Why is there so much difference in the health of residents in one county compared to other counties in the same state? In this report, the County Health Rankings & Roadmaps program explores how wide gaps are throughout Hawaii and what is driving those differences. This information can help Hawaii state leaders as they identify ways for everyone to have a fair chance to lead the healthiest life possible. Specifically, this document can help state leaders understand: 1. What health gaps are and why they matter 2. The size and nature of the health gaps among counties within Hawaii 3. What factors are influencing the health of residents, and 4. What state and local communities can do to address health gaps.