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The Hawaiʻi Physical Activity and Nutrition (PAN) Plan 2030 is a guide to increasing physical activity and healthy eating in the state, with the long-term goal of reducing overweight, obesity, and chronic disease among all Hawaiʻi residents. Physical activity and healthy eating are vital in creating resilient communities and preventing many chronic diseases.
In Hawaiʻi the majority of adults, adolescents, and children do not engage in regular physical activity or eat a nutritious diet. Insufficient physical activity combined with unhealthy eating can substantially increase the risk of health problems such as obesity, high blood pressure, heart disease, diabetes, cancer, and arthritis. However, by creating policies, systems and environments that support healthy eating and active living, communities can become more resilient and thrive.
Vision: We envision a future for Hawaiʻi in which all residents are physically active, eat healthy foods, and live in healthy communities.
Goals: Through healthful eating and regular physical activity, Hawaiʻi residents will:
- Reduce their burden of disease;
- Increase years of healthy life;
- Increase their resilience to deadly viruses; and
- Reduce health disparities.
- Keiki and Youth: 0-18 years old
- Kupuna: 65 years and older
- Low-income: gross household income at or below 185% of federal poverty level
Health disparities exist when a health outcome is seen to a greater or lesser extent between population groups. Identity factors such as race and ethnicity, gender, gender identity and sexual orientation, age, disability; and social determinants like educational attainment, socioeconomic status, worksite, and geographic location all contribute to an individual’s ability to achieve good health. It is important to acknowledge and strive to understand these health disparities and to prioritize vulnerable populations whose access to physical activity and healthy food is compromised by environmental and policy gaps.
The PAN Plan 2030 incorporates principles of the Social Ecological Model and is organized into four sector areas: Community Design and Access, Education, Health Care, and Worksite. The plan prioritizes goals, objectives, and strategies that lead to policy, systems, and environmental change. Objectives were developed using current data, best practices, and evidence-based science, and reflect one or more cross-cutting themes.
The PAN Plan 2030 is meant to be a living document that is reviewed and updated throughout the plan’s timeframe. Implementation of the plan will be a collective effort by individuals and organizations across the state.
The Hawai‘i Physical Activity and Nutrition (PAN) Plan 2030 Implementation Plan, or Hawai‘i Social Determinants of Health Accelerator Plan (SDOH AP), presents activities that will accelerate progress toward the completion of the PAN Plan 2030 objectives.
The SDOH AP was created with Centers for Disease Control and Prevention (CDC) funding, titled Closing the Gap with Social Determinants of Health Accelerator Plans (DP21-2111), which supported the convening of community partners to prioritize existing and anticipated resources towards completion of the PAN Plan 2030 objectives.
The statewide implementation-ready, culturally informed SDOH AP focuses on policy, systems, and environmental changes for the built environment, and food and nutrition security across the sectors of Community Design and Access, Education, Health Care, and Worksite. Ultimately, the SDOH AP provides a roadmap towards the implementation of the PAN Plan 2030 objectives, which will improve health, reduce the prevalence of chronic disease, and reduce health disparities among low-income residents, Native Hawaiian and Other Pacific Islander (NHOPI), and Filipinos through prevention efforts.
Increase by 50%, the number of food outlets that participate in a statewide healthy food incentive program(s).
