The percentage of births outside of marriage in Hawai'i continues to climb, due to changing social attitudes and other factors.

Unmarried mothers gave birth to 36.3 percent of the 17,882 babies born in the state last year, according to vital statistics for 2005 recently released by the state Department of Health.

That compares with 32.3 percent five years earlier and 30.3 percent a decade ago.

The increase is apparent across the state's four main ethnic groups, with nearly 58 percent of Hawaiian babies and 37 percent of Filipino babies born to single moms, and Caucasians and Japanese each at a little more than 18 percent.

The 2005 vital statistics report also put heart disease and cancer as the leading causes of death in Hawai'i and confirm the Islands' position as a top wedding location for nonresident couples.

The state numbers for out-of-wedlock births mirror a national trend. Government health officials reported last week that an all-time high of 37 percent of births in the United States were to unwed mothers. Experts say much of that is likely due to changing demographics and attitudes about marriage and parenthood.

More couples are living together without getting married. And just because a mother is not married doesn't mean the father isn't around or that the parents won't eventually wed, said Loretta Fuddy, chief of the DOH Family Health Services Division.

"You have community norms where it's not necessary to have marriage and as long as the male partner is involved that's fine. Many people will often delay marriage until the infant is 1 or 2 years of age," she said.

Teen moms are often associated with out-of-wedlock births, but the Hawai'i data show a decline in births to girls under the age of 18, and a higher percentage of births to older women, also following national trends.

In 1996, there were 660 babies born to girls under age 18, or 3.6 percent of total live births in the state. By 2000, the number of births to the youngest moms dropped to 560, or 3.2 percent of total births, and in 2005, there were 457 births to girls under the age of 18, or 2.7 percent of total births.

There also was a decrease over the past decade in the number and percentage of births to 18- and 19-year-old moms. During that period, the percentage of births to women age 40 to 44 increased from 2.6 percent to 3.5 percent, and to women 45 and older from 0.10 percent to 0.20 percent.

More women are putting college and career ahead of starting a family, waiting until they are older to have children, said Sylvia Yuen, director of the University of Hawai'i's Center for the Family. Also, fertility treatments and other medical advances allow women to have babies at a later age, she said.

The 2005 vital statistics reveal fewer teen pregnancies and abortions in Hawai'i. In 1996, 1,216 pregnancies were reported to girls under age 18, dropping to 941 in 2000 and 819 in 2005. Yuen said the decline could be due to the increasing availability of after-school activities such as sports that can help keep teenagers out of trouble, and the impact of birth control and abstinence education.

Although teen pregnancies are down in Hawai'i, Yuen said the issue should remain a high priority for social and healthcare interests, especially since younger mothers also tend to be unmarried.

"More often than not when the moms are unmarried, they tend to be younger, and if they tend to be very young they may not have fully matured to the point where they have skills enough to care for a young child," she said.

Young mothers also are more likely not to finish their high school education or continue on to college, thereby limiting their opportunities for earning a living wage, Yuen said. "You have to be concerned because of what it means not just for the girls but for their kids. It's long term; it doesn't end with the pregnancy, so what kind of chance does that child have in life?"

Teen moms also deserve special attention because the 2005 vital statistics show that 41 percent of mothers under age 18 did not get prenatal care during the first trimester of pregnancy, highest of any age group. Health officials say the first three months of pregnancy are a crucial time to assess and intervene in risk factors such as smoking, alcohol or drug use, and to detect diabetes and other conditions that can affect fetal health.

Younger adults may not realize they have high blood pressure or adult-onset diabetes, said Connie Brunn, director of program services for the March of Dimes in Hawai'i. "In case there's a problem it can be picked up early," she said. "If there's uncontrolled diabetes during pregnancy, it can cause very nasty birth defects."

The Neighbor Islands report a much higher percentage of single-mom births than O'ahu, where 32 percent of babies were born out-of-wedlock in 2005. On Maui, the number was 43 percent of total births; on Kaua'i, 47 percent; and the Big Island, 51 percent.

Fuddy said transportation and availability of services are big issues on the Neighbor Islands that keeps some females from getting birth control counseling or proper prenatal care. The same issues impact teen pregnancies in rural and largely Hawaiian communities, since there may be less access to health services and fewer extracurricular programs and jobs.

Sixty-two percent of the girls under age 18 who had babies last year were Hawaiian, followed by Filipinos at 14 percent, Caucasians at 6 percent and Japanese at 3 percent.

But Hawaiians also had a lower abortion rate than other ethnic groups, the 2005 vital statistics show.

Poverty could be one reason Hawaiians have higher percentages of unmarried and teen mothers, and Yuen said that, in general, there is less shame surrounding teen moms and out-of-wedlock births in Polynesian families, and more extended and hanai family members available and willing to help raise children.

Shawn Kanai'aupuni of Kamehameha Schools' Policy Analysis & System Evaluation office agrees that the importance of 'ohana as a Hawaiian cultural value is a possible explanation for why Hawaiians across most age groups are having far more babies than other ethnic groups in the state.

Although Hawaiians represent roughly 20 percent of the state's population of 1.27 million, 38 percent of the babies born to Hawai'i residents last year were Hawaiian. By comparison, 16.5 percent were Caucasian, 15.5 percent were Filipino, 10 percent Japanese, 3 percent Chinese, and 17 percent were other ethnic groups.

"Children are key to 'ohana and treasured, as many 'olelo noe'au (Hawaiian proverbs) attest. And, because 'ohana extends beyond immediate blood relations, family support systems many times can assist with the care and rearing of children," Kanai'aupuni said.

The vital statistics also report that Hawai'i residents underwent 3,524 abortions in 2005, down from 3,901 in 2000 and 4,871 in 1996.

The report says that 8,894 more residents were born than died in 2005. But because of the high number of people who flee to the Mainland annually to escape Hawai'i's high cost of living, the state's population has seen only slight growth in recent years.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.