The culture, community, and science of type 2 diabetes prevention in the US Associated Pacific Islands.
BACKGROUND
The type 2 diabetes epidemic is a global health issue, particularly in the US Associated Pacific Islands (USAPI). Population health approaches targeting policy development and environmental transformations can help prevent or delay diabetes and related complications.


BACKGROUND
Since 1986, the Centers for Disease Control and Prevention, Division of Diabetes Translation has provided financial support to 6 USAPI jurisdictions for diabetes prevention and control programs. Geographic isolation, shortages of health care professionals, dependence on US and international aid, and persistent health care funding challenges are constant concerns in these jurisdictions.


METHODS
In September 2007, representatives from USAPI diabetes prevention and control programs, the Papa Ola Lökahi Pacific Diabetes Education Program, and the Division of Diabetes Translation met to collectively assess program goals within the Essential Public Health Services framework. Participants shared examples of integrated approaches to health promotion and diabetes prevention.


CONCLUSIONS
Despite persistent health care funding challenges, the assessment showed the resourcefulness of the islands' diabetes programs in leveraging resources, creating policy and environmental interventions, and strengthening connections in the traditional cultural systems.


CONCLUSIONS
Population health approaches used in island jurisdictions reflect the resilience of the islands' cultures in navigating between traditional and Western ways of life. Attention to the interface of cultural knowledge and Western science provides the USAPI diabetes prevention and control programs with opportunities to create strong, sustained partnerships with the shared vision of transforming social and environmental conditions so that they can support healthy people living in healthy island communities.
Hosey
Gwen
G
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, 4770 Buford Hwy, Mailstop K-10, Atlanta, GA 30341, USA. ghh0@cdc.gov
Aitaoto
Nia
N
Satterfield
Dawn
D
Kelly
Jane
J
Apaisam
Carter J
CJ
Belyeu-Camacho
Tayna
T
deBrum
Ione
I
Luces
Patrick Solidum
PS
Rengiil
Augusta
A
Turituri
Pasa
P
D002487:Centers for Disease Control and Prevention, U.S.; D003153:Community Health Services; D003256:Community Participation; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D010139:Pacific Islands; D014481:United States