, Hawaii is consistently ranked as one of the top 5 healthiest states. In 2022, Hawaii ranked 3rd out of all US states for overall health. This high ranking is based on measures including prevalence of smoking, obesity rates, availability of primary care physicians, and rates of cardiovascular deaths, cancer deaths and infant mortality.

Here is a table showing Hawaii’s health ranking compared to other states in 2022:

State Overall Health Ranking
Vermont 1
Massachusetts 2
Hawaii 3
Connecticut 4
Utah 5

This consistency in top rankings indicates that Hawaii does an exceptional job of supporting health for its residents.

Tropical Climate

Hawaii’s tropical climate enables an active, outdoor lifestyle year-round. With average temperatures ranging from 75-85 degrees Fahrenheit, exercise like walking, hiking, swimming, surfing and paddling can be enjoyed any day.

The sunny climate provides abundant vitamin D, which supports bone health and immunity. And the lack of extreme winters reduces flu transmission.

Active Lifestyle

Hawaii has a highly active population, with efforts made to enable exercise. Hawaii ranked 2nd among states for percentage of residents who exercise frequently in 2022.

Public parks, beaches, walking paths and community centers provide plenty of options for staying active. Hawaii also has an expanding network of bike lanes to support cycling as a commute method and recreation.

Popular sports and fitness activities include:

  • Surfing
  • Stand-up paddleboarding
  • Swimming
  • Hiking
  • Running
  • Cycling
  • Yoga
  • Team sports like volleyball, basketball, soccer, and outrigger canoeing

Schools emphasize physical education and outdoor time. And workplaces increasingly offer fitness incentives and opportunities.


The traditional Hawaiian diet promotes health through its reliance on fresh, local foods. Staples include fish, poi (made from taro), sweet potatoes, breadfruit, and coconut.

This diet is nutritious, high in fiber and complex carbs. It also has less processed sugar and saturated fats than the standard American diet.

In modern times, many Hawaiians still embrace an updated version of this diet, focusing on fresh, whole foods.

Hawaii has the lowest rate of sugary drink consumption among states. And access to fresh produce is abundant, with Hawaii ranking in the top 15 states for fruit and vegetable consumption.

Hawaii’s strong agricultural industry provides a wealth of local fruits, vegetables, meat and fish. Farmers markets, grocers and restaurants highlight these fresh, local offerings.

Key elements of the traditional Hawaiian diet:

  • Fish – Rich source of omega-3 fatty acids
  • Poi – Provides prebiotics to support gut health
  • Taro – High in fiber, vitamin E, iron and potassium
  • Breadfruit – Packed with vitamin C and potassium
  • Sweet potatoes – Contain vitamin A, vitamin C, iron and fiber
  • Coconut – Source of healthy fats and micronutrients

Ohana – Community & Family

The Hawaiian concept of ohana refers to family, community and a connection to others. This emphasis on ohana provides social support which benefits health.

In Native Hawaiian culture, elders were highly valued and cared for. Multiple generations often lived under one roof or nearby.

This traditional approach reinforced interdependence between family members of all ages. Younger generations learned from elders, while elders relied on family for support.

This ohana model still influences health behaviors today:

  • Close-knit families and communities look out for each other.
  • Elders are respected and involved in raising kids.
  • Children grow up understanding their connection to family and neighbors.

Research shows social support improves health outcomes. The presence of this “village” effect in Hawaii contributes to the population’s health and longevity.

Examples of ohana in action:

  • Multi-generational households
  • Sunday dinners with extended family
  • Sharing of traditional food customs and preparations
  • Participation in community events and clubs
  • Checking in on older relatives and neighbors

Access to Healthcare

While Hawaii has remote, rural areas, most residents have access to high quality medical care and services. Hawaii ranked 10th among states for access to healthcare in 2022.

Contributing factors include:

  • Extensive health insurance coverage. Over 90% of Hawaiians have health insurance, the highest rate of any state.
  • Presence of major healthcare providers. Top facilities include Queen’s Medical Center, Kuakini Medical Center and Kapiolani Medical Center.
  • Higher than average supply of primary care doctors compared to other states.
  • Coverage through Medicaid and Medicare programs.
  • Operation of community health centers across the islands.

This widespread healthcare access enables prevention, monitoring, diagnosis and treatment of health conditions for the majority of Hawaii residents.

Key healthcare stats for Hawaii:

Measure Hawaii National Average
Insured rate 91% 87%
Medicaid coverage 22% 19%
Medicare coverage 18% 17%
Primary care doctors per 100,000 134 115

Focus on Prevention

Hawaii emphasizes preventative care and health education to stop disease before it starts. This prevents sickness and hospitalizations.

Many Hawaiian health agencies provide free health screenings, immunizations, classes and support groups. These services include:

  • Blood pressure, cholesterol and diabetes tests
  • Colon cancer screenings
  • Child vaccine programs
  • Flu shot clinics
  • Smoking cessation programs
  • Nutrition and exercise programs

Hawaiians also utilize complementary wellness approaches like acupuncture and massage therapy as preventative care.

Early intervention improves outcomes for conditions like high blood pressure, cancer, heart disease and diabetes.

Top preventative services used by Hawaiians:

Service Hawaii Utilization National Average
Cholesterol screening 76% screened 72% screened
Colon cancer screening 72% screened 68% screened
Diabetes screening 87% screened 83% screened
Dentist visits 65% visited 64% visited

Mental Wellbeing

The relaxing island atmosphere and appreciation of ohana also contribute to Hawaiian’s mental health. Hawaii has low rates of depression compared other states.

Mental health outreach includes:

  • Community counseling and therapy
  • Support groups
  • Substance abuse treatment
  • Programs to reduce suicide risk among teens and elders

Native Hawaiian culture also provides outlets to alleviate stress through practices like meditation, music, chanting and hula.

Low Rates of Smoking

Hawaii has the lowest smoking rate in the nation, at just 10% of adults. This reduces lung cancer risks and cardiovascular disease.

Factors that discourage smoking include:

  • High state tobacco taxes – the highest in the nation
  • Smoke-free laws for workplaces, restaurants and bars
  • Targeted tobacco cessation programs
  • Aggressive anti-smoking education campaigns

School health programs also aim to prevent smoking initiation among Hawaii’s youth.

As a result, smoking is denormalized and seen as an unacceptable health risk by most residents.

Longer Life Expectancy

Due in part to the health factors outlined above, Hawaiians enjoy greater longevity than residents of nearly every other state.

Key stats on Hawaiian life expectancy:

  • Average life expectancy in Hawaii is 81.6 years. The national average is 78.8 years.
  • Hawaii ranks 2nd for overall life expectancy among states.
  • Female life expectancy is 84.1 years in Hawaii vs. 81.2 nationally.
  • Male life expectancy is 79.2 in Hawaii vs. 76.3 nationally.
  • Hawaiians experience lower rates of premature death before age 75 vs. other states.

The long lifespan of Hawaiians reflects the overall health of the population. Lifestyle, diet, healthcare access and culture all enable extended years of active life.


In review, Hawaii’s status as America’s healthiest state stems from numerous synergistic factors. These include:

  • Tropical climate enabling outdoor activities
  • Active lifestyle among residents
  • Diet emphasizing fresh, local foods
  • Healthcare access across the islands
  • Focus on preventative services and screenings
  • Aggressive anti-smoking efforts
  • Cultural values of ohana, which provide social support networks

Together, these advantages allow Hawaiians to live longer, healthier and more active lives compared to other Americans. The aloha spirit extends to nurturing the physical wellbeing of everyone in the island community.