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Pacific Territories, Commonwealth, and Freely Associated States

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The United States has special relationships with six areas in the Pacific. The total population of these jurisdictions is approximately 480,000 people, spread across the ocean covering an area larger than the continental United States.

All of the U.S.-affiliated Pacific jurisdictions share some challenges related to health care. Similar to many other rural areas, they struggle with maintaining an adequate health workforce. They also face difficulties in financing health care, and some spend a large portion of their health care budgets transporting patients off-island to receive care that is not available locally. The jurisdictions must address both the health concerns of developing nations in treating malnutrition and infectious diseases such as tuberculosis, as well as the chronic health problems faced by developed nations, such as diabetes and cancer.

Three of these jurisdictions, one commonwealth and two territories, are part of the United States:

Residents of these 3 jurisdictions tend to have better health and socio-economic status than those living in the 3 jurisdictions that are not part of the U.S.

The other three jurisdictions are independent nations that have special relationships with the U.S. through individual agreements, the Compact of Free Association. These countries were formerly part of the UN Trust Territory of the Pacific Islands, administered by the United States. The original Compacts have been amended over time and are now Amended Compacts of Free Association. These locations are sovereign states:

The United States provides assistance to these nations for health services through the Compacts and also through discretionary grants from the U.S. Department of Health and Human Services.

Data Sources
Pacific Partnerships for Health: Charting a New Course; U.S. Affiliated Pacific Basin Jurisdictions: Legal, Geographic and Demographic Information

Contacts

CAPT Cathy Wasem, RN  MN
US Public Health Service
Senior Public Health Advisor
Office of Pacific Health
Office of the Regional Health Administrator, HHS Region IX
Phone: 808.541.2015
Email: cathy.wasem@HHS.gov

CAPT John Walmsley
Senior Health Advisor
Office of Pacific Health
Office of the Regional Health Administrator
US DHHS/OASH Region IX
90 7th St., Suite 5-100
San Francisco, CA 94103
Phone: 415.437.8114
Fax:  415.437.8004
Email: john.walmsley@hhs.gov

CAPT Nadine Simons, Regional Health Administrator
Region IX Contact
U.S. Department of Health and Human Services
San Francisco Federal Building
90 7th Street, Suite 5-100
San Francisco, CA 94103
Phone: 415.437.8102
Fax: 415.437.8004
Email: nadine.simons@hhs.gov

Organizations

Administration for Children and Families: Region 9 (ACF)
Federal government
Dedicated to promoting and enhancing the economic independence and social well-being of children, families, individuals, and communities. ACF Region 9 serves Arizona, California, Hawaii, Nevada, American Samoa, the Federated States of Micronesia, Guam, the Marshall Islands, Republic of Palau, and the Commonwealth of the Northern Mariana Islands.

Asian & Pacific Islander American Health Forum (APIAHF)
National organization
Influences policy, mobilizes communities, and strengthens programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders living in the United States and its jurisdictions.

Association of Asian Pacific Community Health Organizations (AAPCHO)
National organization
A membership organization comprised of community health clinics that promotes advocacy, collaboration, and leadership to help improve the health status and access of AA (Asian American) and NHOPIs (Native Hawaiian and Other Pacific Islanders) within the United States, its territories, and freely associated states.

Hawaii and Pacific Basin Area Health Education Centers (AHECs)
State/regional organization
Works to improve the health of the underserved in Hawaii and the Pacific Basin through training and supporting health professions students and health care providers to serve rural and underserved areas.

National Asian Pacific American Families Against Substance Abuse (NAPAFASA)
State/regional organization
Dedicated to addressing the alcohol, tobacco, and other drug issues of Asian American and Pacific Islander (AAPI) populations on the continental U.S., Hawaii, and the six Pacific Island jurisdictions.

National Council of Asian Pacific Islander Physicians (NCAPIP)
National organization
Serves as the voice of Asian American (AA) and Native Hawaiian & Pacific Islander (NHPI) health professionals in advancing the health and well being of these populations and communities.

National Network of Libraries of Medicine, Pacific Southwest Region (NN/LM-PSR)
State/regional organization
Supports collaboration among libraries and information centers that serve health information needs in Arizona, California, Hawaii, Nevada, and the U.S. Territories in the Pacific Basin.

Pacific AIDS Education and Training Center (PAETC)
State/regional organization
Provides AIDS-related training, education and information services to health care providers. Serves California, Arizona, Nevada, Hawaii and the six U.S.-affiliated Pacific Jurisdictions.

