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Hawaii police officers killed at least 36 people between 1994 and 2013, most of those in Honolulu, according to data from the Hawaii Department of Health’s Injury and Prevention Control Section.

Cops also sent thousands more to local emergency rooms — sometimes with serious injuries — where treatment cost citizens and their insurance companies millions of dollars.

Yet, as debate rages across the country about police use of force, Hawaii citizens have been relatively silent on the issue.

Honolulu police cars in a line.

There have been few protests, and none anywhere near the scale of those in Ferguson, Missouri, Cleveland, Ohio and New York City over high profile police killings.

Much of the outrage has been limited to a small group of University of Hawaii faculty members, who are now calling for more accountability of law enforcement.

They are concerned about lethal use of force, officer misconduct and a recent FBI probe into Honolulu Police Chief Louis Kealoha and his department.

“You can safely say that Hawaii is nowhere near the gold standard when it comes to systems of oversight,” said Meda Chesney-Lind, a University of Hawaii criminologist. “We should be part of a national conversation about police accountability but we don’t see that.”

Death Numbers Understated

The numbers don’t give a complete picture of how many people were killed by officers in that 20-year span. For instance, the deaths of Stephen Dinnan and Aaron Torres are not included in the data.

Dinnan died  in 2013 when an unidentified Honolulu police officer put him in a chokehold and held him face-down on the ground. Torres was killed by Honolulu police in 2012, also while being held face-down in the dirt.

The Honolulu Police Department did not identify the officers who killed Torres, but the City Council did approve a $1.4 million settlement with his family.

All but one of the 36 people killed by police died from gunshots.

Data for 2014 was unavailable, although Honolulu police are known to have shot and killed at least two people.

The DOH numbers were compiled from death certificates and billing records from the Hawaii Health Information Corporation.

When compared to national statistics from the federal Centers for Disease Control and Prevention, DOH Epidemiologist Dan Galanis says Hawaii has a lower per capita officer-caused death rate than the rest of the U.S. — but not by much.

The “legal intervention” per capita mortality rate he calculated for the U.S. was 5.85 per 100,000 from 1999 to 2012. Hawaii’s is 4.00. That’s not “statistically significant,” Galanis said, and could be attributed to Hawaii’s low rate of gun violence.

He said the overall mortality rate from guns is three times lower in Hawaii than the rest of the country, and about five times lower than the rates in the top five states.

“We have strict gun control here and therefore pretty low rates of gun-related injuries,” Galanis said. “People are not having as many confrontations with the police with firearms or other lethal threatening means compared with other people in other states.”

The last Honolulu police officer to die in a violent was in 2003. Two HPD officers were gunned down in 1987, .

The Cost of Hospitalization

Hundreds of people each year are taken to the hospital after run-ins with Hawaii’s police, sometimes with serious enough injuries to be hospitalized for several days.

Between 2005 and 2013, the DOH reports that police and other security personnel sent at least 2,285 people to the emergency room. That’s about 253 per year, with almost all of those attributed to law enforcement. Again, most of those were in Honolulu.

Thirty-five people were hospitalized after encounters with the police, with the average stay lasting eight days. The most serious injuries were caused by firearms and officers striking individuals.

By far, striking incidents resulted in the most visits to the ER. Pepper spray, which is classified as poisoning, sent another 48 people to the hospital.

According to DOH, the estimated total cost of the hospital visits is more than $4.2 million, based on medical billing data. Each emergency room visit had an average cost of $1,140. Hospitalizations averaged more than $47,000.

Statistics on the number of people killed or injured by police in 2014 isn’t available yet. But Honolulu police officers shot and killed at least two people last year.