1120: How Pacific Islands Are Facing a Growing Health Crisis

JOHN SHEEHAN:
This is Public Health Review Morning Edition for Wednesday, May 6, 2026. I'm John Sheehan
with news from the Association of State and Territorial Health Officials.

Today, the growing health crisis facing Pacific Islands.

ASTHO Senior Analyst for Environmental Health Shebli Davis talks about how these island
communities are navigating some of the most severe climate-related health risks in the world.
From intensifying typhoons in Guam and the Northern Mariana Islands, to devastating flooding
from little-known Kona Lows in Hawaii, Davis explains how increasingly frequent and extreme
weather events are straining already-limited infrastructure and public health systems.

So, Shebli,
give us a sense of the ways that the territories and freely-associated states in the Pacific are
impacted by climate change.

SHELBI DAVIS: 
Yeah, so, our U.S. territory and freely-associated state members in the Pacific are among the
most at-risk for climate change and health impacts due to their exposure to different climate
hazards, social and environmental vulnerabilities, and just having less resources overall to
prepare and respond to these climate hazards.

SHEEHAN:
Right. So, the hazards can be anything from typhoons in the region we've seen recently, to
potentially even wildfires like we saw in Hawaii last year. And on top of all that, they're isolated to
boot.

So, getting resources in to help is tremendously difficult, as it is getting additional personnel.

DAVIS: 
Exactly, yes. So, we did recently see a few weeks ago, there was a super typhoon that hit the
Northern Mariana Islands in Guam, and we know that climate change is significantly increasing
the frequency, intensity, and durations of these extreme weather events. And so, you know, we at
ASTHO continue to support our island area health agencies so that they can be as resilient as
possible in protecting and improving the health of their communities.

SHEEHAN:
Yeah, talk a little bit more about how ASTHO supports those agencies.

DAVIS: 

Yeah, so, we have a dedicated climate territorial portfolio that includes trainings, learning
opportunities, and peer-to-peer support. Most recently, we collaborated with the University of
Washington, and we also had funding from CDC to co-host a one-day climate and health
workshop for our Pacific Island members, and that was in March of this year. We were able to
bring together staff from five different islands.

So, we brought together staff from Guam, Palau, American Samoa, the Commonwealth of the
Northern Mariana Islands, and the Republic of the Marshall Islands. The workshop was a
culmination of a three-year project and provided our members with an opportunity to share
different success stories and barriers to doing climate work. And then they also had an
opportunity to share their needs and approach partnerships with other areas of public health and
external partners.

SHEEHAN:
Yeah, and you mentioned the typhoon that recently hit the Northern Marianas and Guam. How
are those jurisdictions faring?

DAVIS: 
So, they are in active recovery right now. I also wanted to mention that during our time in Hawaii,
there were a series of Kona Lows that impacted all of the Hawaiian islands. And Kona Lows is
something that many people haven't heard of, but it's essentially a localized, slow-moving,
subtropical cyclone that brings heavy rain.

And there were back-to-back Kona Lows in March and April of this year, which caused
devastating flooding, landslides, and widespread infrastructure damage across Hawaii. And, you
know, they are still in active recovery from these storms. So, it does take some time for these
areas to recover.

SHEEHAN:
Yeah, it bears repeating that, you know, these are territories that are part of the United States
and they're so isolated. And, you know, isolated not just geographically, but, you know, in many
ways culturally and just in communication-ally, you know, it's so hard to communicate with them
because they're in such different time zones that they're living at, you know, sort of staggered
cadences from the mainland.

DAVIS: 
Exactly. Yes, that's a big factor. Those are big factors for sure.

SHEEHAN:

Yeah. And also worth remembering that these health agencies are usually under-resourced, have
fewer personnel working at them, and have to deal with some pretty strong conditions.

DAVIS: 
Yeah, absolutely. A lot of times, the staff at these health agencies wear multiple hats. So, the staff
do food inspections and water inspections, and, you know, these recent Kona Lows, the super
typhoon, you know, underscore the vital role of health agencies and how they protect their
communities from the harmful impacts of climate change.

And at ASTHO, we continue to support them, the health agencies, in their work. They're doing a lot
of different things, and that can also make it a challenge in this area.

SHEEHAN:
Well, Shebli Davis, thanks so much.

DAVIS: 
Yeah, thanks for having me on.

SHEEHAN:
Shebli Davis is an ASTHO senior analyst for environmental health.

Our health is shaped by the
world we live in, from the air we breathe to the food we eat, the water we drink, and the
communities we live in. Our environment impacts our health and well-being.

ASTHO is committed to supporting its members' environmental health initiatives through expert
technical assistance and actionable resources. You can find a link to them in the show notes.

The Public Health Hope Equity Resilience and Opportunity, or PH-HERO initiative, supports state and
territorial health agencies in addressing workforce burnout, moral injury, and retention challenges.
Grounded in trauma-informed and equity-focused approaches, PH-HERO offers curated

resources to protect, support, and strengthen the public health workforce. Discover evidence-
based tools, expert guidance, and research to help build resilient, thriving teams. Learn more

through the link in the show notes.

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of
State and Territorial Health Officials.