title: An assessment of non-communicable diseases, diabetes, and related risk factors in the Territory of Guam: a systems perspective.
abstract: Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the US Territory of Guam and describes the burdens due to NCD, with an emphasis on diabetes; and assesses the system of service capacity and current activities for service delivery, data collection, and reporting as well as identifying the issues that need to be addressed. There has been an increase of 2.6% in the total population between 2000 and 2010. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors are associated with overweight and obesity. The leading causes of death include heart disease, cancer, and cerebrovascular accidents. Population surveys show that 9.1% of the adult population in 2009 reported being diagnosed with diabetes. Other data reports show that of the adults, 35.4% were overweight and 25.9% were obese; and among youth, 30% were overweight or obese. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address NCDs and diabetes. There is no Territory-wide health plan to address the prevention and control of NCDs including diabetes. There are no common standards of care or policy and procedures that are used by all the various medical and health care providers. Based on these findings, priority issues and needs were identified for the administrative and clinical systems.
authors.affiliation: Pacific Chronic Disease Coalition, Atlanta, GA, USA. pcdc10@gmail.com
authors.forename: Henry M
authors.initials: HM
authors.lastname: Ichiho
authors.forename: James W
authors.initials: JW
authors.lastname: Gillan
authors.forename: Nia
authors.initials: N
authors.lastname: Aitaoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006141:Guam / Q000453:epidemiology; D006293:Health Promotion; D006298:Health Services Administration / Q000191:economics / Q000331:legislation & jurisprudence; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007256:Information Systems; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000401:mortality*; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology; D055815:Young Adult
references.citation: Prev Chronic Dis. 2011 Jul;8(4):A86
references.pmid: 21672410
references.citation: MMWR Surveill Summ. 2010 Feb 5;59(1):1-220
references.pmid: 20134401
references.citation: Pac Health Dialog. 2004 Sep;11(2):57-63
references.pmid: 16281679
references.citation: Hawaii J Med Public Health. 2013 May;72(5 Suppl 1):5-9
references.pmid: 23901363
references.citation: Asia Pac J Clin Nutr. 2008;17(2):216-22
references.pmid: 18586639