2020 Guam Community Health Assessment: Key Findings
By: Ella Macatugal
The 2020 Guam Community Health Assessment (CHA), conducted by the Department of Public Health and Social Services (DPHSS) with community stakeholders, provides an updated overview of the island’s health landscape. It offers insights into health priorities, healthcare infrastructure, and population challenges, guiding policy, resource allocation, and public health interventions.
Assessment Process Overview The CHA systematically examines Guam’s health status using a mixed-methods approach, integrating quantitative data (surveys, hospital records, statistics) and qualitative insights (community surveys, focus groups, interviews) to capture diverse community perspectives.
Population Characteristics Guam’s population is younger than the U.S., with many residents under 25. The median age is nine years lower than the U.S. average, requiring strategic healthcare investment for young dependents.
Economic Status and Social Determinants Economic disparities between Guam and the U.S. are significant. Guam’s unemployment rate is higher, median household income is $14,000 lower, and nearly 20% of residents live in poverty. Lower educational attainment, particularly among Pacific Islanders other than Chamorros, also affects health outcomes.
Health Behaviors and Risk Factors Guam's youth have higher rates of risk behaviors, such as drinking and driving. Immunization rates are lower than the U.S. average, with lower HIV testing rates, although youth sexual activity has decreased.
Tobacco and Substance Use Youth tobacco and e-cigarette use are significant concerns, and marijuana use among youth is high. The report emphasizes the need for improved cessation programs, as many tobacco users wish to quit. Refer to Tables 18 and 21 from the CHA Summary below.
Noncommunicable Diseases (NCDs) Obesity, diabetes, and cardiovascular conditions are major health issues. Diabetes prevalence is higher than in the U.S., and screening rates for cancers are lower, with higher incidences of breast and cervical cancers. Refer to Table 56 from the CHA Summary below.
Infectious Diseases Guam has elevated rates of certain vaccine-preventable diseases, including Hepatitis A and B, varicella, and mumps. TB rates remain high, and dengue transmission since 2019 adds to public health challenges.
Mental Health and Suicide Mental health issues, especially among youth, are growing. Depression rates are high, and youth suicide rates exceed U.S. levels, highlighting the need for expanded mental health services.
Healthcare Infrastructure Guam’s healthcare infrastructure has improved but still lags behind U.S. benchmarks. The island has fewer healthcare providers and lower per capita spending, though insurance coverage has increased, reaching 94% for individuals over 65, primarily through Medicare.
Key Priorities for Guam
The 2020 assessment identifies several key health priorities for the island, which reflect both persistent issues and emerging challenges. These include:
Prevention and control of noncommunicable diseases (NCDs): Diabetes, cardiovascular disease, and obesity remain critical concerns.
Mental health and suicide prevention: Urgent attention is needed to address the high rates of depression and suicide, particularly among youth.
Health system infrastructure and access: While improvements have been made, there is a need to further expand healthcare capacity and ensure equitable access to services.
Substance abuse prevention: Tackling tobacco use, especially among youth, and addressing the growing concern over marijuana and other drug use are crucial.
Healthcare financing and insurance coverage: Expanding access to affordable healthcare and improving health insurance coverage for all populations is a priority.
Health promotion and education: Continued efforts are needed to educate the community on preventive health behaviors and encourage healthier lifestyles.