Pacific Basin Dental Association (PBDA)
International organization
Promotes good oral health in the Pacific Basin, facilitates improvements in oral health services, carries out continuing education, improves networking among dental professionals, and strengthens surveillance.

Pacific Basin Telehealth Resource Center
State/regional organization
One of the telehealth resource centers funded by the federal Office for the Advancement of Telehealth. Assists health care organizations, health care networks, and health care providers in the implementation of cost-effective telehealth programs to serve rural and medically underserved areas and populations. Includes Hawaii and the Pacific Basin.

Pacific Island Health Officers Association (PIHOA)
International organization
Serves as a unifying voice and credible authority on issues of regional public health significance in the Pacific. Represents the collective health interests of Guam, the Commonwealth of the Northern Mariana Islands (CNMI), American Samoa, the Federated States of Micronesia (FSM), the Republic of the Marshall Islands (RMI), and the Republic of Palau.

Secretariat of the Pacific Community (SPC)
International organization
Works to create a secure and prosperous Pacific Community, whose people are healthy and manage their resources in an economically, environmentally and socially sustainable way.

U.S. Department of the Interior: Office of Insular Affairs (OIA)
Federal government
Coordinates federal policy in the territories of American Samoa, Guam, the U.S. Virgin Islands, and the Commonwealth of the Northern Mariana Islands. Administers and oversees U.S. federal assistance provided to the Freely Associated States of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau under the Compacts of Free Association.

World Health Organization Western Pacific Regional Office (WHO WPRO)
International organization
Works together with partners from all sectors of society for public health activities, including: research, data banking, evaluation, awareness raising, and resource mobilization.

Tools

Asian and Pacific Islander Technical Assistance Project
Technical assistance
Designed to increase opportunities for Asian and Pacific Islanders (API) to alleviate alcohol and other drug related problems in their families and communities through technical assistance.
Sponsoring organization: National Asian Pacific American Families Against Substance Abuse

Asian/Pacific Islanders and Cardiovascular Diseases: Statistical Fact Sheet
Website
Outlines the leading causes of death among Asian/Pacific Islander men and women.
Sponsoring organization: American Heart Association

FastStats A to Z: Health of Asian or Pacific Islander Population
Website
Offers links to various health data involving the Asian and Pacific Islander Population. Statistics include topics of births, deaths, health status, and access to health care.
Sponsoring organization: National Center for Health Statistics

MedlinePlus: Asian-American Health
Website
Lists resources available from different sponsors providing health-related information pertaining to Asian & Pacific Islander populations. Includes links to statistics, demographics, research, and organizations. Resources are freely available with the exception of Medline Plus journal articles.
Sponsoring organization: National Library of Medicine

NN/LM Pacific Southwest Region: Regional Information for the U. S. Territories in the Pacific
Website
Overview of the region, with links to state and regional agencies, health associations, and other resources for the U.S. Associated Pacific Islands including American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Federated States of Micronesia (FSM), Guam, Republic of the Marshall Islands (RMI), and Republic of Palau (Palau).
Sponsoring organization: National Network of Libraries of Medicine, Pacific Southwest Region

Office of Minority Health & Health Disparities (OMHD): Native Hawaiian & Other Pacific Islander (NHOPI) Populations
Website
Provides information on health issues of Native Hawaiian and Other Pacific Islanders (NHOPIs), including peoples of Hawaii, Guam, Samoa, and other Pacific Islands.
Sponsoring organization: Centers for Disease Control and Prevention

Pacific Open Learning Health Net (POLHN)
Website
Seeks to improve the quality and standards of practice of health professionals by providing online and hybrid courses, plus course materials and health information to health professionals in the Pacific Island countries. Supported countries include but are not limited to: Palau, Micronesia, Marshall Islands, and Samoa. Distributes digital and print products to learning centers located in hospitals, community health centers, and nursing schools throughout the region.
Sponsoring organization: World Health Organization Western Pacific Regional Office

Provider's Guide to Quality & Culture: Pacific Islanders
Website
Designed to help health care professionals better understand and more effectively respond to the growing needs of Pacific Islanders in the United States. Includes resources on cultural competency, challenges to health and well-being, and the population's strengths and protective factors.
Sponsoring organization: U.S. Department of Health and Human Services

