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The COVID-19 pandemic has had significant adverse impacts across multiple dimensions in the state of Hawaiʻi beyond the direct effects of the disease itself. According to a new series of Public Health Reports from the University of Hawaiʻi Economic Research Organization (UHERO), almost 2 in 3 adults in the state reported negative effects on mental health, food security, job security, housing and poverty. Almost one in 10 has had a family member die due to COVID-19.

Survey responses for the report were collected in May 2022 and obtained in partnership with the Pacific Alliance Against COVID-19.

“We’ve recruited a cohort of more than 2,000 adults throughout the state to help us understand these issues. Using monthly surveys deployed rapidly to this cohort, we can collect data on health, social factors, attitudes and behaviors over time and monitor changes that could inform public health policy,” said Ruben Juarez, economics professor in UH Mānoa’s College of Social Sciences (CSS) and newly appointed HMSA Endowed Professor of Health Economics at UHERO.

Highlights of the June 20 UHERO report:

  • Vaccination rate and booster shots among adults: Hawaiʻi is leading the nation with the highest vaccination rate. More than 93.3% of respondents were vaccinated, while 6.7% remain unvaccinated. Among those vaccinated, 53.4% received one booster shot, 31.6% received two or more booster shots, and 15% have not received a booster shot.
  • COVID-19 positivity and estimated immunity: 1 in 4 individuals reported a confirmed COVID-19 positive test. Almost 50% of unvaccinated individuals have been infected with COVID. In addition, individuals who received a booster shot are 46% less likely to be infected than those who did not. It is estimated that more than 95.9% of adults have some degree of immunity to the virus due to infection or vaccination.
  • Negative effects of COVID-19 have been very significant in Hawaiʻi’s populations: Almost 2 in 3 adults in the state reported a negative effect of COVID-19. (23% had their savings depleted, 18% had trouble with the education of their children, 15% were unable to pay rent, 12% were laid off or had their work hours reduced, 12% had a friend who died and 9% had a family member who died.)
  • Mental health: More than 1 in 3 adults reported symptoms of depression. 11% of adults reported low self-esteem, and about 4% of adults in the cohort had suicidal thoughts over the last year. Unvaccinated individuals are more likely to experience mental health problems than vaccinated individuals.
  • Food insecurity: More than 20% of adults reported low or very low food security. Individuals who got infected with COVID-19 and those unvaccinated, experienced more food insecurity.
  • Characteristics of the unvaccinated population: Unvaccinated individuals tend to be younger and have lower education levels than vaccinated individuals. Less than 4% of individuals with a bachelor’s degree reported to be unvaccinated. In contrast, individuals who just completed high school versus those who did not complete high school reported unvaccinated rates of 14% and 41%, respectively.
  • Long-COVID: Almost 1 in 3 adults in Hawaiʻi who got infected with COVID-19 experienced symptoms of long-COVID. 58% of the symptoms were cough and shortness of breath. 49% fatigue, 48% mental fog or headaches. 25% joint or chest pain, and 24% loss of taste or smell. The average length of the symptoms differed by vaccination status. Unvaccinated individuals with long-COVID experienced symptoms for about five months post-infection, whereas vaccinated and boosted individuals reported an average of about three months.

In addition to Juarez, other co-authors of the study include:

  • Timothy Halliday, CSS professor of economics and UHERO research fellow
  • Carl Bonham, UHERO executive director and CSS professor of economics
  • Daniela Bond-Smith, UHERO researcher
  • Colin Moore, UHERO associate professor and CSS School of Communications chair

The UHERO Public Health Reports series is designed to systematically understand adversities by providing Hawaiʻi leaders and their communities with data to inform the design and execution of public health programs. While the first series of Public Health Reports focuses on the impacts of COVID-19 on Hawaiʻi’s population, future reports will cover a variety of timely topics related to public health and policy.

UHERO is housed in UH Mānoa’s College of Social Sciences. Its HMSA Distinguished Endowed Professorship in Health Economics is focused on improving the health care of Hawaiʻi’s people and economy.

For more, visit UHERO‘s website.

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