- Secure long-term funding for Hawaiʻi’s Double Up Food Bucks program, which matches Supplemental Nutrition Assistance Program (SNAP) food stamp dollars spent on Hawaiʻi-grown produce
- Implement a statewide Produce Prescription Program, which enables participants to redeem "prescriptions" for produce at participating markets and grocery stores
Activities | Responsible Parties | Completed By |
---|---|---|
1. Secure long-term funding for Hawai‘i’s DA BUX program | American Heart Association (AHA); Hawaii Public Health Institute (HIPHI); The Food Basket | 2024 |
2. Provide technical assistance to support the implementation of Produce Prescription Programs | Kokua Kalihi Valley (KKV); University of Hawaii (UH) Department of Human Nutrition, Food and Animal Sciences | 2023 |
3. Implement Local Institutional Purchasing Hui Oahu Good Food Purchasing Program (Act 175,176) in schools and hospitals | Department of Education (DOE); Department of Health (DO Department of Public Safety (DPS); Department of Defense (DOD); UH | Ongoing |
4. Work with Good Food Alliance to identify a platform where the same technology can be used to accept Supplemental Nutrition Assistance Program (SNAP) and WIC Electronic Benefit Transfer (EBT) | Maui Nui Food Alliance (MNFA); DOH; DOH, Women, Infants and Children (WIC) | 2024 |
Enact at least two statewide policies to increase access to healthy food and/or decrease access to unhealthy food/beverages.
- Enact a fee on sugar-sweetened beverages, where revenue is allocated to obesity prevention initiatives
- Establish long-term, state funding for a Double Up Food Bucks SNAP incentive program
Activities | Responsible Parties | Completed By |
---|---|---|
1. Implement Healthy by Default policy across all counties | DOH | 2023-2024 |
2. Support DOH SSB counter-marketing campaign | AHA; HIPHI | 2023 |
3. Educate networks on need to reduce SSB consumption and the health risks associated with consumption | HIPHI; DOH; AHA | 2025 |
4. Support School Garden Coordinator to enhance nutritious food options in schools | DOE; HIPHI; DOH | 2025 |
5. Support the establishment of Medicaid coverage for Produce Prescription Programs | AlohaCare; Anti-Hunger Coalition | 2025 |
Establish and sustain a funded Food Access Coordinator in each county to facilitate an active coalition.
- Food access coalitions will create and implement county-level action plans aimed at increasing access to, and consumption of, healthy food
- Secure county funding to support the activities of the coordinator and food access coalition
Activities | Responsible Parties | Completed By |
---|---|---|
1. Food access coalitions will create and implement county level action plans aimed at increasing access to and consumption of healthy food | DOH; Non-profit county agencies that house Food Access Coordinators (e.g., HIPHI, City and County, Malama Kaua‘i) | 2024 |
2. Secure county funding to support the activities of the coordinator and food access coalition | Non-profit county agencies that house Food Access Coordinators (e.g., HIPHI, City and County, Malama Kaua‘i) | 2025 |
3. Conduct a needs assessment | Non-profit county agencies that house Food Access Coordinators (e.g., HIPHI, City and County, Malama Kaua‘i); Evaluator | 2023 |
Establish and sustain a funded, statewide Breastfeeding Coordinator to facilitate efforts supportive of breastfeeding exclusivity and duration.
- Assess statewide resources and capacity to fund and establish state-level Breastfeeding Coordinator position
- Develop scope and position description to include knowledge of indigenous cultures and breastfeeding support needs
- Identify gaps and strategically integrate the breastfeeding coordinator position in a way that bridges these gaps
Activities | Responsible Parties | Completed By |
---|---|---|
1. Assess statewide resources and capacity to fund and establish state-level breastfeeding coordinator position | DOH; HIPHI; Statewide Breastfeeding Workgroup; Breastfeeding Hawai‘i | 2023-2025 |
2. Develop scope and position description to include knowledge of indigenous cultures and breastfeeding support needs | DOH; HIPHI; Statewide Breastfeeding Workgroup; Breastfeeding Hawai‘i; Hawai‘i Indigenous Breastfeeding Collaborative; Papa Ola Lokahi | 2023-2024 |
3. Identify gaps and strategically integrate the breastfeeding coordinator in a way that bridges these gaps | DOH; HIPHI; Statewide Breastfeeding Workgroup; Lactation Access Transforming Communities in Hawai‘i (LATCH) | 2023-2024 |
Develop guidelines to promote healthy food donations and purchase of healthy food to be adopted by 100% of Hawaiʻi food banks.
