ASTHO supports the work of U.S. territories and freely associated states to improve population and community health. ASTHO's members include the chief health officials of the five U.S. territories and three sovereign nations that have entered into Compacts of Free Association with the United States, which are collectively referred to as the Island Areas or Island Jurisdictions.
U.S. Territories
- American Samoa
- Commonwealth of the Northern Mariana Islands
- Guam
- Puerto Rico
- U.S. Virgin Islands
Freely Associated States
- Federated States of Micronesia
- The Republic of the Marshall Islands
- The Republic of Palau
Providing public health services in remote islands in the Pacific and the Atlantic is often more costly than in the states. Due to differences in services configuration, eligibility for federal funding and programs, population health needs, and increased susceptibility to climate crisis, their policy needs are complex and often substantially different than those of the states. Given the uniqueness of each jurisdiction, we work to ensure our resources and technical assistance are tailored to their needs.
Featured
Developing a Data Dashboard to Address Health Equity Concerns: Insights from Puerto Rico
The Puerto Rico Department of Health's Health Equity Program developed a social determinants of health data dashboard to identify health equity concerns, sharing insights and recommendations for similar public health initiatives.
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What Territorial Health Officials Need to Know about Grants Management
These introductory materials provide territorial health officials and their leadership teams with an overview of grants management—an essential health department function.
Explore the Module
Bringing the U.S. Territories Closer to Medicaid Equity
After years of advocacy, ASTHO and our partners are celebrating the recently signed Consolidated Appropriations Act.
Read the Blog Post
Key Strategies to Engage Communities During COVID-19
This two-part video series highlights how states and territories have worked with community members in their responses to COVID-19.
Watch Part 1Latest Island Areas Resources
Improving Indirect Cost Rate Use in Island Jurisdictions
Island Areas Workgroup, Health Financing Subgroup
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Strengthening Leadership, Risk Communications, and Preparedness in the Islands
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Using Health Equity Indicators to Guide Community Health Improvement in U.S. Territories and Freely Associated States
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Collaborations
ASTHO and the Island Areas are supported by multiple organizations representing an array of public health topics. Below are a few partner organizations that work with us to support our island jurisdiction members.
- Pacific Islands Health Officers Association
- CDC Foundation
- World Health Organization
- Western Pacific Health Organization
- Puerto Rico Science, Technology & Research Trust
- Partners in Health U.S.
ASTHO also manages two committees that support policy efforts in the island areas.
- The Insular Affairs Committee provides a forum for ASTHO’s island members to exchange information on policy challenges and solutions.
- Two key priorities of this committee are territorial Medicaid parity and fully funding the renegotiated Compacts of Free Association.
- The Island Areas Workgroup aims to work with federal and non-profit partners to improve administrative, procedural, or programmatic policies that impact the island areas.
- In Oct. 2022, the workgroup developed a report highlighting the need to represent Island Area data within federal public health datasets.