Preliminary Hawai'i Public Health Workforce Supply and Demand Assessment.

Ensuring the adequacy of the public health workforce requires an understanding of its size and composition, as well as the population's demand for services. The current article describes research undertaken as a first step toward developing an estimate of the supply of and demand for Hawai'i's public health workforce. Using an organizational-level survey, data was obtained from a subset of 34 organizations considered to be major providers of population-based public health services in Hawai'i. The results indicate that estimates of the existing public health workforce range from 3,429 to 3,846 workers. Calculations of functional demand reveal that an additional 317 to 502 employees will be required to compensate for vacancies and projected retirements over the next five years; though, the discussion points to the fact that this number may be closer to 1,005 to 1,664. While, an additional 594 to 848 employees would be needed to meet the current missions of organizations in this sample and to best meet community need. While these findings are neither exhaustive nor definitive, they raise issues concerning the state's supply of public health workers in terms of their ability to adequately meet demand for services. More research is needed to confirm these findings and track Hawai'i's public health workforce to assure a strong local public health system.

Insights about Fall Prevention of Older Adults in the State of Hawai'i.

The senior population in Hawai'i is growing at a dramatic pace. In the older population, falls and fall-related injuries are leading causes of morbidity and mortality. Moreover, the health care costs for falls are very high. The State of Hawai'i has taken measures to prevent falls through the promotion of medication reviews, vision checks, home assessments, and exercise. However, current published examinations of fall preventive measures have been insufficient, and more research is needed to confirm risk factors, effectiveness of preventive measures, and to explore future objectives. This paper examined the validity of fall risk factors and fall preventive measures for Hawai'i's seniors by conducting mail questionnaire surveys to a sample of seniors using medical alert services from one company in Hawai'i. The results of chi-square analysis suggest that having reduced ability to perform Activities of Daily Living (ADL) and reduced Instrumental Activities of Daily Living (IADL) were associated with a greater risk of falls (P < .01). In addition, those who fell were more likely to talk about fall preventions with their family members or friends and health providers compared with those who did not (P = .048 and .003, respectively). Evidence-based exercise programs for strengthening muscles and controlling physical balance may be needed to improve ADL and IADL. Furthermore, the results suggest that seniors do not accept that they are at risk of falling before they actually fall. Public health providers should consider how they approach seniors, and how they inform them of the importance of fall prevention across the life span.

Propensity for Japanese-American older adults' use of medical alert services in Hawaii.

AIM: Hawaii is a fast-aging, multi-ethnic state. At present, ethnic Japanese represent the largest segment of the elderly population (aged ≥65 years). Studies in Western countries have identified an association between ethnicity and the use of homecare services. The present study sought to substantiate this association in relation to the use of a personal emergency response system service by older ethnic Japanese adults in Hawaii. METHODS: Questionnaires were mailed to 585 elderly subscribers of a company providing personal emergency response system services in Hawaii in 2014. The questionnaire inquired about the subscriber's ethnicity, functional disability, number of medications taken and falls experienced. Additional information on the sex, age and service payer was obtained for each of the responding subscribers from the corporate database. The χ2 -test and t-test were carried out to assess the associations between factors. RESULTS: A total of 244 questionnaires were analyzed (41.7% response rate; mean age of respondents 86.1 + 7.8 years). Compared with non-Japanese older adults, ethnic Japanese older adults had a higher propensity to use the personal emergency response system services, were older, used fewer prescribed medications and were more likely to have these services paid for by family members or to pay themselves. CONCLUSIONS: Japanese culture might influence the use of personal emergency response system services. Ethnic Japanese older adults might want to receive homecare services focusing on preventing minor accidents from becoming medical crises because of their high level of concern for health, their independence and the availability of family support. Healthcare planners should consider such factors in the provision of care in Hawaii. Geriatr Gerontol Int 2017; 17: 1392-1398.