2021 Guam Epidemiological Profile Summary

By: Kasey Xu

Guam 2021 Epidemiological Profile Overview
The 2021 Epidemiological Profile, created by the Guam State Epidemiological Outcomes Workgroup (SEOW), reports the distribution and characteristics of the most pressing health-related issues among Guam’s population. It presents variations in health patterns with respect to sociodemographic factors, informs policy-making, and highlights prevention strategic plans for better future treatment infrastructure and health outcomes.

Data Sources and Methods Overview
The SEOW identified indicators specific to Guam that shaped alcohol, tobacco, drug consumption, and mental health, and the consequences of these issues. Datasets from population-based surveillance systems, surveys, hospital records, and the US Census Bureau were used to analyze prominent health issues.

Population Demographics and Characteristics
Guam’s population of 153,836 in 2020 showed a decrease from 2010 Census counts. About 38% of the population is below the age of 25. The population is multi-racial and multi-ethnic, with CHamorus being the largest ethnic group.


Key Findings: Substance Misuse, Suicide, Mental Illness

Substance Misuse - Tobacco

Prevalence of smoking in Guam is higher than the median smoking prevalence in all U.S. states and territories. Consumption remains high for both adults and youth, with vaping also being high among youth. Socioeconomic disparities reveal that the poor and less educated tend to smoke more. Policy changes such as increasing the legal age for tobacco consumption has helped decrease youth tobacco smoking.

Substance Misuse - Alcohol

Alcohol use, binge drinking, and heavy drinking are lower among Guam adults and youth compared to the U.S. Whites/Caucasians had the highest prevalence of drinking. Youth alcohol use and binge drinking has significantly declined after the minimum legal drinking age was raised from 18 to 21 in 2010. In recent years, the decline has leveled off and risen.

Substance Misuse - Illicit Drugs

Prevalence of other illicit drug use has increased among Guam high school students compared to the U.S. Marijuana use among Guam youth is higher than among adults. These trends and findings highlight the need for more environmental interventions and policy changes in substance misuse prevention.

Consequences of Substance Misuse

  • Tobacco: The top 3 causes of death (heart diseases, cancer, & cerebrovascular diseases) are directly caused by tobacco.

  • Alcohol: Alcohol directly contributes to cancer and poses a major risk for liver, breast, oropharyngeal, and colorectal cancer. Underage drinking presents risks for adverse health, behavioral impacts, and likelihood of future dependency.

  • Illicit Drug Use: Illicit drug use is linked to drug offenses and frequently results in seizures of methamphetamine and marijuana.

Suicide and Mental Illness

Guam’s suicide rate decreased from 2020 to 2021 but remains higher than the U.S. rate. Suicide deaths occur predominantly among young adults and males. Chuukese and CHamorus have the highest ethnicity-specific suicide rates. In the midst of the pandemic, about 1 in 10 Guam adults reported having depression.

Conclusion and Key Priorities

Challenges in substance misuse control and suicide prevention remain. Tobacco, smoking, smokeless/electronic vaping product use are still significantly higher in Guam. Alarming issues for the youth persist and require greater attention to alcohol use and the use of e-cigarettes, marijuana, and prescription drugs. Given Guam’s high rates of suicide, aggressive screening is crucial for mental illness detection and treatment. Developing a sustainable suicide prevention infrastructure and implementing effective mental health interventions are essential as a public health priority.