Rural Utilities Service Implementation of the SUTA Initiative
Website
Describes and offers additional links to information on the Substantially Underserved Trust Area (SUTA) provisions of the Food, Conservation & Energy Act of 2008 (2008 Farm Bill), which works to assist tribes in meeting their unique utility infrastructure needs and improve economic development and quality of life.
Sponsoring organization: USDA Rural Development

State Data Center (SCD) Program
Website
Official sources of state-level demographic, economic, and social statistics produced by the U.S. Census Bureau. Includes links to the data center in each state and U.S. Commonwealth and Territory.
Sponsoring organization: U.S. Census Bureau

State Offices of Minority and Multicultural Health Liaison Map
Website
Provides contact information for state offices of minority and multicultural health through an interactive map. Includes information for the U.S. Commonwealths and Territories.
Sponsoring organization: HHS Office of Minority Health

Territorial & Jurisdiction Oral Health Programs
Website
Provides information on oral health programs in the U.S. territories and jurisdictions of the Atlantic and Pacific.
Sponsoring organization: Association of State and Territorial Dental Directors

Title V Information System
Website
Provides access to data and reports from the 59 States and Jurisdictions that receive Title V Block Grant funds from the Maternal and Child Health Bureau.
Sponsoring organization: Maternal and Child Health

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this state that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Documents, Reports and Other Publications

Compacts of Free Association: Improvements Needed to Assess and Address Growing Migration
Sponsoring organization: Government Accountability Office
Describes compact migration, reviews enumeration approaches, evaluates impact reporting, and reviews Interior grants related to the impact on compacts with the freely associated states, the U.S. territories, and Hawaii.
Date: 11 / 2011

Health Coverage and Access to Care Among Asian Americans, Native Hawaiians and Pacific Islanders
Sponsoring organization: Kaiser Family Foundation
Examines the health coverage, access to health care, and health status of Asian American, Native Hawaiian and Pacific Islander ethnic groups in the United States, and finds that certain subgroups are doing worse than others in terms of health insurance coverage and access to health care.
Date: 04 / 2008

Maternal and Child Health of Asian Americans, Native Hawaiians, and Pacific Islanders
Sponsoring organization: Asian & Pacific Islander American Health Forum
Describes indicators of maternal and child health, including prenatal care, low birth weight, and infant mortality, within AA and NHPI (Asian American, Native Hawaiian, and Pacific Islander) populations in the United States and Pacific Islands.
Date: 05 / 2012

Native Hawaiian and Pacific Islander Health Disparities
Author(s): Wom Kim Cook, Corina Chung, Taunu'u Ve'e
Sponsoring organization: Asian & Pacific Islander American Health Forum
Provides an overview of NHPA (Native Hawaiian and Pacific Islander) health in the United States. Where possible, this health brief also includes data on the health status of NHPAs living in the USAPI (U.S.-Affiliated Pacific Islands.)
Date: 08 / 2010

Pacific Partners for Tobacco-Free Islands: Weaving Together Our Resources and Cultures to Address Tobacco Use
Sponsoring organization: Legacy
Promotes enhanced knowledge or awareness among tobacco control experts and practitioners in the United States about unique cultural and socioeconomic aspects of tobacco control in various USAPI (U.S. Associated Pacific Islands) jurisdictions.
Date: 05 / 2012

Pacific Partnerships for Health: Charting a New Course
Sponsoring organization: Institute of Medicine
Provides an overview of health care services in the U.S.-Associated Pacific Basin and discusses the U.S. role in the region's health care delivery systems.
Date: 1998

Puerto Rico and the U.S. Island Areas
Sponsoring organization: U.S. Census Bureau
Provides a brief history of Puerto Rico and the U.S. Island Areas, including: American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands. Presents demographic, economic, and educational data gathered between 2007 and 2010.
Date: 2012

U.S. Affiliated Pacific Basin Jurisdictions: Legal, Geographic and Demographic Information
Author(s): Cathy Wasem
Provides an overview of the geography, population, and relationship to the U.S. for the six Pacific jurisdictions: American Samoa, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, Guam, the Republic of Palau, and the Republic of the Marshall Islands.
Date: 2004

Youth Risk Behavior Surveillance: Pacific Island United States Territories, 2007
Author(s): Jaclynn Lippe, Nancy Brener, Laura Kann. et al.
Sponsoring organization: Centers for Disease Control and Prevention
Summarizes results from surveys of students in grades 9-12 conducted in five territories: American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Republic of the Marshall Islands, and Republic of Palau, during January-June 2007.
Date: 11 / 2008

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Page last updated 3/12/2013
Page last reviewed 5/24/2013

 

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