IntroductionFood and housing insecurity are social determinants of health related to chronic disease, including diabetes, cardiovascular disease (CVD), and asthma. How these insecurities affect chronic disease among the 3 largest racial groups in Hawaiʻi is unknown. The purpose of this study was to examine chronic disease by housing and food insecurity among whites, Asians, and Native Hawaiian/other Pacific Islanders (NHOPIs) in Hawaiʻi.MethodsWe pooled data on 9,907 respondents from the 2009 and 2012 Behavioral Risk Factor Surveillance System. Dependent variables were diabetes, CVD, and asthma. Independent variables were housing and food insecurity. Logistic regression models were stratified by race to examine within-group differences by severity of insecurity.ResultsCompared with housing secure respondents, housing insecure NHOPIs had higher adjusted odds of diabetes (odds ratio [OR] = 1.85; 95% confidence interval [CI], 1.13–3.01) and CVD (OR = 1.85; 95% CI, 1.04–3.28), and housing insecure whites (OR = 1.52; 95% CI, 1.12–2.04) and Asians (OR = 1.93; 95% CI, 1.29–2.88) had higher adjusted odds of asthma. Compared with food secure participants, food insecure NHOPIs had higher adjusted odds of diabetes (OR = 2.17; 95% CI, 1.28–3.68); food insecure whites (OR = 1.88; 95% CI, 1.16–3.05) and NHOPIs (OR = 2.04; 95% CI, 1.10–3.78) had higher adjusted odds of CVD, and food insecure whites (OR = 1.53; 95% CI, 1.06–2.22) and Asians (OR = 1.79; 95% CI, 1.05–3.06) had higher adjusted odds of asthma.ConclusionHousing and food insecurity are associated with higher rates of chronic diseases among some races in Hawaiʻi. Policy makers should work to increase affordable housing and improve policies to increase food affordability.

This study underscores the importance of disaggregating analyses by sexual identity in studies that examine weight-chronic disease associations.

What is already known on this topic? Self-measured blood pressure monitoring programs (BPMPs) are effective in helping people with hypertension control their blood pressure. What is added by this report?This article explores the experiences of 5 Hawaiʻi-based Federally Qualified Health Centers (FQHCs) in implementing self-measured BPMPs. Because no nationally recognized self-measured BPMP curriculum existed at the time of this evaluation, the purpose of this article was to understand how FQHCs designed and implemented self-measured BPMPs in practice.What are the implications for public health practice? Policy makers, funding organizations, and intervention designers can draw on these experiences to make improvements to self-measured BPMPs in terms of support and toward the development of a standardized intervention curriculum.