Healthcare disparities in paradise? Hawaii Lt. Gov. Josh Green, MD, discusses health equity leadership and Hawaii’s COVID response with Bill Finerfrock.

Hawaii has long held the record for the highest average life expectancy in the US. The islands also enjoy some of the lowest COVID-19 infection and mortality numbers along with high vaccination rates. After growing up in Pennsylvania and with his medical degree in hand, Dr. Josh Green joined the National Health Service Corps and in 2000 was stationed in Hawaii. He began his life’s work as a family and emergency room physician in rural hospitals and clinics on Hawai’i Island (Big Island). Serving in the very rural districts of Hawai’i Island acquainted Dr. Green with Hawaii’s rich culture and people. He also witnessed first-hand the lack of healthcare resources in those areas, which he says was his inspiration to begin his local political career and bring a voice to underserved communities. Dr. Green attributes near-universal healthcare coverage and a strong emphasis on primary care with Hawaiians good life expectancy, but Native Hawaiians live comparatively shorter lives. Parts of Hawaii are still in many respects the frontier, with poverty rates exacerbated by COVID’s impact on tourism, and difficult access to specialist care being important aspects of the disparities equation.

“Hawaii has a history of leading on certain health issues, and we were essentially the first state to have universal healthcare coverage with the Prepaid Health Care Act of 1974.”
Josh Green, MD, Lieutenant Governor, Hawaii

“In Hawaii, if a person works half time or more than 3 weeks out of the month, they must be given healthcare insurance. We also have a very vibrant Medicaid program. What that has meant is that everyone is covered, with a very small sliver of exceptions.”
Josh Green, MD, Lieutenant Governor, Hawaii

“Most of our indicators on healthcare matters are just transcendent because people have got a lot of primary care and coverage. However, we also have a lot of people that struggle more. Our native Hawaiian community, for example, lives on average a decade less.”
Josh Green, MD, Lieutenant Governor, Hawaii

“What we tend to do in our rural areas is have community health centers, it’s a big part of our system. We funded the community health centers with tobacco settlement funds and taxes and so we have a vibrant community health system.”
Josh Green, MD, Lieutenant Governor, Hawaii

Episode Transcription