- Convene a working group with representation from Hawaiʻi's foodbank network, to develop guidelines for healthy food donations
Activities | Responsible Parties | Completed By |
---|---|---|
1. Convene a work group, with representation from Hawai‘i’s foodbank network, to develop guidelines for healthy food donations | DOH; HIPHI | 2023 |
2. Develop Healthy Food Bank Guidelines toolkit for Healthy Keiki Pantry | HIPHI, Healthy Eating Active Living (HEAL) Coalition Coordinators | 2024 |
3. Distribute Healthy Food in Hawai‘i: Guidelines for Food Banks, Pantries, Schools and Communities | HIPHI; AHA; MNFA | 2024 |
Increase by 50 miles, the total miles of low-stress pedestrian infrastructure including, but not limited to, sidewalks and trails.
- Incorporate the specifications for "desirable" level of service described in the Hawaiʻi Department of Transportation’s Pedestrian Toolbox into the development of low-stress pedestrian infrastructure
- Increase Safe Routes to Schools and Safe Routes to Parks programs and projects
- Develop policies to encourage shade tree planting, to increase canopy cover, on high volume pedestrian corridors and trails
- Increase share of state and county transportation budgets dedicated to pedestrian infrastructure
- Implement Vision Zero and Complete Streets policies to increase safety and comfort of pedestrian experience
Activities | Responsible Parties | Completed By |
---|---|---|
1. Increase Safe Routes to Schools (SRTS) and Safe Routes to Parks (SRTP) programs and projects | DOH; HIPHI; AlohaCare (SRTS Working Group) | 2023-2025 |
2. Develop policies to create environments where trees can thrive, increasing and preserving canopy cover on high volume pedestrian corridors and trails | DOH; Department of Land and Natural Resources (DLNR); National Park Service (NPS) | 2024 |
3. Identify and update county-specific tree management plans | DLNR | 2023-2025 |
4. Provide accountability and evaluate Complete Streets and Vision Zero (VZ) implementation of Environmental Impact Statement (EIS)/ Environmental Assessment (EA) applications and other project proposals | DOH; HIPHI; AlohaCare (SRTS Working Group) | 2025 |
5. Establish a pipeline of projects from the pedestrian master plans, add to the Transportation Improvement Program (TIP), Statewide Transportation Improvement Program (STIP) and complete necessary planning and environmental reviews for a few projects each year | Metropolitan Planning Organizations (MPOs); Department of Public Works; Planning Department; Department of Transportation | 2025 |
Increase by 100 miles, the total miles of low-stress bicycle infrastructure including, but not limited to, protected bike lanes and off-street paths.
- Increase Safe Routes to Schools and Safe Routes to Parks projects
- Develop policies to encourage shade tree planting, to increase canopy cover, on high volume bicycle corridors and trails
- Increase share of state and county transportation budgets dedicated to bicycle facilities
- Implement Vision Zero and Complete Streets policies and projects to increase safety and comfort of bicyclist experience
Activities | Responsible Parties | Completed By |
---|---|---|
1. Increase Safe Routes to Schools (SRTS) and Safe Routes to Parks (SRTP) programs and projects | DOH; HIPHI; AlohaCare (SRTS Working Group) | 2023-2025 |
2. Develop policies to create environments where trees can thrive, increasing and preserving canopy cover on high volume pedestrian corridors and trails | DOH; Department of Land and Natural Resources (DLNR); National Park Service (NPS) | 2024 |
3. Identify and update county-specific tree management plans | DLNR | 2023-2025 |
4. Provide accountability and evaluate Complete Streets and Vision Zero (VZ) implementation of Environmental Impact Statement (EIS)/ Environmental Assessment (EA) applications and other project proposals | DOH; HIPHI; AlohaCare (SRTS Working Group) | 2025 |
5. Establish a pipeline of projects from the pedestrian master plans, add to the Transportation Improvement Program (TIP), Statewide Transportation Improvement Program (STIP) and complete necessary planning and environmental reviews for a few projects each year | Metropolitan Planning Organizations (MPOs); Department of Public Works; Planning Department; Department of Transportation | 2025 |
The state and each county will identify and adopt mode-share goals and measurements that prioritize walking and wheelchairs, bicycling, and transit use.
