Hawaii’s aging wave tests the state’s elder-care capacity

Hawaii, despite having the longest life expectancy in the U.S., is confronting a fast‑growing elderly population that outpaces geriatric care, with shortages across the workforce and long appointment waits. Geriatric specialists are concentrated on Oahu, while islands like Hawaii, Kauai, and Maui have few or none, forcing primary care doctors to shoulder complex elder care. Efforts like JABSOM’s geriatric fellowship and loan-repayment programs aim to expand capacity, but systemic funding, reimbursement, and care-coordination barriers remain, especially as dementia cases rise and care becomes more time-intensive but less well reimbursed.