Hawaii ranked No. 1

In a place where sunshine and the outdoor lifestyle long have been treasured, it’s no surprise Hawaii once again came out on top of the rankings for the healthiest state.

But while the Aloha State gets kudos for making strides in several areas, the 2014 rankings also show where health can improve.

Among the dozens of measures the United Health Foundations’ 2014 America’s Health Ranking used to gauge the state’s health, the highlights of this year’s report include a decline in the percentage of smoking adults from 16.8 percent to 14.6 percent. However, e-cigarette use, roll-your-own tobacco and water pipes are on the rise among middle and high school students, state Department of Health spokeswoman Janice Okubo said.

Hawaii also has the lowest rate of preventable hospitalizations in the nation, and the numbers have been declining, making up just 27 out of 1,000 Medicare dischargees, down from 35 per 1,000 a decade ago, according to the report released Tuesday.

Violent crime decreased from 287 to 239 offenses per 1,000 in the past year.

The health rankings give the state credit for continued success in those areas as well as lowering obesity rates, but work still needs to be done in extending health care access to Native Hawaiians, state health officials acknowledged.

Additionally, binge drinking, low high school graduation rates and high incidents of Salmonella remain problem areas, according to the report. And since the Halemaumau vent began spewing sulfur dioxide in 2008, air quality has continued to suffer.

It is the second year in a row Hawaii placed at the top of the rankings, and the state has been in the top six slots during the 25-year life of the ranking system. The state ranked second in 2012 and third in 2011. Vermont and Massachusetts were second and third this year, and Mississippi ranked at the bottom.

“We do think the ranking reflects our community’s commitment to maintaining healthy lifestyles,” DOH acting director Keith Yamamoto said in a phone interview. “We also know there are things we need to work on.”

The state ranked 37th for binge drinking, with 18.2 percent of adult men reporting they had five or more drinks at least once in the past month, a percentage point above the national average but lower than the 21.5 percent rate the state reported in 2012.

Efforts also are needed to boost the number of children who receive immunization, through increasing outreach to communities and health care providers, Yamamoto said. Immunizations among children ages 19 to 35 months old decreased 17 percent in the past year, from 80.2 percent to 66.5 percent.

“We’re anxious to have the new administration come on board so we can continue to work on these issues,” Yamamoto said.

In a statement, Gov. David Ige said he looks forward to working with public health and health care providers to ensure access to care and reduce chronic disease and injury.

“I’m proud to say that Hawaii is the healthiest state in the nation, and we must continue to invest in our public health efforts,” Ige said.

State Sen. Josh Green, D-Kona, Ka‘u — an emergency room physician and chairman of the Committee on Health — said the state essentially thrives in preventative health care but falls short in safety net hospital services and facilities.

“Historically, we insure such a large percentage of people and give them basic care, catching some chronic issues early on,” Green said. “That said, we have a somewhat fractured hospital system and we got a poor grade in trauma access and hospital access just a few months ago.”

Email Bret Yager at byager@westhawaiitoday.com.