HIPHI Candidate Survey – 2026
Hawai‘i Public Health Institute
From; DUKE4GOV.COM
Email. contactduke4gov@proton.me
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The Center of Disease Control has changed the childhood vaccination schedule against the advice of medical professionals, removing many vaccines from their recommended list. This risks leaving insurance providers to determine which vaccinations they deem necessary. Hawai‘i’s Department of Health is working with other states to have unified recommendations for their residents.
Question: Require health insurers to provide no-cost coverage for evidence-based preventive health services recommended by the Hawai’i Department of Health, including immunizations?
PASS, No simple answer
Sugary beverages are a leading cause of obesity and cardiovascular diseases. Placing fees on beverages with added sugar (such as soda, energy, and sports drinks) have been shown to reduce consumption, improving health outcomes as a result. A 2-cent per ounce fee on these products would generate over $60 million in revenue for the state, which could be used to fund health initiatives for those most in need like prevention programs, food access expansion, and health care investments.
Question: Enact a 2-cent per ounce fee on sugar-sweetened beverages and using the revenue for community-driven health initiatives?
Strongly Support
Comment, the tax should be higher
Food is Medicine (FIM) recognizes food as a critical component of health care. It involves integrating nutrition interventions into clinical care to improve patient health outcomes, particularly for those with diet-related conditions such as diabetes, hypertension, and cardiovascular disease. Examples of intervention could be health providers prescribing fresh fruits, vegetables and proteins to patients, or meals designed by dietitians to meet specific medical and nutritional needs.
Question: Increase infrastructure and state support for food-is-medicine programs like medically tailored meals, produce prescription programs and nutrition services integrated with healthcare?
Strongly Support
Additional thoughts/questions on prevention questions.
Goal is to power the people to understand the issue, plan, prepare themselves, the crockpot proposal- discounted so to prepare healthy meals themselves.
Oral Health Questions
Hawai‘i expanded Medicaid coverage to include adult dental benefits in 2023. This has been significant in ensuring oral health care is accessible to those who need it the most.
Question: Preserve the current level of funding for Medicaid dental benefits for adults?
Support
Caveat. Money or funding is difficult with large US national deficits,
cutting back on federal health funding, like to see more free/low cost dental services supported by charities and the public.
Keiki in Hawaiʻi have among the highest rates of dental decay in the nation, in part due to the limited dental care services available in rural areas and outer islands. Dental hygienists have robust training, but are currently limited in the services they can provide in public health settings, like schools.
Question: Allow dental hygienists to practice to the full scope of their licensure and training in limited public health settings?
Strongly Support
There’s a significant dental care shortage throughout Hawai‘i, specifically in areas on the neighbor islands, leaving many residents without access to the care they need.
Question: Invest in dental workforce education programs in Hawaiʻi, Maui, and Kauaʻi counties to increase access to dental care statewide?
Strongly Support
Additional thoughts/questions on oral health questions.
Cost is high, for education, and the ultimate dental service
Affordability Questions
Hawaiʻi residents currently have no legal right to Paid Family and Medical Leave (PFML). PFML insurance supports workers in balancing work and their health/the health of their families by allowing workers to take time off without sacrificing income.
Question: Create a statewide Paid Family and Medical Leave program to allow up to 12 weeks of paid leave for employees to provide care for a newborn, bond with a new child, manage chronic disease, or care for a family member with a serious health condition?
Pass,
expensive, maybe a private endowed fund to help
One in three households in Hawaiʻi experienced food insecurity last year. For these families, the cost of school meals is a barrier to accessing nutritious food. Hawai‘i has increased the income limit for free school meals, but many are still ineligible, leaving many students hungry and unable to learn during the school day. 8 states have expanded free school meals to all students.
Question: Provide free school meals to all students at public schools by 2030?
Pass,
like to create a program where certified need to feed students are fed in schools, through a school program where students grow vegetables, and prepare their own lunch rice and veggies other students can participate with donations from families to help the meals prepared together.
45% of households in Hawai‘i make less than the survival budget and are considered Asset Limited, Income Constrained, Employed (ALICE). A family of 4 needs to earn over $110,000 just to make ends meet in Hawai‘i in 2026. That requires a full-time worker to make more than $26 per hour, yet the minimum wage will only be $18 in 2028.
Question: Raise the minimum wage to a livable wage where one full-time job per adult is enough to afford basic needs.
