The state of Hawaii has slipped from its top 10 ranking in an annual report that evaluates the health of women and children across the U.S.
The United Health Foundation ranked Hawaii No. 12 this year in its “2025 Health of Women and Children Report,” down from No. 8 in the U.S. last year, after analyzing 125 measures of health and well- being that include access to care, chronic conditions, and depression, among other factors.
The America’s Health Rankings report — which mostly uses data from 2023-2024 — also offers a comprehensive, state-by-state look at data across multiple health indicators, including mental, behavioral and physical health outcomes, as well as social and economic determinants.
Hawaii’s strengths include a low prevalence of frequent distress, as well as of multiple chronic conditions among women. Hawaii ranked No. 1 for avoidance rate of care due to cost both this year and last year as well as adequate insurance coverage for children.
The state, however, ranked low on adequate prenatal care, infant child care affordability, and food sufficiency for children. The state was ranked last, at No. 50, for adequate prenatal care in the latest report, as it was in last year’s report.
Hawaii, with its shortage of mental health therapists, also ranked last, at No. 50, for access to attention-deficit/hyperactivity disorder (ADHD) treatment for children. Another challenge that has been consistent in Hawaii across the years is the high housing cost burden among households with children.
Comparing the reports side by side, most indicators remained similar, but some that worsened included the physical inactivity rate and e-cigarette and tobacco use among women.
The 2025 report cited a high prevalence of excessive drinking among women as a challenge, whereas the 2024 report cited a high prevalence of insufficient sleep. It also noted that infant mortality rates increased 10%.
DOH said it appreciates the insights provided in the report, and that it would continue to promote healthy behaviors and pursue effective public health policies.
The department was pleased to see that Hawaii continues to perform strongly in access to care, environmental quality and children’s health coverage, but noted areas where continued attention is needed.
“Hawaii ranks last in adequate prenatal care, and we know that Pacific Islander communities experience disproportionately high rates of inadequate prenatal care,” said DOH in a statement. “The Department remains committed to addressing these inequities through ongoing partnerships, community outreach, and efforts to make early and consistent prenatal care more accessible.”
Additionally, the challenges that Hawaii families face with housing costs, child care affordability and food security are also concerning, as they directly influence health, and “are a priority for statewide, inter-jurisdictional collaboration.”
“Overall, while Hawaii remains a national leader in many areas of women’s and children’s health, we recognize the work ahead,” said DOH, adding that it remains committed to advancing health equity, improving prenatal and maternal health outcomes, and ensuring all families in Hawaii have the opportunities and support they need to thrive.
Nationally, the report found many concerning trends, including a 36% jump in maternal mortality, or death during pregnancy, childbirth or within six weeks of a pregnancy’s end, which is considered a critical health indicator.
There was also a 4% jump in infant mortality, and a 4% jump in child mortality, which counts individuals between the ages of 1 to 19. Other concerns include an 11% increase in depression among women and 9% increase in mental health conditions among children.
The report noted a 21% increase between 2021—2022 to 2023-2024 in children ages 3 to 17 who had ADHD and were taking medication and had received behavioral treatment for it.
Some encouraging gains in health include improvements in childhood overweight and obesity rates, early childhood education enrollment, and some clinical care measures.
The goal of the America Health Rankings reports are to provide a benchmark for states so that public health departments can monitor trends over time and compare their measures with those of other states.
Massachusetts ranked No. 1 in women’s and children’s health, with a low prevalence of adverse childhood experiences and high percentage of women college graduates, while Louisiana ranked No. 50, with a high child mortality rate and high percentage of children in poverty.
WHERE HAWAII RANKS
This is where Hawaii ranked in women’s and children’s health according to the United Health Foundation
>> Rank: No. 12 healthiest in the U.S.
>> Strengths: Low prevalence of frequent physical distress, and of multiple chronic conditions among women; low percentage of children in poverty.
>> Challenges: High prevalence of excessive drinking among women; low prevalence of adequate sleep among children; high housing cost burden among households with children.
>> Improvements: Unemployment declined; preventative dental visits among children improved.
>> Slipping: Infant mortality increased; asthma rate among children increased; e-cigarette and smoking increased among women.
>> Top rankings: Hawaii ranked No. 1 for percentage of women that avoided care due to cost; adequate insurance for children; air and water quality.
>> Bottom rankings: Hawaii ranked No. 50 for adequate prenatal care for women; insufficient sleep for women; Access to ADHD treatment for children.
Source: America’s Health Rankings 2025 Health of Women and Children Report
FIVE HEALTHIEST STATES
1. Massachusetts
2. Vermont
3. Minnesota
4. New Hampshire
5. Utah
LEAST HEALTHIEST STATES
46. West Virginia
47. Oklahoma
48. Mississippi
49. Arkansas
50. Louisiana
Source: AmericasHealthRankings.org
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