The County of Kauai has been involved over the past two years in developing a General Plan for the island to address policies which will guide public decisions-making for the next 20 years.
This current draft plan is the first time that the Planning Department has included a section on Community Health and the department must be congratulated in extending the plan into this area. I have interest in the area of the plan dealing with Community Health because I am both a retired ob/gyn physician and have an advanced degree in public health.
In addition to my review of the draft 20-year General Plan I have discussed many of the community issues with Dr. Janet Berreman, the recently hired head of the Kauai District Health Office. A summary of the information I have gathered is reviewed below.
Public health issues are extremely important to local communities for it is estimated that an active public and personal health approach accounts for 80-90 percent of wellness, while providers of healthcare provide only 10-20 percent of wellness to an individual. Yet the attention paid to public health areas and the money spent are often insubstantial.
Lack of affordable housing is not often thought of as a public health problem but it is one of the major public health issues facing Kauai. Expensive, overcrowded, inadequate housing affects families in a multitude of physical, sociological and psychological ways.
While some new subdivisions were included in the draft General Plan, I am personally against their blanket inclusion. I would argue that subdivisions be approved only if 70 percent of the housing in a subdivision is affordable for the median Kauai family, leaving 30 percent of the subdivision for expensive housing with starting costs above $400,000.
Without such guidelines included in the planning document the island will continue to be a place unaffordable to local families. The unfettered county approval for ultra expensive housing simply must stop and the housing crisis must be addressed with local families as the focal point for decision-making.
Teen pregnancy and teen births in Hawaii are higher on average than on the Mainland and this is particularly true of Hawaiian and Pacific Island teens. At the same time, reproductive health education in public schools is abysmal and proposed changes for reproductive health education needs to be included in the plan as a public health issue.
The University of Hawaii has developed a culturally specific program for 11- to 13-year-olds called Pono Choices. Some Kauai schools are already using this program and I would like to see support and use of this important educational tool in all the Kauai schools.
Other areas which need attention in the plan are education on seat belt use, decreasing the illegal use of cell phones and texting while driving and drug/alcohol use as it relates to traffic deaths and domestic violence. Food insecurity, the lack of/or high cost of healthy food and the inadequate/unaffordable care for our growing elderly population are other major areas of concern for many island families and should be addressed in the General Plan.
Sound public health policies are a major contributor to individual and community health. Kauai offers a beautiful natural environment. Now we must design measures within the General Plan that best serve the needs of the local community and provide safeguards to protect current and future generations.
Judy Shabert, MD, is a resident of Kilauea.