Pass, agree generally but how do we pay for this without hurting small business and the economy
Hawaiʻi residents face some of the highest transportation costs in the nation, and many communities lack affordable, reliable transportation options to access work, school, healthcare, and essential services. Expanding free public transit for all statewide could reduce financial burdens on families, improve mobility for youth, kūpuna, and low-income residents, and help decrease traffic congestion and greenhouse gas emissions.
Question: Implement free public transit for all statewide in Hawaiʻi to improve transportation access, reduce household transportation costs, support climate goals, and expand mobility for all residents.
Pass, Hawaii has a great transportation system, especially Oahu, and the bus fare and pass is low, lets find ways to help the ones in need to get bus passes
In Hawai’i, a family of 4 needs more than $110,000/year just to afford their basic needs, but SNAP benefits end when their income reaches just $74,000 or 200% of the Federal Poverty Level (FPL). Expanding SNAP benefits beyond the 200% FPL would allow benefits to gradually decline to $0 as a family’s income rises. Presently, families are faced with an immediate loss of over $10,000 in SNAP benefits annually for earning just $1 over the 200% FPL.
Question: Expand access to SNAP benefits to families and individuals earning below 300% of the Federal Poverty Level.
Pass,
Again wondering where money comes from, with federal govt cutting back and in deficit, and taxes high and consumers constrained. Like to see programs of citizens part of a community food growing and distribution program,
Additional thoughts/questions on affordability questions.
The situation in the world, the US, and Hawaii requires us to start planning on a self sufficient, circular economy. We can take care of ourselves if we plan and work together to provide the essential products, especially food, to exist in a healthy environmental system.
General Health Questions
Community Health Workers (CHWs) serve as liaisons between the community and health care/social services. Services provided by CHWs include culturally-informed health promotion and education, assistance in accessing medical and non-medical services, translation services, care coordination, and social support. The state has not yet established a pathway for Medicaid payment for services provided by CHWs.
Question: Establish a pathway to Medicaid reimbursement for Community Health Workers?
pass, cost
Question: Invest in training, certification, and career pathways for CHWs?
Strongly Support
People over the age of 60 make up more than 25% of the state’s population and that number is projected to grow. Dignified care for kūpuna is a growing concern statewide.
Question: Provide tax credits for out-of-pocket care costs for unpaid family caregivers of kūpuna (elders) and/or those with disabilities?
Support
State and federal programs are essential to supporting and improving the lives of our residents. Medicaid and SNAP have already been under attack, while many new programs are needed to improve our well being.
Question: Identify additional revenue sources from those who can afford it most, to ensure funding is available to sustain existing and implement new necessary social programs?
Support
Additional thoughts/questions on general health questions.
What we eat is who we are, healthy or not, best to grow organic, no chemicals, food on clean land. This keeps our land, and water, and air, cleaner and our bodies healthier.
Alcohol and Drug Questions
State alcohol taxes in Hawaiʻi have not kept pace with inflation for nearly 30 years. Public health research shows that increasing alcohol taxes can help prevent underage drinking and reduce excessive drinking while generating state revenue for community priorities such as prevention, treatment, housing, and education. Adjusting the alcohol taxes for inflation would bring in an additional $50 million annually to our state.
Question: Adjust and index the state alcohol excise tax to current inflationary standards to help fund vital community services (i.e., substance use prevention and treatment services, affordable housing and houseless services, PE and health teachers in all schools)?
Strongly Support
Sweetened, high-alcohol beverages such as BuzzBallz and Four Loko are often associated with underage and young adult binge drinking. They often contain significantly more alcohol than a standard beer and can be marketed in ways that appeal to youth.
Question: Enact higher taxation rates of sugary, high alcohol content drinks (e.g., BuzzBallz, Four Loko) relative to standard beer and wine to compensate for their increased harm?
Strongly Support
Most recent data shows alcohol-impaired driving contributed to 42% of all motor vehicle deaths on Hawai‘i’s roads. The National Transportation Safety Board recommends lowering the per se limit for alcohol-impaired driving from 0.08 blood alcohol concentration (BAC) to 0.05 BAC as a recommended strategy to lower alcohol-impaired crashes and deaths.
Question: Lower the legal limit for alcohol impaired driving from 0.08 blood alcohol concentration (BAC) to 0.05 BAC to prevent and reduce crashes and fatalities?
