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DEMOGRAPHICS - Births in Hawai'i
County  |  Age Group  |  Ethnicity  |  Population Type
Fertility plays an important role in shaping the demographic makeup of a population. It is one of the three demographic processes, along with migration and mortality, that determine the size and composition of a health care market or service area. Birth rate is one measure of fertility. In the health status and health resource utilization chapters of Health Trends, other aspects of fertility are addressed.

Louis Pol and Richard Thomas describe the importance of understanding fertility and its relationship to health status:

    "The relationship between fertility and health status suggests that the healthiest segments of the population are not the most prolific (the most fertile).... Those who are in the best health are likely to be those who are best educated, most affluent and most knowledgeable about contraception. [It has been observed nationally that those] groups with high fertility rates generally suffer disadvantages that have either a direct or indirect impact on the health of mother and child.... In general, these high-fertility populations suffer from high rates of infant mortality, maternal mortality, birth complications, low-birth-weight babies, birth defects, and mental retardation.... This results in the creation of large numbers of individuals whose health is impaired from before birth and many of whom are never given the opportunity to improve."1
Decreasing Birth Rate: Since 1980, annual births have ranged from a high of 20,438 in 1990 to a low of 17,032 in 1999. Hawai'i's birth rate declined significantly between 1980 and 2011, from 18.8 births to 13.7 births per 1,000 population, a decrease of 21.9 percent. This decline is due in part to the aging of the population, preference for fewer children, and increasing delays in child bearing.

Hawai`i vs. United States Birth Rate: In 1997, Hawai'i's birth rate, which had been higher than the national rate, converged with the U.S. birth rate at 14.3 births per 1,000 population. Overall, birth rates in both Hawai'i and the nation declined during the 1990's. In recent years the birth rate has leveled off, fluctuating between 12.7 and 14.5 births per 1,000 population, with Hawaii's rate remaining slightly above the U.S.

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> Birth Rate, Hawai`i vs. U.S.
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Source: Hawai`i State Department of Health, Office of Health Status Monitoring, Vital Statistics Records.; Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics Reports.; U.S. Census Bureau, Population Division.
Note: Rates are crude per 1,000 population.