What it Takes to Age in Place in Hawaiʻi: The Income Older Adults Need to Meet Basic Needs
by James Mak, UHERO, October 7, 2026
Hawaiʻi’s population is aging rapidly. In 2024, there were 310,324 adults age 65 and over living in Hawaiʻi, making up 21.5% of the State’s population.[1] A decade ago, it was only 16.2%. By 2035, one in four people in Hawaiʻi is expected to be age 65 and over.[2] The first of the baby boomers—born between 1946 and 1964—are turning 80 this year. Fifteen years from now one in four people age 65 and over in Hawaiʻi will be 85 or over.[3] These “oldest old” will no longer work and, thus, will have lower incomes but will face potentially large expenses for health care. For many older adults the pressing question is: How much income will be required for them to live independently?
The Elder Index for Hawaiʻi
The Gerontology Institute at the University of Massachusetts Boston recently released its 2025 Elder Economic Security Standard Index (Elder Index).[4] The Elder Index estimates the minimum amount of income required to afford basic necessities among households that include one or two adults age 65 or older living independently without private and public subsidies. For each household, the Index’s hypothetical “bare-bones” budget includes outlays for housing, health care[5], transportation, food, and miscellaneous essentials, but doesn’t include eating out, taking vacations, savings, gifts, or entertainment. Housing outlays include property taxes, insurance, fuels and utilities, condo fees and mortgage payments (interest + principal), if any.[6] Repaying principal on a mortgage builds home equity, so part of this outlay is saving. Outlays exclude the implicit cost of home equity, which would be the main housing cost for those who own outright or only have a few years left on a mortgage, and can be large given Hawaiʻi home values. The budget is specific to household size (single or couple, both 65 or older), location (county, metropolitan area, and state), health status (excellent, good, poor), and housing tenure (rent vs own; own with or without a mortgage). (During 2015-2019, about 30% of households in Hawaiʻi were headed by an adult 65 and over. Among them, 35.2% owned their home with a mortgage, 41.1% owned without a mortgage and 20.9% rented.)[7]
The Elder Index helps to answer important questions about how affordability varies across states and localities among the elderly depending on whether one is living with a spouse or alone, health status, and renting or living in one’s own home. It is an easy tool to use. However, because its estimates rely on a lot of simplifying assumptions some sacrifice in precision may be required.
In this essay I employ the Elder Index to estimate the basic budgets for selected elderly households in Hawaiʻi and the incomes they need to afford those budgets.
Table 1 compares Elder Index budgets for Hawaiʻi and for the U.S. (the national average).[8]
The U.S. Bureau of Economic Analysis (BEA) publishes annual data on differences in price levels across states. In 2024, Hawaiʻi had the second highest overall prices in the nation (after California).[9] So it is not surprising that Hawaiʻi’s Elder Index values, displayed in Table 1, would be higher than the national averages. In other words, Hawaiʻi households require more income than U.S. households to purchase basic necessities.
Table 1 shows that for owners (couples and singles) who still have a mortgage, their Elder Index values are, respectively, 22% and 27% above the national averages. For couples and singles who rent, their Index values are 17% and 21% above the national averages. But for those homeowners who have paid off their mortgage, their Index values are barely higher than national averages ($3,346 per month vs. $3,244 per month for couples and $2,197 vs $2,162 for singles).[10] This shows that Hawaiʻi’s higher monthly budgets are largely driven by its higher outlays for housing. For renters and owners still carrying a mortgage, the difference in the budgets for housing between Hawaiʻi and the U.S. accounts for 80% to over 90% of the difference in their Elder Index values. Housing is the largest household outlay for every elder household in Hawaiʻi, except for couples who have already paid off their home mortgage; for homeowners without a mortgage, health care is the largest monthly expense. Health care is the second largest expense for renters and owners who still have a mortgage.
Health status matters when it comes to the cost of health care. In Table 1 adults are assumed to be in good health. Consider an elder couple who are renters and in poor health, their monthly health care expenses would rise by 31.4% to $1,374; and the couple with excellent health would see their health care expenses fall by 17.2% to $866.[11]
Trends in Hawaiʻi’s Elder Index
Have the required incomes to pay for basic necessities increased over time for Hawaiʻi’s elderly population? Yes, but not after adjustment for inflation. I examined historical data on the Elder Index values going back to 2016.[12] To illustrate, I focused only on singles and couples who were renters and in good health. In nominal dollars (i.e. not accounting for inflation), the Elder Index for singles rose from $2,513 per month in 2016 to $3,436 per month in 2025; but after adjusting for inflation, the Index rose from $3,305 to $3,436 (in 2025 dollars.)[13] The average annual percentage increase was only three-tenths of one percent.[14] For couples, the Elder Index rose from $3,437 per month (nominal dollars) in 2016 to $4,585 per month in 2025. Adjusting for inflation, the Index rose from $4,521 per month to $4,585 per month in 2025, with an average annual percentage increase of less than two-tenth (.0017) of one percent. Overall, basic necessities for these elderly renters increased roughly in tandem with inflation over this 10 year period. Elderly households whose incomes could not keep up with inflation might be challenged to make ends meet.
