title: Development and health in the Pacific: which way to die?
abstract: Development in the Pacific has largely ignored the importance of health as a pathway and an outcome. This paper reviews the effects of development on health and health services in the region. It aims to highlight the plight of development that happens without considering the sociocultural and physical environments of the small island countries. The review shows that health and social conditions in the Pacific are deteriorating. The process of development has been externally controlled without community participation. Pacific leaders have been preoccupied with economic development and have not been cognisant of health and social consequences. During progress an enjoyable life can be achieved through sustainable development with community participation. However, indicators of economic growth in the Pacific do not correlate with those of health. The increase of rape, suicide, drug abuse, sexual promiscuity and crime suggests that Pacific islanders are increasingly disillusioned by the present developmental approach: they have ceased to enjoy life before death. It is suggested that decentralized development planning with community involvement, integrating health and social considerations, would be the way out of this dilemma.
authors.affiliation: Pacific Basin Medical Officer Training Program, Pohnpei, Federated States of Micronesia.
authors.forename: S A
authors.initials: SA
authors.lastname: Finau
mesh_terms: D001294:Attitude to Health; D003153:Community Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003466:Cultural Characteristics; D003906:Developing Countries; D004782:Environmental Health; D006304:Health Status; D006801:Humans; D008019:Life Style; D010139:Pacific Islands