Micronesian Migrants in Hawaii: Health Issues and Culturally Appropriate, Community-Based Solutions

More than 20,000 Micronesians have migrated to Guam, Hawaii, or the Commonwealth of the Northern Mariana Islands. Of these migrants, more than 8,000 now live in Hawaii. Factors in their home islands driving the recent emigration include the limited economic resources and struggling health care systems. Education systems in Micronesia are inadequate, and there are few job opportunities. The rates of infectious diseases remain high while at the same time, the epidemiologic transition in health has led to an explosion of non-communicable diseases. In Hawaii, the impact of the Micronesians emigration has been significant with most health and education expenses un-reimbursed. The health care costs alone are substantial as many Micronesians travel to Guam or Hawaii for medical treatment unavailable in their home islands. At the same time, Micronesians have difficulty accessing and navigating the health care system. While governmental, private, and academic programs already provide innovative and communitybased services to the Micronesian population, more work remains to be done. Not only are additional services, tailored to the culture and needs of Micronesian migrants, needed but a keener awareness and understanding of the issues surrounding Hawaii’s migrant population must be promoted among all public health stakeholders to ensure that the priority necessary to successfully address these challenges is recognized.