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.
- American Samoa
- Commonwealth of the Northern Mariana Islands
- 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.
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
Latest Island Areas Resources
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.