Health Consequences of Disparity: the US Affiliated Pacific Islands

Health disparities and the social determinants of health are often discussed, but their relationship to political forces, the integrity of cultures, social and environmental change, and mental health outcomes are not well understood. Specifically the US Affiliated Pacific Islands Jurisdictions (USPAIJ) is an area of profound isolation and deprivation with a unique sociocultural history. This article provides an overview of health disparities in the US Affiliated Pacific in the context of the environment, and international and state policies. The article explores how the political, economic, social, and environmental context of the USAPIJ shapes health status and provides a "social determinants of health" model for health improvement for the people of the region.