A gap analysis of the public health systems in the US-affiliated insular areas

This presentation will provide results from a cross-cutting gap analysis of the public health systems in the five United States territories (American Samoa, Guam, Commonwealth of the Northern Mariana Islands, Puerto Rico, and the US Virgin Islands) and three nations with compacts of free association with the United States (Federated States of Micronesia, Republic of the Marshall Islands, Palau). Common strengths and weakness across all the jurisdictions will be emphasized. The gap analysis is based on existing assessments obtained through national and international organizations, such as the CDC and World Health Organization; documents from our in-region partner organizations; and ASTHO survey data. We adapted PRECEDE-PROCEED framework for planning to organize the information. The major findings from each document were coded for the jurisdiction of interest and one of the following categories: political, economic, and social factors; geographic and environmental factors; health outcomes; partnerships; public health agency and governmental priorities; or health agency internal capacities. We then analyzed the coded text to arrive at key themes in each of the categories. Though the United States territories and freely associated states span a diverse geographic region, they share some similar challenges in their public health systems. ASTHO is using the results of this gap analysis to tailor its technical assistance public health agencies in these US insular jurisdictions. Other organizations providing technical assistance and aid in these jurisdictions can utilize these findings to assist with their work.