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More than three years since COVID-19 was introduced to the world, most Hawaiʻi residents consider their health to be good or excellent. But there are significant differences across socio-economic and demographic categories, including ethnicity, according to the results of a Rapid Health Survey released on July 12 by the University of Hawaiʻi Economic Research Organization (UHERO).

The UHERO Public Health Report, “Shaping Health in Hawaiʻi: The Influences of Poverty, Housing and Food Insecurity,” surveyed 1,575 adult residents across the state. The study examined the links between mental health, food security and socio-economic determinants, such as housing conditions and poverty status. The report shows that those experiencing housing insecurity, food insecurity and poverty were more likely to have been negatively impacted by the pandemic and reported worse physical and mental health.

“The survey underscores the intricate links among health, socio-economic status and lifestyle conditions in shaping individual well-being,” said lead researcher Ruben Juarez, UHERO-HMSA Endowed Professor in Health Economics. “The pervasive impacts of the COVID-19 pandemic, particularly Long-COVID, highlight the continuous need for multifaceted interventions that address economic stability, housing security and equitable healthcare.”

Long-COVID affected 35% of respondents, up from 30% in 2022. Juarez said that there is a clear association between long-COVID and unemployment, with 49% of unemployed vs. 28% of employed individuals reporting long-COVID in May 2023.

Other key findings include:

  • General health outcomes. More than 70% of participants considered their health to be good to excellent, but Native Hawaiians and Filipinos tended to report lower health ratings in comparison to Whites and Non-Filipino Asians. Individuals with high income or food security tended to have more positive health perceptions, while those dealing with the long-term effects of COVID-19, or who had delayed healthcare, especially mental health services, reported lower health scores.
  • Mental health and well-being. One-third of participants reported symptoms of depression, with significant risk factors being unemployment and recent COVID-19 positivity. Housing instability, housing cost burden and poverty were also correlated with higher rates of depression symptoms. About 80% of respondents reported no food security issues, but—compared to findings in 2022—there was a small increase in those reporting very low food security. Unemployment, recent COVID-19 positivity, younger age, certain ethnicities such as Native Hawaiians and Filipinos, poverty and housing instability all correlated with increased food insecurity.

This report is based on results from the third wave of the UHERO Rapid Health Survey conducted in June 2023 by UHERO’s public health team, in partnership with the Pacific Alliance Against COVID-19. In future reports, the team aims to increase the sample size of survey respondents and deepen its exploration of these findings, including exploring causality and cost, to offer a more thorough understanding of these complex social determinants of health.

Read the full report on UHERO’s website.

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