U.S. Associated Pacific Islands Health Care Teams Chart the Course

U.S. Associated Pacific Islands Health Care Teams Chart the Course for 
Non-Communicable Disease Prevention and Management


CONTACT: Paige Rohe,  prohe@chronicdisease.org, 470-809-0589

ATLANTA, July 14, 2017—Work to turn back the rising threat posed by non-communicable (NCD) diseases, particularly diabetes and cardiovascular disease, continues to build momentum in the US Associated Pacific Islands (USAPI). Since 2009, the Pacific Chronic Disease Council, a council of the National Association of Chronic Disease Directors (NACDD), has provided leadership in the development of a Pacific NCD Collaborative Initiative, proactively targeting healthcare system transformations and expanding population outreach in the region, which spans twice the geographic area of the continental U.S., and has a population of approximately half a million people.

The Pacific NCD Collaborative is supported by the Centers for Disease Control and Prevention’s (CDC’s) Division of Diabetes Translation. It engages local health professional trainers and multidisciplinary teams from the region’s health systems in specialized learning sessions held at 6 to 8 month intervals. These learning sessions offer peer-to-peer dialogue and support to adapt the Chronic Care Model, an evidence-based approach that targets healthcare system improvements, uses information technology, adopts disease management best practices, supports diabetes self-management, and aligns community resources in the region. The Collaborative grounds diabetes preventive care best practices into the core of its work and is striving to sustain gains securely into the future.

In June 2017, the Republic of the Marshall Islands co-hosted the biannual Pacific NCD Collaborative learning session with the Pacific Chronic Disease Council to advance improvements in health outcomes across the USAPI. 

“NCD death rates continue to rise among the Pacific people along with increasing numbers of diabetes-related complications such as amputations and kidney failure,” stated Honorable Kalani Kaneko, minister of health for the Republic of the Marshall Islands. “We must find ways to bend the curve and decrease the numbers. I commend the NCD Collaborative, as it helps us share lessons learned and strengthen action with government ministries, healthcare systems, and community-based partners across the region.”

Some examples from the 11 Pacific NCD Collaborative Initiative teams’ efforts reported during the June 2017 learning session (across an 18-month period – November 2015 to April 2017), include:

  • A median drop of A1c of almost 1 percent (0.9 percent) in Majuro, Republic of the Marshall Islands, and in the Republic of Palau (0.7 percent). Studies have confirmed that each percentage point drop in A1c lowers the risk of diabetes related microvascular complications by about 40 percent.
  • Clinical performance measures improved in several Pacific NCD Collaborative sites. These included: blood pressure control (Federated States of Micronesia [FSM], Kosrae and Pohnpei; and the Republic of Palau), regular foot exams (Majuro, RMI and Kosrae, FSM), and documented diabetes self-management goal setting (Kosrae, FSM and Republic of Palau).
  • An increase in the number of patients with diabetes whose information is entered into the Chronic Disease Electronic Management System (CDEMS), a computerized patient registry and database that allows individual patient and physician tracking of preventive care practices, benchmarking, and population management across the majority of the participating teams.
  • CDEMS adaptations to accommodate unique data collection and patient management needs in USAPI health systems. These included: standardization of data run charts to show trends in diabetes clinical outcomes and addition of data entry fields for tracking complex medical concerns (i.e., use of betel nut with tobacco, combined infectious and chronic illnesses such as tuberculosis and diabetes, and population health screening and tracking).
  • Expansion of culturally-relevant education materials and resources to help inform and activate individuals living with diabetes and their families.

About Non-Communicable Diseases in the U.S. Associated Pacific Islands

The USAPI includes: the flag territories of American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands; the freely associated jurisdictions of the Federated States of Micronesia; the Republic of Palau; and the Republic of the Marshall Islands.

In 2015, eight of the 10 countries identified as having the world’s highest diabetes prevalence rates were from the Pacific region. By 2030, the Western Pacific Region will have the largest number of people with diabetes, some 113 million, representing an almost 50% increase from 2010. Non-communicable diseases, particularly heart disease, cancers, lung disease, and diabetes, account for up to 75% of recorded deaths in the Pacific.

In 2010, the Pacific Islands Health Officers Association (PIHOA) issued a resolution declaring a state of emergency due to the epidemic of NCDs, encouraging collaboration to combat the burden of these health conditions in the region.

“PCDC is taking action in regards to this declaration,” stated Mr. Patrick Luces, PCDC Chair, “the Pacific NCD Collaborative respects the unique USAPI cultures, decision making process, and evidence-based healthcare, while acknowledging the strengths, wisdom, and resources of the Pacific people.”

“In 2009, NACDD made a strong commitment to the PCDC to fight chronic diseases throughout the USAPI,” says John Robitscher, CEO of NACDD. “We are proud to be a part of the success achieved so far and are as committed as ever to finding solutions to reducing the non-communicable disease burden in the Pacific – whether that’s through helping to facilitate community-clinic linkages, addressing environmental factors, or supporting transformation of health care systems,” he said.

Progress against reducing the burden of NCDs in the USAPI communities is made possible through the valuable support of PCDC’s various partners, including PIHOA, Pacific Basin Medical Association, West Virginia University’s Office of Health Services Research, and the Centers for Disease Control and Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation.


The National Association of Chronic Disease Directors
Promoting Health. Preventing Disease.

The National Association of Chronic Disease Directors (NACDD) and its more than 6,500 members seek to strengthen state-based leadership and expertise for chronic disease prevention and control in states and nationally. Established in 1988, in partnership with the U.S. Centers for Disease Control and Prevention, NACDD is the only membership association of its kind to serve and represent every chronic disease division in all states and U.S. territories. For more information, visit chronicdisease.org.


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