Children should have affordable, comprehensive, quality healthcare from birth throughout childhood.

Learn more about our oral health campaign.


Children should be free from abuse, neglect, exploitation, and violence. Economic security is also vital.

Learn more about our Paid Family Leave campaign.


Children and their families should have access to affordable, high-quality early education, and childcare.

Learn more about our early childhood education and care campaign.

Childhood lead poisoning prevention

View the report and more resources
October 2020

Childhood lead poisoning is a serious health threat that impacts millions of children throughout the United States, including Hawai’i. From 2018 to 2019, only about 26% of Hawai’i children ages 1 and 2 years were tested for lead. About 1% of children tested showed elevated blood lead levels above or equal to 5 μg/dL, according to data collected by the Hawai’i Childhood Lead Poisoning Prevention Program, or HI-CLPPP. (There is no safe level of lead.)

Even low levels of lead exposure can have severe long- term consequences that follow children into adulthood.i Despite this, many states, including Hawai’i, do not require testing all children for lead. Many cases go unrecognized, and the actual rate of lead poisoning is unknown. With universal childhood testing and the recommendations outlined in our reports, we can protect children and the larger community from the life-altering effects of this completely preventable health threat.

Early Childhood Data and Research

Hawaii Early Learning Needs Assessment

The report provides a state-wide assessment of the early learning system for children birth through age five and focuses on childcare and preschool centers, family childcare homes, and family-child interaction learning programs.  The study was conducted in partnership with the University of Hawaiʻi Center on the Family with funding from the Samuel N. and Mary Castle Foundation. 

The report serves as a critical tool to evaluate and improve how Hawaiʻi supports the development of all of its children. Findings reveal areas of crucial need and bright spots.

Areas in need of action include increasing the number of childcare and preschool seats. Overall, there are only enough seats to serve about one in four children, but many communities are childcare deserts with few or no options for families. The report shows there is a critical shortage of infant-toddler care. Hawaiʻi has 37 children under age three for every licensed infant-toddler center seat, and some islands have no infant-toddler centers. As a result of the shortage, parents try to get on a waiting list long before their baby is born. 

Cost is a second key concern. Hawaiʻi has the nation’s least affordable center-based care, relative to family income. The federal government defines affordable childcare as 7% of family income for all children, combined.  However, care for only one child in Hawaiʻi consumes approximately 13% of the typical Hawai‘i family’s income. 

A third area of need is support for the early childhood providers themselves, many of whom do not earn a living wage. Some providers need access to on-site professional development and a pathway to earning a credential or college degree in the early childhood field. Finally, the cost of running a childcare program is prohibitive. Centers and family childcare providers struggle to keep tuition as low as possible while remaining viable as a business. 

Hawaiʻi’s early learning has many bright spots as well. 

Hawaiʻi has many childcare centers with national accreditation, which is an indicator of quality. Public prekindergarten is growing and we have unique options such as Hawaiian language immersion, family-child interaction groups where parents and children play and learn together, and programs for children who are homeless.

According to the study, a strong, high quality early childhood system is a necessary investment in Hawaiʻi’s future.  High quality early learning programs help children develop to their full potential. Reliable, affordable childcare allows parents to remain in the workforce, increasing family self-sufficiency and ensuring stability for employers.

Summary Report

Full Report

Technical Supplement

Family Leave Insurance Research


The U.S. Department of Labor funded research into how a family leave insurance program could be best implemented in Hawaiʻi. The research found that family leave insurance is:


A family leave insurance program providing 16 weeks of wage replacement would cost around $58.00 per year per worker. That’s about $2.50 per paycheck.

Needed & Widely Supported

Virtually everyone will need this benefit at some point in their lives, yet many of Hawaiʻi’s workers do not have a single day of family leave, paid or unpaid.

Hawaiʻi’s workers need this benefit.

62% of workers polled had, at some point, wanted to take time off from work to care for a new child or an ailing family member Hawaiʻi’s workers support family leave insurance.

94% of workers polled had a “very favorable” or “somewhat favorable” perception of family leave insurance

Good for Businesses

Under California’s family leave insurance law—which took effect in 2004—the majority of employers in the state of reported either a positive or null effect on employee productivity, profitability, and performance. 

Summary Report

Full Report

Children's Oral Health Research


The DOH’s Hawaiʻi Smiles statewide third-grade screening project was conducted two years ago. It found that:

  • 71% have tooth decay, which is higher than the national average of 52%
  • 22% have untreated tooth decay, indicating they are not receiving dental care
  • about 7% are in need of urgent dental care because of pain or infection
  • there are significant oral health disparities by income as well as by race/ethnicity