The Elder Index for the Counties
Tables 2 and 3 compare 2025 Elder Index budgets for each county in Hawaiʻi.
For each population group, Table 4 shows the most affordable and the least affordable county to live in. Among the four counties, Honolulu is the least affordable county while the Big Island (Hawaiʻi) and Kauaʻi share the distinction of being the most affordable, depending on housing tenure. Differences in affordability appear to be largely explained by differences in the cost of housing (Table 4, column 3 vs column 4).
Discussion and Conclusion
In recent years, concern over “affordability” has come to the forefront of public attention nation-wide. According to UHERO’s Steven Bond-Smith “Hawaiʻi residents face a unique mix of high prices and low incomes.”[15] He notes that in 23 of the past 25 years, more Hawaiʻi residents have moved to other states than new arrivals have moved to Hawaiʻi. And it’s the young, working age people who are leaving the islands.[16] Lawmakers in Hawaiʻi have recognized the problem of affordability for quite some time. Hawaiʻi Revised Statutes 201-3(5) requires the State Department of Business, Economic Development and Tourism (DBEDT) to produce a report (beginning in 2009) on the Self-Sufficiency Income Standard (SSIS) for Hawaiʻi every two years.[17] Like the Elder Index, the SSIS “measures the income needed for families to meet basic needs without subsidies.” The latest SSIS report, released in December 2025, compares 2024 SSIS values among the counties.[18] The report finds that Kauaʻi is the least affordable county, while Hawaiʻi County is the most affordable. The report concludes that “there is urgent need for targeted policy intervention.”
The SSIS and the Elder Index are not strictly comparable for several reasons. Most importantly, the SSIS focuses on hypothetical families of different size (with or without preschool or school-age children) while the Elder Index focuses narrowly on elderly households with every member age 65 and over. Adults in SSIS work and have incomes, and, thus, must pay taxes which are included in their family budgets. And families with children have childcare expenses; among all households they face the greatest affordability challenges. Finally, outlay for housing is measured differently in the two indices.[19]
For this essay, I employed the Elder Index to estimate the minimum household incomes required to afford basic necessities in households that include one or two adults age 65 or older living independently without subsidies. Even on subsistence budgets, the estimates show that Hawaiʻi’s older adults require higher incomes to afford basic necessities. Estimates further show that Honolulu is the least affordable county for older adults, followed by Maui County, while Hawaiʻi and Kauaʻi counties are generally more affordable. The higher income requirement in Hawaiʻi (relative to the U.S.) and in Honolulu county (relative to the Neighbor Island counties) is driven largely by the higher outlay for housing.
Housing affordability is a big problem confronting all Hawaiʻi residents, not just the elderly. UHERO’s Byron Gangnes notes that in 2024 the median home price in Honolulu was double the affordable price.[20] The U.S. Bureau of Economic Analysis (BEA) estimates that in 2024 average rent in Hawaiʻi was 25% higher than the national average.[21] Without offering specific solutions, Gangnes argues that measures will likely be needed on both the demand (e.g. subsidies to homebuyers) and supply side (e.g. incentives to build affordable housing). Focusing more attention on developing more housing would benefit everyone in Hawaiʻi, and not just the elderly population.
It is important to note that while much of this essay is about housing affordability, the affordability of health care will become a much bigger issue moving forward as the share and number of Hawaiʻi’s 85+ population increase rapidly, even as Hawaiʻi’s “chronic” shortage of physicians is getting worse.[22] Not all elderly population 65 and over are alike. The “oldest olds” will have much higher health care requirements than seniors in their mid-60s and 70s. They will require greater community support.[23] Ignoring the rapid rise in future health care costs and accessibility would be a mistake. Managing health care costs and increasing accessibility would also benefit all Hawaiʻi residents, not just the elderly.
Finally, the Elder Index does not address the issue of long term care for the elderly.
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LINK: FOOTNOTES