ASTHO supports the 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 Insular Areas or Island Jurisdictions.
- Puerto Rico
- U.S. Virgin Islands
- American Samoa
- Commonwealth of the Northern Mariana 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
Avoiding the Cliff: Financing Medicaid in the Territories
Medicaid plays a critical role in providing access to health services for low-income U.S. citizens in the territories. This podcast discusses the need for a permanent funding solution.Listen to the podcast
Latest Island Jurisdiction Resources
Public Health Confronts the Mosquito: Special Considerations for United States Territories and Freely Associated StatesLearn More
Sharing Island Stories on Health Equity: Setting the Stage for Equity in the Island AreasLearn More
Jurisdictions Using Policy to Address Unique Island Area Health ChallengesLearn More
ASTHO and the island jurisdictions 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
ASTHO also manages two committees that supports policy efforts in the insular area jurisdictions. The Insular Areas Affairs Subcommittee provides a forum for ASTHO’s insular area island members to exchange information on policy challenges and solutions. The Island Insular Areas Workgroup aims to work with federal and non-profit partners to improve administrative, procedural, or programmatic policies that impact the insular areas island jurisdictions.