1. Outcomes of Healthcare in Kosrae, Pohnpei and F.S.M. Emily Leutgeb Ellie Steiner Ryan Johnsen Adam Koenig Tyler Aronstein

2. Introduction to Outcomes of Healthcare Outcomes are defined by: o What happens after care has been provided  Perceived Quality of Care by Patients  How healthy is the Population  Customer Satisfaction o How to improve it

3. Three Stages of Health and Illness in Micronesia 1.Introduction of infectious disease o Increased ship contact during the 1800s o Considerable population loss on all islands 2. Introduction of western medicine o Following WWI o Improved santitation o Brought infectious disease under control 3. Shifting burden of illness o Jobs multiplied, disposable income grew o Westernization of diets o Focus more on non-communicable diseases Today: Micronesia still faces the lingering effects of the older disease burden while trying to combat the new illnesses associated with the modern life style.

4. The Numbers StatOldNew Life Expectancy(1994) 65.2 Years(2009) 69 Years Infant Mortality(1994) 46/1,000(2009) 39/1,000 Diabetes(1956) 8(1976) 522 Heart Disease(1956) 192(1976) 1,494

5. Source: Vital Statistics Unit, FSM Department of Health and Social Affairs

6. The Dentist in Kosrae They have good access but how is it being used? o Transportation Problems They are receiving the same quality care that people in the United States are. Beatle Nut

7. The President of F.S.M. Health care is the third most funded by the government His opinion on the NEW nursing program at the F.S.M. Mis-allocation of funds due to Compact Free Association Exercise

8. Adam’s Pharmacy Visit Constipation + Pills = Diarrhea Cost Effective Physiological Response No questions asked, no health history considered

9. Suicide Rate/Psych issues in Micronesia Number of suicides has risen sharply in Micronesia since the 1960s o Suicide rates now being amongst the highest in the world Lack of mental health facilities "Burden of mental health goes hand-in-hand with rapid urbanization and social changes such as poverty and physical illness" (Global Health Care) Suicide prevention programs in high schools Leading cause of death for 15-24 age group

10. Kathy Benjamin Coordinator of the new nursing program at the College of Micronesia Preceived vs. Actual o Traveling abroad for medical care

11. Tour Guide in Kosrae Hospital Have surveys worked for responses? New ideas for receiving input on healthcare

12. Various Locals - JoJo the Bus Driver

13. Various Locals - Josh the teacher 10th Grade Earth Science Teacher From California Avoided Kosrea medical help at all costs o Preventative o Found help from family in the States

14. Various Locals - Airplane dude "I think they're doing the best they can"

15. Misuse of Resources Old Ambulance vs. New Ambulance HIV/AIDS Surveillance and HIV Prevention Projects for the Pacific Islands o $203,006 in Grants o Condoms in bathroom

16. The Facts CDC reported that the FSM does not require vaccines for any person. Healthcare is at a higher level than the rest of the pacific region related to United States focus.

17. What Should The FSM Do To improve Outcomes? Increase Diabetes Resources Expand “Go Local” and Other Educational Programs about Staying Healthy o Preventative services like exercise facilities and changing the mindset of “normal” living Better Medical Documentation o Birth Certificates o Death Certificates Make a Cancer Registry Better Education Programs to Defer Social Stigmas

18. What Should Future Researchers Do? Surveys DO NOT WORK! o Strive for personal contact o Face-to-Face Surveying o Incentive Based Surveying o Invest in the areas being researched Enjoy your time!

19. Sources CDC o http://www.cdc.gov/HIV/topics/funding/state- awards/fm.htm WHO o FSM Health Profile http://www.who.int/gho/countries/fsm.pdf Health Issues in the Federated States of Micronesia o Mortality Analysis of Registered Deaths in the FSM from 1990-2003 o Disease in Micronesia: A Historical Survey Cancer in Kosrae Cancer in Micronesia Global Health Care by Carol Holtz