Hawaiʻi life expectancy decline smaller than US average during COVID-19 pandemic

While life expectancy across the U.S. declined significantly during the COVID-19 pandemic, a new study led by researchers at the University of Hawaiʻi Thompson School of Social Work & Public Health and the Hawaiʻi State Department of Health found that Hawaiʻi experienced a smaller decline compared to national trends.

Yan Yan Wu, Michael Phillips and Kathryn L. Braun from the UH Mānoa Department of Public Health Sciences, along with Lance Ching and Claire Prieto from the Department of Health Chronic Disease Prevention & Health Promotion Division, found that life expectancy in Hawaiʻi declined by 1.4 years, from 82.1 in 2019 to 80.7 in 2021. Nationwide, the decline over the same period was 2.4 years, from 78.8 to 76.4. Their findings were published in the Asia Pacific Journal of Public Health.

“The smaller magnitude and delayed timing of Hawaiʻi’s decline may reflect the state’s geographic isolation and early implementation of public health interventions,” said Wu, the study’s lead author. “In 2022, life expectancy partially rebounded by 0.5 years in Hawaiʻi and by 0.9 years nationally, with Hawaiʻi remaining about four years higher than the U.S. average throughout the pandemic.”

“Hawaiʻi ranks among the top U.S. states for COVID-19 vaccination coverage. By May 2023, data reported by the U.S. Centers for Disease Control and Prevention (CDC) showed that more than 90% of residents received at least one dose and more than 80% were considered fully vaccinated with the primary COVID-19 vaccine series,” said Ching, epidemiologist with the DOH Chronic Disease Prevention & Health Promotion Division. “These high vaccination levels—reached over the course of the pandemic—helped delay the peak of COVID-19 mortality in Hawaiʻi by approximately six months compared to the national average and contributed to the state’s distinction of having the lowest age-adjusted COVID-19 death rate in the country.”

Key findings

• Life expectancy in Hawaiʻi remained stable from 2018 to 2020 (82.3, 82.1, and 82.0 years, respectively).
• A decline occurred in 2021 to 80.7 years, followed by a partial rebound to 81.2 years in 2022.
• Among males, life expectancy fell from 79.2 years in 2018 to 77.5 years in 2021, then rose to 78.2 years in 2022.
• Among females, life expectancy fell from 85.4 years in 2018 to 84.0 years in 2021, rebounding to 84.4 years in 2022.
• The gap between female and male life expectancy widened to 6.5 years in 2021 before narrowing to 6.2 years in 2022—the same as in 2019.
• Despite these fluctuations, Hawaiʻi’s overall decline in life expectancy remained less severe than the U.S. average throughout the pandemic.

Policy implications

The researchers note that Hawaiʻi’s better outcomes underscore the effectiveness of early public health interventions, strong community engagement, and high vaccine uptake. They recommend that future policies build on these strengths by investing in rapid-response infrastructure and maintaining high vaccination coverage to better protect vulnerable communities during future disease outbreaks.