- Develop context-appropriate county-level Transportation Demand Management (TDM) Plans to establish mode baselines
- Develop more inclusive and comprehensive metrics for measuring active transportation beyond work and school commutes
- Support development of community Safe Routes to School (SRTS) plans, funding of SRTS infrastructure, free transit for minors, etc
Baseline | Target | Status Date- 07/01/2024 | |
---|---|---|---|
State | 0 | 1 | 0 |
County | 0 | 4 | 1 |
Activities | Responsible Parties | Completed By |
---|---|---|
1. Develop more inclusive and comprehensive metrics for measuring active transportation beyond work and school commutes | DOH; MPOs; Hawaii State Energy Office (HSEO) | 2022-2025 |
2. Conduct statewide and county-specific technical assistance (TA) and workshops on mode share transportation management | DOH; HSEO; HIPHI; O‘ahu MPO | 2022-2025 |
3. Develop context-appropriate county-level Transportation Demand Management Plans to establish goals and baselines | All Counties | 2025 |
Increase by 10%, the proportion of existing urbanized land that is zoned to support walkable communities.
- Promote Equitable Transit Oriented Development (ETOD), town centers, mixed-use development, and upzoning for new development and zoning updates
- Adopt parking policy reforms to reduce parking oversupply, unbundle residential parking, reduce or eliminate parking minimums, and/or shift costs
- Change Level-of-Service to Vehicle Miles Traveled (VMT) in environmental review of new development
Activities | Responsible Parties | Completed By |
---|---|---|
1. Develop a communications campaign to promote Equitable Transit Oriented Development (ETOD), town centers, mixed-use development, and up zoning for new development and zoning updates | AlohaCare; HIPHI | 2025 |
2. Adopt parking policy reforms to reduce parking oversupply, unbundle residential parking, reduce or eliminate parking minimums, shift costs | Ulupono Initiative; AARP | 2025 |
3. Convene stakeholders at Hawai‘i Congress of Planning Officials to bring planners together and discuss zoning | Planning Department; AlohaCare; DOH | Annually |
Adopt at least one policy to require annual courses in Health Education and Physical Education from grades K-8, in the Department of Education, that are aligned with national recommendations for instructional time and teacher licensing.
- Support a Board of Education policy change to require annual courses in Health Education in grades K-8 in Department of Education (DOE) public non-charter schools
- Support a Board of Education policy change to require annual courses in Physical Education in grades K-8 in DOE public non-charter schools
Baseline | Target | Status Date- 07/01/2024 | |
---|---|---|---|
Health Education courses | 0 | 1 | 0 |
Physical Education courses | 0 | 1 | 0 |
Activities | Responsible Parties | Completed By |
---|---|---|
1. Review and prepare National PE Standards for adoption | Department of Education (DOE), Office of Curriculum and Instructional Design (OCID) | 2024- 2027 |
2. Investigate the development of an advertisement/education campaign about the importance of PE and Health Education and that targets parents and families | DOE; DOH; AHA | 2023 |
3. Update Wellness Guidelines to incorporate Safe Routes to School and Farm to School initiatives | DOE School Food Services Branch (SFSB); DOH; State Wellness Committee; HIPHI | 2025 |
Develop a system to monitor and support implementation of the Early Childhood Care and Education Wellness Guidelines.
- Convene both public and private early learning community stakeholders to determine barriers to implementation of Hawaiʻi’s Early Childhood Care and Education (ECE) Wellness Guidelines
- Collaborate with ECE stakeholders to create a physical activity and nutrition ECE setting focused training curricula developed from the Hawaiʻi ECE Wellness Guidelines
- Partner with leaders in the early learning community to identify and implement incentives to support provider implementation of the ECE Wellness Guidelines
Activities | Responsible Parties | Completed By |
---|---|---|
1. Convene both public and private early learning community stakeholders to determine barriers to implementation of Hawai‘i’s Early Childhood Care and Education (ECE) Wellness Guidelines | DOH; Early Childhood Action Strategy (ECAS) | 2023 |
2. Create an action plan to identify strategies and leads/stakeholders of those strategies | DOH; ECAS | 2023 |
3. Establish a policy to require monitoring and implementation of ECE Wellness Guidelines | AHA | 2025 |
50% of public non-charter schools participating in the Safety and Wellness Survey will meet at least 90% of the wellness guidelines.
