State health officials this week released an ambitious strategic plan for reducing chronic conditions such as asthma, diabetes, obesity and heart disease, stressing that the COVID-19 pandemic had underscored the importance of improving the health of residents.

About 2 out of 3 Hawaii adults has one or more chronic conditions, according to health officials, making them particularly vulnerable if infected by the coronavirus. Researchers have found that nearly two-thirds of COVID hospitalizations in the U.S. were linked to obesity, diabetes, hypertension and heart failure.

The Healthy Hawaii Strategic Plan 2030 lays out specific targets that the state hopes to meet over the next decade for reducing diseases such as cancer and asthma, as well as boosting exercise levels and healthy eating. The plan, for example, aims to increase the percentage of high school teens who are getting at least an hour of aerobic exercise a day to 30.6% from 19.6%. The plan also lays out targets for specific ethnicities and population groups. For example, low-income and unemployed adults have struggled with high rates of smoking. By identifying groups that are at higher risks of certain conditions or behaviors, health officials hope to better target resources.

The plan, which state officials say was a collaboration among more than 200 stakeholders, including hospitals, health insurers, government agencies, urban planners and educators, among others, over two years seeks to go beyond the normal public health campaign and actually transform the environments where Hawaii residents live and work, changing what policymakers refer to as the “social determinants of health.”

“Where we live actually offers opportunities or challenges to living healthy, and so by coordinating this plan our goal is that we would provide equitable opportunities for living healthy wherever you live in Hawaii,” said Lola Irwin, administrator for the Department of Health’s chronic disease prevention and health promotion division.

To that end the plan lays out goals such as increasing sidewalks and bike lanes to boost exercise and making sure that parks and beaches are smoke-free and well maintained.

The plan also sets goals for workplaces, such as increasing the number of employers that allow time off for cancer screenings, making it easier for women to breastfeed at work and establishing statewide policies that help boost physical activity and healthy food options at government work sites.

“It’s a little aspirational, but at the same time it does have real goals and if you have political leaders, they can point to this and say, ‘Hey, we are not meeting our goals of becoming more healthy,’” said Mark Garrity, president of Urban Pacific Consulting, who assisted with the plan. “It gives political leaders a certain amount of backup and cover to be able to push for these things.”

The plan includes six different program areas: asthma, cancer, diabetes, heart disease and stroke, physical activity and nutrition, and tobacco use.