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In Hawaiʻi, chronic diseases are among the most prevalent, costly, and preventable of all health problems. The past two decades have seen unprecedented increases in chronic disease and obesity due to pronounced changes in the environment, behavior, and lifestyle. Sixty-four percent of adults are living with at least one chronic condition such as diabetes or heart disease.1 Chronic diseases account for the top three leading causes of death.3
Most chronic diseases can be prevented by eating well, being physically active, avoiding tobacco, and getting regular health screenings. Tobacco use is the single most preventable cause of death and disease, followed by physical inactivity and poor nutrition.8,9 These three risk factors are major contributors to the development of chronic diseases such as asthma, diabetes, many types of cancer, and heart disease and stroke.10
The COVID-19 global pandemic highlights the necessity for a comprehensive approach that supports innovative changes in both the public health and health care delivery systems. Adopting such an approach would address the needs of all people, including priority populations, by promoting efficient coordination between public health and health care and adapting to rapidly changing circumstances that impact population health.
Partners across the state of Hawaiʻi who developed the HHSP are committed to preventing chronic disease for all residents. Recent success in large-scale public health interventions is the result of going beyond programming to focus on policy, systems, and environmental change approaches. The HHSP is a strategic plan that focuses on creating higher order environmental, policy and systems changes that make healthy behaviors the “default” choice.