- Create a toolkit to share with all participating public schools that highlights resources for the four lowest scoring wellness guidelines
- Create a social media campaign to educate families and community stakeholders on the DOE safety and wellness guidelines and opportunities to support wellness in schools
- Conduct a study to evaluate qualities/characteristics/infrastructure/resources that contribute to the schools with the lowest Safety and Wellness Survey (SAWS) score and the highest SAWS score
Activities | Responsible Parties | Completed By |
---|---|---|
1. Update Wellness Guidelines | DOH; DOE; HIPHI, Farm to School Hui | 2024 |
2. Create a toolkit to share with all participating public schools that highlights resources for the four lowest scoring Wellness Guidelines | DOH; DOE; HIPHI, Farm to School Hui | 2024 |
3. Develop and implement targeted training and technical assistance for Wellness Guidelines | DOH; DOE; HIPHI, Farm to School Hui | 2025 |
Establish and sustain a funded statewide Food Systems Education Coordinator position to support ʻāina-based education, which promotes healthy eating in preschool through grade 12 (P-12) education settings.
- Assess statewide resources and capacity to fund and establish state-level Food Systems Education Coordinator position
- Develop scope and position description to include knowledge of ʻāina-based education
- Identify gaps and strategically integrate the Food Systems Education Coordinator position in a way that bridges these gaps
Activities | Responsible Parties | Completed By |
---|---|---|
1. Develop scope and position description to include knowledge of ‘aina-based education | HIPHI, Farm to School Hui | 2023 |
2. Support policy and legislation to establish and fund the Food Systems Education Coordinator | HIPHI, Farm to School Hui | 2024 |
3. Sustain funding for the School Garden Coordinator | DOE; HIPHI, Farm to School Hui | 2025 |
Increase by 5%, the number of people enrolled in nutrition and physical activity programs that are offered by health system payers.
- Expand coverage for Diabetes Prevention Programs (DPPs), or evidence-based DPP-like programs (e.g., Pili 'Ohana Department of Native Hawaiian Health)
- Work with providers, health system payers, and worksites to increase awareness of and referrals to covered PAN programs
- Participate in Health Information Technology (HIT) workgroup to discuss potential referral options between health care organizations and self-management education programs related to physical activity and nutrition
Activities | Responsible Parties | Completed By |
---|---|---|
1. Expand coverage for and increase enrollment in Diabetes Prevention Programs (DPPs) or evidence-based DPP-like programs (e.g., Pili ‘Ohana Department of Native Hawaiian Health, bike, park, and/or produce prescriptions) | HIPHI; DOH; AlohaCare; Hawaii Primary Care Association (HPCA) | 2025 |
2. Work with providers, health system payers, and worksites to increase awareness of, and referrals to, covered DPPs | HIPHI; DOH; AlohaCare; HPCA | 2024 |
Implement a Hawaiʻi-specific hospital recognition program to incentivize promotion of exclusive breastfeeding through adoption of best practices that 100% of maternity care hospitals will participate in.
- Develop a statewide maternity care hospital recognition program, which sets policies and standards to support exclusive breastfeeding
- Convene a Hawaiʻi hospital recognition program workgroup to create, administer, and evaluate the program
Activities | Responsible Parties | Completed By |
---|---|---|
1. Convene a Hawai‘i hospital recognition program work group to develop a statewide maternity care hospital recognition program which incentivizes the adoption of policies and standards to support exclusive breastfeeding | DOH; HIPHI; Hawai‘i Maternal Infant Health Collaborative; Breastfeeding Hawai‘i | 2024 |
2. Administer and evaluate the statewide maternity care hospital recognition program | DOH; HIPHI; Hawai‘i Maternal Infant Health Collaborative; Breastfeeding Hawai‘i | 2025 |
Establish comprehensive coverage for lactation consultation services and lactation supplies by all health insurance companies in the State of Hawaiʻi.
