5 Things Hawaii: Gov. Green’s health priorities, UH Manoa & Native Hawaiian healthcare workforce, Stroke care


Eli Kirshbaum


Our last Hawaii newsletter of 2022 includes an overview of some of incoming Governor Josh Green’s health-related priorities, insight from a UH Manoa leader about new funding for supporting Native Hawaiians entering the healthcare workforce, and recommendations for how to improve Hawaii’s approach to stroke care.

Our team is also hard at work putting the finishing touches on next month’s 2023 Hawaii State of Reform Health Policy Conference! We released our Detailed Agenda today—take a look at some of the exciting speakers and panels we have slated for the event. Be sure to register if you haven’t already, and we look forward to seeing you there!

Thanks for reading, and we look forward to continuing to working with Hawaii’s healthcare policy stakeholders in 2023. Have a great rest of the year!

Eli Kirshbaum
State of Reform


1. Newly elected Gov. Green’s health priorities

During his inauguration ceremony earlier this month, newly elected Hawaii Governor Josh Green outlined some public health initiatives he plans to pursue going forward. Continuing his focus on supporting the unhoused, the former lieutenant governor intends to work with city leaders across the state to continue building Kauhale villages—state-designated communal living spaces for unhoused Hawaiians.

“We can set an example for the whole world on the issues of housing, homelessness, poverty, and climate change if we truly come together and commit to putting our values of ohana and aloha into practice, and make them a reality for everyone in Hawaii,” Green said. Some of his other priorities include distributing $50 million in Grants-in-Aid to various charitable organizations, providing scholarships to reimburse loans for health professionals, and eliminating tax hikes on food and medicine.


2. Q&A: How will new funding given to UH help support Native Hawaiians’ healthcare careers?

The US Department of Health and Human Services recently awarded the University of Hawaii at Manoa’s Native Hawaiian Center of Excellence with a $3.4 million grant. NHCOE Principal Investigator Dr. Winona Lee spoke with State of Reform last week about how this funding will support Native Hawaiians in their pursuit of health-related professions, explaining that many NH students lack the necessary resources.

The grant will fund the NH Student Pathway to Medicine Program, which convenes NH role models including physicians and medical students to counsel pre-med students about pursuing careers in medicine. It will also fund Medical College Admission Test preparation support. ” …it is difficult for NH students to realize that attending a health professions school is within reach, both in terms of their academic potential, as well as with financial and social support,” she said.


3. Hawaii’s need for healthcare professionals grew 76% over past 3 years

Hawaii currently has nearly 4,000 healthcare job openings—up from 2,200 openings in 2019, representing a 76% increase. This is according to the Healthcare Association of Hawaii, which released a report last month about the accelerating shortage of health professionals in the state.

HAH says the registered specialty nurse workforce has the greatest need, with job openings for the profession having increased 116% since 2019. Hawaii’s smallest islands, including Lanai and Molokai, have the highest healthcare job vacancy rate. The report also notes that many training programs for essential healthcare professions like nurse aides and LPNs are only available on Oahu, indicating a need for the state to establish more training programs on neighboring islands.


4. Hawaii Stroke Coalition looks to improve state’s stroke care

The Hawaii Stroke Coalition recently hosted an educational event to discuss options for improving stroke care in the state. Strokes are the top cause of chronic disability and the third leading cause of death in Hawaii. Epidemiologist Dr. Dan Galanis said one area the state could improve on is increasing the number of patients who arrive at healthcare facilities using EMS for transport.

Hawaii’s annual proportion of patients arriving by EMS was 5.3% in 2022, compared to a US average of 57.7%. Neurointensivist Dr. Matt Koenig said doctors have a greater chance of successfully treating a stroke patient if treatment is started in the first 60 to 90 minutes. That is why transportation by EMS is important, as care can start in the ambulance.


5. Hawaii has lowest rate of early-stage lung cancer diagnosis in the country

The American Lung Cancer Association’s 2022 State of Lung Cancer report ranked Hawaii last in the nation for early-stage lung cancer diagnosis—a 20% early diagnosis rate compared to the national average of 26%. Early diagnosis is important because more treatment is available at earlier stages of the cancer, the report said. Most cases are identified at later stages once the cancer has spread, thus limiting treatment options

The report also ranked the state near the bottom of the nation for lung cancer screening and survival rate with only 3% of Hawaiians with high lung cancer risk receiving screenings in 2022 (compared to the 6% national average). Hawaii created an early lung cancer screening task force earlier this year to develop a strategy to increase lung cancer screening rates in the state.