Guam

Guam is an unincorporated U.S. territory in the western Pacific. It lies on the other side of the international date line from the continental U.S. For context, Guam is approximately eight hours, by plane, west of Hawaii. Guam’s history and relationship with the United States has been profoundly influenced by the U.S. military, more so than the other islands in the region.

Government

The U.S. president is considered the head of state, while the governor of Guam is the head of government.

Healthcare and Facilities

Health services in Guam are organized by four independent agencies, including the Department of Public Health and Social Services, the Department of Mental Health and Substance Use, the Department of Vocational and Rehabilitative Services, and Guam Memorial Hospital Authority. Guam has two main hospitals for citizens and one naval hospital for military families.

Guam operates a Medicaid program to support care for low-income residents. Territorial Medicaid programs are underfunded relative to the states. Unlike state Medicaid programs, territorial Medicaid programs have (1) a cap on total federal contributions and (2) a federal funding match set by law rather than based on per-capita incomes. Learn more about the need for equitable Medicaid funding for the territories via ASTHO's Permanent, Sustainable Medicaid Funding for U.S. Territories Policy Statement.

Key Priorities

In the 2016 ASTHO Profile report, Guam’s Department of Health highlighted these priorities:

• Address the elimination of noncommunicable diseases.
• Increase outreach to uninsured, underinsured, indigent, and high-risk groups for nursing services.
• Continue education programs for family planning, childhood mental health, and abstinence.

Disease Burden

Like the rest of the Pacific, Guam works to address significant noncommunicable and communicable disease burdens. Top causes of death in 2019 were:

• Ischemic heart disease
• Stroke
• Diabetes
• Chronic kidney disease
• Lung cancer