Hawai’i County Agriculture Development Plan

At a Glance:

Location: Hawai'i County, Hawai'i

Date: 2012

Vital Condition: Basic Needs for Health and Safety, Belonging and Civic Muscle, Meaningful Work and Wealth

Determinants of Health: nutrition, food access, belonging and civic muscle, meaningful work and wealth, physical activity, food access

Affected Population: Black, Indigenous, and People of Color, People Living in Poverty

Research Methods: Literature review, Quantitative research, Stakeholder Interviews

Community Types: urban, rural

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The current Hawai‘i County Agriculture Development Plan (the Agriculture Plan) was commissioned by the Hawai‘i County Department of Research and Development in 2008 and approved by the Hawai‘i County Council in 2010. The purpose of the Agriculture Plan is to serve as a guide for county government, local advocacy groups, and local businesses to revitalize agriculture as a basis for economic development.

Hawai‘i Island is the largest of the Hawaiian Islands. With 185,079 residents, it has the second-largest population of the archipelago, but the fourth highest population density (behind O‘ahu, Maui, and Kaua‘i). Hawai‘i County accounts for 63% of the farmland and 40% of existing farm employment in the state. Abundant fertile lands and a 12-month growing season create the potential for a high level of food self-reliance, yet the island imports an estimated 85% of its food.

While the importance of the Agriculture Plan to economic development and land use is well recognized, the impact of agriculture policy on health has not been considered until recently. To fill this gap in information, The Kohala Center applied a formal process, health impact assessment (HIA), to evaluate the potential positive and negative impacts of Agriculture Plan policies on the health of Hawai‘i Island residents. Note that “health” in this context includes socioeconomic as well as physical health. For the purposes of the following discussion, the project used the World Health Organization definition of health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity and determinants of health that include the social and economic environment, the physical environment, and individual characteristics and behaviors.

Between March 2010 and December 2011, The Kohala Center, together with researchers from Kaiser Permanente Center for Health Research, Hawai’i and the Hawai‘i Department of Agriculture, as well as local stakeholders in agriculture, health, and public policy, conducted a HIA of three Hawai‘i County Agriculture Development Plan policy recommendations with strong potential impact on health:

  1. Institutional buying: increase the ability of federal, state, county, and local NGO institutions to buy locally grown and produced food, utilizing the prototype of farm-to-school programs
  2. Commercial expansion of food agriculture: through public-private partnerships increase the amount of food produced on Hawai‘i for the local market, to reach a goal of 30% Hawai‘i Island food self-reliance in 2020; and
  3. Home production: promote the expansion of home, community, and school gardening through public education.


Abundant fertile lands and a 12-month growing season create the potential for a high level of food self-reliance, yet the island imports an estimated 85% of its food.

About This Health Impact Assessment

This report summarizes the findings of the health impact assessment. The goal of the HIA is to inform legislative and regulatory decision-making so that these three Agriculture Plan policies are implemented in ways that maximize health benefits and minimize health risks for Hawai‘i Island residents. In particular, this HIA examines the impact of each of the three Agriculture Plan policies on five health outcomes or determinants of health, from the range of personal, social, economic, and environmental factors that can affect the health status of individuals or communities:

  1. Food security
  2. Obesity
  3. Food-borne illness
  4. Economy
  5. Well-being and cultural connectedness

The HIA process first assesses current health conditions, and then combines data from a variety of sources, including published reports and research analyses, expert local opinion, and new analysis, to predict the potential impacts of each of the three selected Agriculture Plan policies on each of the five health-related factors or outcomes. Finally, the HIA offers recommendations to maximize health benefits and minimize health risks associated with implementation of each of the three selected Agriculture Plan policies.


Kohala Center staff members had an opportunity to meet with the Office of Planning staff members during the strategy development period and made additional specific suggestions during the draft review period. All of the key issues and most of the HIA recommendations were included in the final state strategy documents, with dollar figures attached to some of the recommended initiatives.

This Health Impact Assessment Report first appeared in The Cross-Sector Toolkit for Health. The Cross-Sector Toolkit for Health was originally developed by the Health Impact Project, formerly a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The creation of this resource was supported by a grant from the Health Impact Project. The views expressed are those of the author(s) and do not necessarily reflect the views of The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.

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