Hawaii, the only U.S. state composed entirely of islands, covers 6,423 square miles, with a 2019 estimated population of 1,415,872 people – 273,806 living in rural Hawaii (USDA-ERS). Honolulu, the capital, is located on the island of Oahu. The state's largest cities are Honolulu, Pearl City, Hilo, and Kailua. According to 2019 data from the U.S. Census Bureau, 25.5% of the state's population is white, 2.2% is African-American, 37.6% is Asian, 0.4% is American Indian or Alaska Native, 10.1% is Native Hawaiian or Other Pacific Islander, and 10.7% is of Hispanic or Latino origin.

Hawaii Rural Healthcare Facilities

According to data.HRSA.gov, as of January 2021 Hawaii had:

• 9 Critical Access Hospitals
• 13 Rural Health Clinics
• 26 Federally Qualified Health Center sites located outside of Urbanized Areas
• 2 short term hospitals located outside of Urbanized Areas

Selected Social Determinants of Health for Rural Hawaii

Although most Hawaiians have some form of health insurance coverage, 4.1% of residents remain uninsured (Kaiser, 2019). According to the Economic Research Service, the average per capita income in 2019 was $57,015, with the rural per capita income at $45,682. The ERS reports, based on 2019 ACS data, that the poverty rate in rural Hawaii is 12.1%, compared with 8.3% in urban areas of the state. 7.6% of the rural population has not completed high school, while 8.1% of the urban population lacks a high school diploma according to 2015-2019 ACS data reported by ERS. The unemployment rate in rural Hawaii is 3.2%, while in urban Hawaii it is 2.6% (USDA-ERS, 2019).

Hawaii State Office of Primary Care and Rural Health
Phone: 808.586.4122
Coordinates federal, state, and local efforts aimed at improving the health of Hawaii's rural and medically underserved populations.
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