Deaths from suicide, alcohol and drugs have climbed substantially over the past 12 years in Hawaii, though the state tops the nation for overall health care, a new study shows.
Suicide deaths rose to the second-highest rate in the country at 15.2 per 100,000 in 2017, the latest data available, from 8.2 per 100,000 in 2005, while alcohol deaths climbed to 5.8 from 3.5 and drug poisonings increased to 13.8 from 9.4, according to the 2019 scorecard on state health system performance released Tuesday night by the Commonwealth Fund.
“It is an alarming trend,” said Pua Kaninau-Santos, chairwoman of the Oahu Prevent Suicide Hawaii Task Force and community liaison for the American Foundation of Suicide Prevention, who lost her 18-year-old son Kaniela to suicide in 2003. “It’s increasing all over the place. We know there’s more stressors in place, and we already have research that tells us certain things like the opioid crisis is at hand, so that would put more and more people at risk that could add to trending rates. Social media plays a hand in it as well. It puts people in a lot of additional vulnerable spaces. Mental health plays a very important role in all of this, too. It’s not just any one thing, but it’s many things.”
The report called deaths from suicide, alcohol and drugs a “national crisis” that is affecting states in different ways.
“What we’re seeing is a regional epidemic when it comes to premature deaths from suicide, alcohol, and drugs,” said David Blumenthal, president of the Commonwealth Fund, in a news release. “It’s going to take solutions that meet local need, and greater cooperation across all sectors — at both the federal and state level — to end the crisis that is shortening life expectancy in the United States.”
States are “losing ground” when it comes to so-called deaths of despair, with an increasing number hard-hit by the opioid epidemic, the report said.
“These are definitely challenges for Hawaii like they are in all states, but rates are getting higher,” said David Radley, senior scientist for health system performance tracking at the Commonwealth Fund. “Hawaii isn’t as burdened as a lot of other states by these so-called deaths of despair. But that doesn’t diminish the real impact these are having in Hawaii. They are real things and definitely something that if I’m a leader in Hawaii, I’d want to be paying attention to.”
”The opportunity from this is really about providing resources in the community,” Kaninau-Santos added, including resources like the state crisis line at 832-3100 and suicide prevention lifeline at 800-273-TALK for people who are struggling with depression or anxiety. “The good thing is we still have things in place that we are actually doing that’s helping. They’re not alone.”
Hawaii was among four states that ranked lower on more indicators than they improved on. Rising health costs continue to be a growing burden for working families in the islands, with employee insurance costs as a share of median income worsening in 2017 from 2013. The state also got worse in recent years in the rate of adults with mental illness reporting an unmet need, 30-day hospital readmissions, and higher infant mortality and obesity rates.
Despite those measures, Hawaii’s health care system ranks the best of the 50 states and Washington, D.C., largely due to its high levels of health care access with only 5% of adults and 2% of children uninsured, a result of the state’s 1974 Prepaid Health Care Act, which requires that employers provide health insurance for employees who work at least 20 hours per week.
“We think of health insurance as being the foundation of a high-performing health system,” Radley said. “Even though there are challenges … there’s relatively few things where Hawaii isn’t in the top half.”
Hawaii also improved in potentially avoidable emergency department visits, fewer colorectal cancer deaths per 100,000 and increasing the number of both adults and children receiving mental health treatment, as well as cancer screenings.
The Commonwealth Fund’s report measured 47 health care indicators covering access, quality, service use and costs of care, health outcomes and income-based health care disparities based on the most recent data from federal agencies including the U.S. Census Bureau, Centers for Disease Control and Prevention, and Centers for Medicare and Medicaid Services.