title: An assessment of non-communicable diseases, diabetes, and related risk factors in the commonwealth of the Northern Mariana Islands: 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 Commonwealth of the Northern Mariana Islands (CNMI) and describes the burdens due to NCDs, 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 identifies the issues that need to be addressed. There has been a 22.7% decline in the population between 2000 and 2010. Findings of medical and health data reveal that the risk factors of lifestyle behaviors lead to overweight and obesity and subsequent NCD. The leading causes of death are heart disease, stroke and cancer. The 2009 BRFSS survey reveals that the prevalence rate for diabetes was 9.8%. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCDs. There is no overall health plan to address NCDs or diabetes, there is little coordination between the medical care and public health staff, and there is no functional data system to identify, register, and track patients with diabetes. Based on the findings, priority issues and problems to be addressed for the administrative system and clinical system are identified.
authors.affiliation: Pacific Chronic Disease Coalition, Atlanta, GA, USA. pcdc10@gmail.com
authors.forename: Henry M
authors.initials: HM
authors.lastname: Ichiho
authors.forename: Becky
authors.initials: B
authors.lastname: Robles
authors.forename: Nia
authors.initials: N
authors.lastname: Aitaoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D005260:Female; D006266:Health Education; D006268:Health Facilities / Q000600:supply & distribution; D006298:Health Services Administration / Q000191:economics / Q000331:legislation & jurisprudence; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007256:Information Systems; D008297:Male; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000401:mortality; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D010820:Physicians / Q000600:supply & distribution; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology; D055815:Young Adult
references.citation: Pac Health Dialog. 2004 Sep;11(2):23-9
references.pmid: 16281674
references.citation: Prev Chronic Dis. 2011 Jul;8(4):A86
references.pmid: 21672410
references.citation: Hawaii J Med Public Health. 2013 May;72(5 Suppl 1):5-9
references.pmid: 23901363