title: Ulithi Atoll health assessment: a peek at the health of rural Micronesia.
abstract: BACKGROUND
  The health challenges of Micronesians are generally well known. However most of the health-related data collection occurs in the population centers and relatively little is known about the health of the residents of Micronesia's rural outer islands. This is of particular concern in the Federated States of Micronesia (FSM) where a large portion of the population lives on the outer islands. To gain a better understanding of the health issues facing the isolated outer islands of Micronesia, a health survey was performed on Ulithi Atoll in Yap, FSM.
  
  
  METHODS
  A survey was created by the Yap State Department of Health Services and members of the Ulithian community. The survey was carried out on two of the four inhabited islands of Ulithi Atoll in July 2004. Both island communities actively participated in the survey providing translation and data gathering assistance.
  
  
  RESULTS
  It was estimated that a >90% response rate for both islands was achieved. Analysis demonstrated that relative to the U.S., the Atoll's population experienced high rates of obesity (45%), hypertension (29%), and smoking (55%). Sixty-six percent of men surveyed reported alcohol use versus 16% of women. Use of alcohol was markedly lower on Fatharai Island where a Chief had mandated abstinence. Preventative health screening was limited with over 80% of women having pap smear in the past 2 years. In addition, the community identified finances and transportation as the main difficulties in accessing healthcare.
  
  
  CONCLUSIONS
  Overall, the research identified a number of health issues that require closer attention, in particular hypertension, overweight, obesity, alcohol misuse, smoking prevalence, betel nut/ tobacco chewing, and domestic violence. There is indication that the community may be ready to address some of these issues. The value of community action within cultural frameworks is apparent, and there may be potential to extend culturally-based approaches to address a broader range of issues.
authors.affiliation: Wa'ab Community Health Center Colonia, Yap State, Federated States of Micronesia.
authors.forename: W Thane
authors.initials: WT
authors.lastname: Hancock
authors.forename: A Mark
authors.initials: AM
authors.lastname: Durand
authors.forename: Arthur
authors.initials: A
authors.lastname: Yolwa
authors.forename: Josey
authors.initials: J
authors.lastname: Sagury
authors.forename: Clotilda
authors.initials: C
authors.lastname: Legthar
authors.forename: Mihi
authors.initials: M
authors.lastname: Ratima
authors.forename: Kelly
authors.initials: K
authors.lastname: Wachi
authors.forename: Aparajita
authors.initials: A
authors.lastname: Adhikary
authors.forename: Mikela
authors.initials: M
authors.lastname: Yarawamai
authors.forename: Ana
authors.initials: A
authors.lastname: Yarawamai
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Maskarinec
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology; D003256:Community Participation; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006304:Health Status; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D008849:Micronesia; D008875:Middle Aged; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care; D012423:Rural Health / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population / Q000706:statistics & numerical data; D055815:Young Adult