It is well appreciated that the social determinants of health are intimately related with health outcomes. However, there is a paucity of literature that explores these themes comprehensively for the indigenous people within Micronesia. Certain Micronesia-specific factors, such as transitions from traditional diets, the consumption of betel nut, and exposure to radiation from the nuclear bomb testing in the Marshall Islands, have predisposed certain Micronesian populations to an increased risk of developing a variety of malignancies. Furthermore, severe weather events and rising sea levels attributed to climate change threaten to compromise cancer care resources and displace entire Micronesian populations. The consequences of these risks are expected to increase the strain on the already challenged, disjointed, and burdened healthcare infrastructure in Micronesia, likely leading to more expenses in off-island referrals. A general shortage of Pacific Islander physicians within the workforce reduces the number of patients that can be seen, as well as the quality of culturally competent care that is delivered. In this narrative review, we comprehensively underscore the health disparities and cancer inequities faced by the underserved communities within Micronesia.
For many people living in low-income coastal communities, marine resources provide a crucial source of animal protein and are of major nutritional importance. However, because of various human-induced pressures, such as overfishing and poor resource management, marine resources are deteriorating at an unprecedented rate. Climate change effects this dynamic by contributing directly to marine resource deterioration and acting as an effect multiplier, worsening already-present problems in the systems. This deterioration threatens the viability of marine resources to support future food security demands and presents multiple health implications for coastal communities that rely upon these resources. This research used a narrative review to explore how the impacts of climate change are projected to impact human health and sustainable development throughout subsistence fishing communities. A case study approach focusing on the Pacific Ocean region of Micronesia was conducted to provide a practical indication of the future scenario applicable to other geographical regions across the globe. The results indicate that climate change is likely to exacerbate adverse health outcomes such as food insecurity, ciguatera fish poisoning, heatstroke, and mental health problems and that climate change may lead to the deterioration of traditional cultural practices. As the climate crisis is happening now and will be an issue extending into the foreseeable future, it is necessary to implement adaptation strategies, funding, and governance to limit global emissions, preserve marine resources, and support human well-being. Therefore, this research details adaptation strategies, such as diversifying fish catch and reviving traditional postharvest preservation methods, that may help communities adapt to climate change.