- Engage lactation consultants and other breastfeeding stakeholders to:-Develop reimbursement models for Medicaid and commercial payers-Pilot coverage processes
Activities | Responsible Parties | Completed By |
---|---|---|
1. Take an inventory of lactation support services that are currently covered by health insurance companies | Early Childhood Action Strategy (ECAS); Hawai‘i Association of Health Plans | 2024 |
2. Conduct a sunrise study to assess the needed structural changes | Auditor’s Office; Breastfeeding Coalition | 2025 |
3. Incorporate Community Health Workers (CHWs), doulas, Native Hawaiian health care providers into lactation care (e.g., Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs)) | FQHCs; Hawai‘i Association of Health Plans | 2025 |
Establish at least two statewide policies designed to increase physical activity and/or healthy food options in government worksites.
- Establish a comprehensive worksite physical activity policy
- Establish a policy that requires nutrition standards for worksite vending machines and for meetings/events where food is served
Activities | Responsible Parties | Completed By |
---|---|---|
1. Establish a comprehensive worksite physical activity policy | DOH | 2024 |
2. Establish a paid family leave policy | DOH; ECAS; HIPHI | 2025 |
3. Establish and sustain a Worksite Wellness (WSW) position at the Department of Health | DOH | 2025 |
Establish at least one statewide policy that supports breastfeeding exclusivity and duration.
- Establish a statewide Paid Family Leave policy, which will support mothers' ability to breastfeed by providing leave time for mothers to care for their newborns
- Encourage employers to adopt an Infant at Work policy, which allows employees the option of bringing their infants into the workplace and can support exclusive breastfeeding
- Encourage employers to adopt a Work from Home policy, which provides telecommuting options for breastfeeding mothers
Activities | Responsible Parties | Completed By |
---|---|---|
1. Establish the provision of a breastfeeding pump as a benefit from health insurance companies that are not already compliant with Affordable Care Act (ACA) | HI CalMED; Breastfeeding Hawai‘i | 2024 |
2. Explore provision of workplace lactation consultation benefits | DOH; HIPHI; Breastfeeding Hawai‘i | 2024 |
3. Establish breastfeeding coordinator position at DOH to provide expertise and coordination across all sectors | DOH | 2025 |
Implement a statewide, comprehensive worksite wellness recognition program that at least 10 very small-, 15 small-, 10 medium-, and 5 large-employers will participate in.
- Identify stakeholders and convene an advisory group to develop a Hawaiʻi-specific, evidence-based worksite wellness recognition program that includes the following areas:
- Asthma
- Cancer
- Diabetes
- Heart Disease and Stroke
- Physical Activity and Nutrition
- Tobacco
- Pilot the recognition program with a group of diverse employers and modify the program based on their feedback
Baseline | Target | Status Date- 07/01/2024 | |
---|---|---|---|
Very Small | 0 | 10 | 0 |
Small | 0 | 15 | 0 |
Medium | 0 | 10 | 0 |
Large | 0 | 5 | 0 |
Activities | Responsible Parties | Completed By |
---|---|---|
1. Convene an advisory group to develop a Hawai‘i specific, comprehensive WSW recognition program that will include all aspects of health | HIPHI; AlohaCare; HMSA; Kaiser; UHA Health Insurance; DOH | 2024 |
2. Pilot a recognition program with a group of diverse employers | HIPHI; AlohaCare; HMSA; Kaiser; UHA Health Insurance; DOH | 2025 |
3. Establish infrastructure for the program at the DOH, statewide | DOH | 2025 |
The long-term measures are broad measures that help assess progress toward achieving the Healthy Hawaiʻi Vision 2030.