Promoting A Healthier Hawaii

Loretta Fuddy, director of the state Department of Health, works to improve the health and environment of the people of Hawaii

When Loretta Fuddy toasts to your good health, she means it more earnestly than anyone else in the state. Her accountability as a public official depends on it.

Fuddy, 65, is the director of the state Department of Health, an agency of 3,000 employees who administer the mission, policies and outcomes of our public health system. It seems inconceivable that government is entrusted with something as ethereal and personal as one’s health. Yet, it is central to the well-being of a society.

Put on that platform, it is worth a closer look at the government official who holds the reins and responsibilities for health policies in Hawaii. As access and affordability of health care become major issues in our lives, we want to ensure that our ranking public health official is purposefully directed.

The direction to public service started early in Fuddy’s life, as she was raised in Kaimuki and educated at Sacred Hearts Academy. Her parochial upbringing taught her to be an industrious, motivated and purpose-driven citizen.

“I’m a child of the ’60s, the Kennedy era of ‘ask what you can do for your country’ public service and Catholic values,” says Fuddy, known to her friends as “Deliana.”

“Once I started working in sociology, helping local families, children and special-needs individuals, the roots of public health were planted.”

Fuddy embellished her passion with degrees in social work and public health from the University of Hawaii. She also did doctoral studies at Johns Hopkins University. She served as deputy director of the state Department of Health from 2001 to 2002. She was appointed director in March 2011, culminating 38 years of experience in the fields of health and human services.

While her job affects many lives, the average citizen usually has only a cursory connection with her office. For many, life begins there.

The state Department of Health at 1250 Punchbowl St. in downtown Honolulu is where vital records, such as birth certificates and marriage licenses, are filed.

We officially become a state statistic when we pass through its portals – just ask Barack Obama. You can’t prove that you exist without paperwork from DOH.

But the mission of the department goes beyond that.

“The scope of the Department of Health is very large,” Fuddy says. “Our mission is to preserve and protect the health and environment of the people of Hawaii.

“Health is all-encompassing. It’s not just physical health. It’s the alignment of social, mental and spiritual well-being – body, mind, spirit – that allows citizens to be actively engaged in the community.”

It’s a perspective that doesn’t come from a trite mission statement.

Fuddy, you see, is the first social worker to be tapped for the director of health role. Past directors tended to have medical or public heath backgrounds. Her background and passion come from a premise that social determinants – conditions in which people are born, grow, live, work and age – drive sustainability. When Fuddy and her colleagues look at health policies and standards in our state, they screen them through a lens of social, environmental and behavioral impacts.

This has been the department’s mandate from the start. It’s not unique to her administration, but the complexity and dynamics of the health-delivery system never have been more robust. The players – citizens, medical practitioners, insurers and policy-makers – are engaged in a chess game of systemic survival as never before.

As health costs climb higher, we face the realities of an aging population and prevailing chronic health conditions such as cancer, diabetes and heart disease. Suddenly health care reform is the big elephant in the room. Hawaii’s health care costs exceed $8.8 billion, or more than 13 percent of the state’s economy in 2009.