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.