Rural health disparities: Evidence from Hawaiʻi

This article examines how rurality contributes to health disparities in the Hawaiian Islands using data from the June 2023 wave of a statewide health survey. We analyze self-reported health outcomes alongside sociodemographic factors including age, gender, race/ethnicity, income, education, and disability. Our findings show that rurality is one of the strongest predictors of poorer health outcomes, particularly in relation to physical health. Crucially, rurality amplifies the negative health impacts of both disability and poverty, indicating that marginalization compounds in rural contexts. By highlighting these interaction effects, the study contributes to research on rural health disparities and informs regional science debates on spatial inequality and territorial cohesion. By demonstrating that rurality amplifies poverty- and disability-related health disadvantages, our findings provide new insights into territorial cohesion and spatial justice challenges in regional science. The case of Hawaiʻi illustrates how place-based health disadvantages emerge in geographically distinct settings, reinforcing the need for spatially targeted policy interventions.