ACCESSING HEALTH EQUITY
A workforce in crisis
How Hawaii’s physician shortage is deepening health disparities By Hope Racine
H
awaii is facing a healthcare workforce crisis—one that’s deepening existing disparities and impacting the health of
the state’s inhabitants.
“Hawaii has historically been a poster child for diversity, and we are known for our healthy lifestyle,” said Elizabeth Ignacio, MD.
Hawaii is one of the most diverse states in the United States, with a multilingual and multicultural population including Japanese, Chinese, Korean, native Hawaiian, Pacific Islander and Filipino residents. But as Dr. Ignacio points out, despite the assumptions of Hawaii’s healthiness, underserved populations of the Aloha State experience many of the same disparities facing
30 IRQ | WINTER 2023
underrepresented minority communities in the rest of the country.
The Hawaiian health crisis According to the Office of Minority Health in the U.S. Department of Health and Human Services, data indicate that rates of smoking, alcohol consumption and obesity are higher in Native Hawaiian and Pacific Islander communities. These problems are compounded by a lack of adequate access to cancer prevention and control programs in those communities.1 Diabetes is also a large concern— Hawaiian underrepresented minorities (URMs) are 2.5 times more likely to receive a diagnosis than white populations, and data indicate that 39% of the population has uncontrolled diabetes. Finally, compared with white
populations, Asian American URMs in Hawaii have nearly twice the infant mortality rate, are four times more likely to suffer from a stroke and are three times more likely to be obese compared with the overall Asian American population.1,2
The factors leading to these disparities are the same as those in many rural communities or underserved ZIP codes: cost of living, food scarcity, housing and accessible healthcare. Due to the provider shortage, access to care is a key concern for Hawaii.
“When we talk about Hawaii, we are talking about the problems facing a lot of areas in the United States,” Dr. Ignacio said. “The state is touted as very healthy, with a focus on the outdoors and employer-required insurance programs. But one of the things that we’ve been failing in is our provider numbers. Although our patients are diverse and many are physically fit, we’re not meeting the challenge of how many providers exist in our state.”
This deficit has a direct impact on access to care. Since the start of the
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40
