Options and Choices in Relation to Adopting Healthy Lifestyles in the Pacific Islands Region

Abstract

The low-lying atoll states of the Pacific region, including Kiribati, Tuvalu, and the Republic of the Marshall Islands, face numerous challenges as a result of climate change and the related rise in sea level. A health transition from communicable to noncommunicable lifestyle-related diseases among these communities is placing a significant burden on medical services and broader welfare provision. This article considers the broad range of both internal and external factors that influence the options available and choices made in relation to being able to maintain a healthy lifestyle in these communities.

A narrative review of noncommunicable diseases in the Pacific region: A case study of the island of Niue

“…6 Poverty severely limits not only the choices communities make, but the options that are available in the first place. 7 The relationship also works in the opposite direction, with NCDs exacerbating poverty. The financial costs borne by individuals for treating and managing these conditions is significant, mostly because of the price of medical treatment and the loss of employment opportunities.…”

“…11 Many articles framed this dietary shift as being devastating to the health of the Pacific. 2,4,7,8,12 Urbanisation, too, has had an impact, with increasingly Western lifestyles in the Pacific being associated with more sedentary lifestyles as the availability of processed foods made growing your own food and other traditional practices less common. 2,7,13…”

“…Consequently, accessing already-overwhelmed health services becomes ever more difficult. 7,16 One study pointed out that the drivers of climate change originate primarily from the greenhouse gas emissions of industrialised countries, yet the effects are felt most acutely in the Pacific. 11 Given this external origin of the problem, such countries should take more responsibility in addressing the resulting NCD crisis in the Pacific region.…”

“…Focusing too heavily on individual behaviour interventions risks ignoring these contexts at best, or recreating colonial power imbalances at worst. 7,10 Additionally, solutions should focus on supporting local capacity. This ensures Pacific communities have technical skills, which, when coupled with Indigenous Pacific knowledge and practices, will enable communities to enact self-determination over solutions to the NCD Issue 32 • April 2021 crisis.…”

“…This ensures Pacific communities have technical skills, which, when coupled with Indigenous Pacific knowledge and practices, will enable communities to enact self-determination over solutions to the NCD Issue 32 • April 2021 crisis. 7,24,26 Local capacity is also essential to ensure communities can sustain interventions once external health practitioners leave. 20 For Niue specifically, it is recommended that a national NCD plan be developed.…”