Strongly Support
In the 2025 Alcohol and Cancer Risk: The U.S. Surgeon General’s Advisory, the Surgeon General links numerous types of cancer to alcohol consumption, yet many people are unaware of this risk. The advisory says alcoholic beverages should have a warning label about the risks.
Question: Require cancer warning labels on alcohol advertising and promotional materials?
Strongly Support
As Hawaiʻi considers legalizing recreational cannabis use, some experts have recommended a public health approach that places oversight with the Department of Health (DOH) rather than agencies focused primarily on business development or revenue generation. Taking a similar approach to tobacco, placing cannabis responsibility in the DOH could prioritize youth prevention, consumer safety, product regulation, and public education.
Question: If recreational cannabis is legalized, place regulatory and licensing authority under our state Department of Health to ensure proper public health protections?
Pass, need more research
Additional thoughts/questions on alcohol and drug questions.
Tobacco and Nicotine Questions
Tobacco use remains the leading cause of preventable death and disease, claiming the lives of 1,400 Hawai‘i adults each year. Youth use of e-cigarettes has been a growing concern, with higher rates on neighbor islands. 8 in 10 youth who use tobacco, started with a flavored product.
Question: End the sale of all flavored tobacco and nicotine products, such as cigarettes, small cigars, e-cigarettes, and nicotine pouches; flavors include menthol, fruit, candy, and more?
Strongly Support
In 2018 the legislature declared the sale of tobacco products a matter of statewide concern and nullified any existing local laws and prevented any new local laws that restrict the sale of these products, including e-cigarettes. Deterring youth tobacco use is a growing concern, particularly on neighbor islands.
Question: Authorize counties to enact stricter regulations on the sale and access to tobacco products than is mandated by the state?
Strongly Support
Nicotine is one of the most addictive substances in the world. Nicotine pouches are quickly becoming a rising threat to our health, as usage rates have increased 250% from January 2023 to August 2025. These products are extremely potent, flavorful and addictive. The Food and Drug Administration (FDA) has a limited list of less harmful products that are authorized for sale in the U.S., but most nicotine pouch products sold in Hawai‘i are not on this list, and thus federally illegal.
Question: Limit nicotine products available for sale in Hawai‘i, only to those that are federally legal and authorized for sale by the FDA.
Support
In 1998, upon determining that the tobacco industry lied about the health risks of using their products, a legal settlement was reached between the tobacco industry and 46 states, including Hawaiʻi. The Tobacco Settlement requires annual payments by the tobacco industry to the states and is intended to be used toward prevention and cessation services. Hawai‘i allocates 12.5% of the annual payment towards tobacco prevention and cessations services. In 2025, the state spent around $7.5 million on prevention. The cost of health care directly caused by smoking is around $600 million annually.
Question: Continue to allocate funds from the Tobacco Settlement toward tobacco prevention and cessation services for the community?
Strongly Support
Additional thoughts/questions on tobacco and nicotine questions.
The sale of tobacco products should be taxed high enough to cover the costs to the public
Climate Health Questions
Climate-related health impacts in Hawaiʻi include extreme heat, wildfire smoke exposure, vector-borne disease risk, flooding, water insecurity, food system disruption, and mental health impacts following disasters. An effective public health response to climate change requires robust surveillance systems capable of detecting health impacts in near real time and informing prevention strategies. Currently, the Hawaiʻi Department of Health has only one epidemiologist focused on environmental health statewide.
Question: Allocate funds to the Hawaiʻi Department of Health to expand environmental health and climate-related epidemiology capacity, including surveillance, monitoring, and response to climate-sensitive health threats?
Pass, not surveillance, a privacy issue
Extreme heat is one of the leading weather-related causes of death and illness globally, and Hawaiʻi is experiencing rising temperatures and more frequent heat risk days. Children, kūpuna, outdoor workers, athletes, and communities with limited access to cooling are disproportionately affected.
Question: Improve statewide heat resilience efforts, including heat-health monitoring, shade and cooling infrastructure, school and workplace heat safety protections, and community education programs.
Strongly Support
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Additional thoughts/questions on climate health questions.
Energy consumption is of issue, air conditioning is not a simple answer as it consumes too much energy, look into low energy use options to keep cool, lots of water availability, new age cooling devices
Additional thoughts/questions on any issues.
Health of Hawaii starts with the environment, how we grow our food without chemicals, group community effort to grow vegetables, fruits, and nuts/seeds, and an educational and distribution system to power people to grow, prepare, and eat organic as much as possible, foods, preferably vegetarian/vegan.
Mahalo