561085 research-article2014
APHXXX10.1177/1010539514561085Asia-Pacific Journal of Public HealthHokama and Binns
Original Article
Progress in Island Health in the Asia-Pacific Region
Asia-Pacific Journal of Public Health 2015, Vol. 27(1) 29–32 © 2014 APJPH Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1010539514561085 aph.sagepub.com
Tomiko Hokama, MD, PhD1 and Colin Binns, MBBS, MPH, PhD2
Abstract The Asia-Pacific region contains many islands, perhaps up to 100 000. The provision of public health and health care to small isolated groups poses particular challenges in the 21st century. The health of island populations has improved over the past 3 decades, but maintaining and improving current levels of health is made more difficult by emigration and the difficulty of maintaining communications. Keywords Western Pacific, islands, public health, life expectancy
The Asia-Pacific Academic Consortium for Public Health (APACPH) has had a major emphasis on public health in rural and remote areas since its inception. Because of the nature of the AsiaPacific region, island health has always been an important part of our meetings, and on several occasions, APACPH has held meetings on islands in our region, including Okinawa, Taiwan, Hong Kong, Sri Lanka, and Bali.1 The Asia-Pacific region is a region of islands, with more island provinces and states than any other World Health Organization (WHO). The consortium has held several seminars on the specific public health issues that relate to islands, including a special supplement in the Asia-Pacific Journal of Public Health. Prof Walter Patrick had a particular interest in the health of minority groups, including island dwellers in our region and he participated in several symposia on island health. During the APACPH seminar on Island Health in Okinawa in 2009, in his keynote address, he outlined some of the stages in the provision of health to islands in our region: (1) Missionary to Plantation Medicine. (2) Nationalism to Egalitarian Primary Health Care in the post-colonial era. (3) Health for All. Efforts were made to extend opportunities for “health for all” to rural communities, including some islands, in the 1980s.
1University 2Curtin
of the Ryukyus, Nishihara, Okinawa, Japan University, Perth, Western Australia, Australia
Corresponding Author: Tomiko Hokama, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. Email: [email protected]
Downloaded from aph.sagepub.com at University of Bath - The Library on July 9, 2015
30
Asia-Pacific Journal of Public Health 27(1)
(4) Era of “Rural” Health Care. More recently a new dynamic phase in health care for island and rural communities is emerging characterized as the Era of “Rural” Health Care, where technology transport and “high tech” interventions are becoming part of an overall care process. Medical schools and universities in Island States and countries are addressing the changing dynamics in epidemiological transitions, from acute to chronic conditions to diminish urban-rural differentials. The larger island states with sound economic bases are able to handle these trends and meet the costs and maintain access, but smaller islands will need public health support to reach 21st century standards of health outcomes.2(p1)
In his speech, Prof Patrick recognized that the larger island states are able to provide public health services similar to continental states, but that in the modern world, smaller islands had great difficulty in providing high-quality services. The Asia-Pacific region contains many islands, perhaps 100 000, although it is doubtful if anyone has ever counted them accurately. Several members of APACPH are archipelagos, including Indonesia, the Philippines, and Japan. The Indonesian nation comprises 18 000 islands, with an estimated population of 247 million; the Philippines has 7000 islands and a population of 97 million; and Japan has 6000 islands and 127 million people. There are numerous islands in the Pacific with 20 000 to 30 000 scattered over distances of thousands of kilometers. Examples of small island states include Niue (population
APHXXX10.1177/1010539514561085Asia-Pacific Journal of Public HealthHokama and Binns
Original Article
Progress in Island Health in the Asia-Pacific Region
Asia-Pacific Journal of Public Health 2015, Vol. 27(1) 29–32 © 2014 APJPH Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1010539514561085 aph.sagepub.com
Tomiko Hokama, MD, PhD1 and Colin Binns, MBBS, MPH, PhD2
Abstract The Asia-Pacific region contains many islands, perhaps up to 100 000. The provision of public health and health care to small isolated groups poses particular challenges in the 21st century. The health of island populations has improved over the past 3 decades, but maintaining and improving current levels of health is made more difficult by emigration and the difficulty of maintaining communications. Keywords Western Pacific, islands, public health, life expectancy
The Asia-Pacific Academic Consortium for Public Health (APACPH) has had a major emphasis on public health in rural and remote areas since its inception. Because of the nature of the AsiaPacific region, island health has always been an important part of our meetings, and on several occasions, APACPH has held meetings on islands in our region, including Okinawa, Taiwan, Hong Kong, Sri Lanka, and Bali.1 The Asia-Pacific region is a region of islands, with more island provinces and states than any other World Health Organization (WHO). The consortium has held several seminars on the specific public health issues that relate to islands, including a special supplement in the Asia-Pacific Journal of Public Health. Prof Walter Patrick had a particular interest in the health of minority groups, including island dwellers in our region and he participated in several symposia on island health. During the APACPH seminar on Island Health in Okinawa in 2009, in his keynote address, he outlined some of the stages in the provision of health to islands in our region: (1) Missionary to Plantation Medicine. (2) Nationalism to Egalitarian Primary Health Care in the post-colonial era. (3) Health for All. Efforts were made to extend opportunities for “health for all” to rural communities, including some islands, in the 1980s.
1University 2Curtin
of the Ryukyus, Nishihara, Okinawa, Japan University, Perth, Western Australia, Australia
Corresponding Author: Tomiko Hokama, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. Email: [email protected]
Downloaded from aph.sagepub.com at University of Bath - The Library on July 9, 2015
30
Asia-Pacific Journal of Public Health 27(1)
(4) Era of “Rural” Health Care. More recently a new dynamic phase in health care for island and rural communities is emerging characterized as the Era of “Rural” Health Care, where technology transport and “high tech” interventions are becoming part of an overall care process. Medical schools and universities in Island States and countries are addressing the changing dynamics in epidemiological transitions, from acute to chronic conditions to diminish urban-rural differentials. The larger island states with sound economic bases are able to handle these trends and meet the costs and maintain access, but smaller islands will need public health support to reach 21st century standards of health outcomes.2(p1)
In his speech, Prof Patrick recognized that the larger island states are able to provide public health services similar to continental states, but that in the modern world, smaller islands had great difficulty in providing high-quality services. The Asia-Pacific region contains many islands, perhaps 100 000, although it is doubtful if anyone has ever counted them accurately. Several members of APACPH are archipelagos, including Indonesia, the Philippines, and Japan. The Indonesian nation comprises 18 000 islands, with an estimated population of 247 million; the Philippines has 7000 islands and a population of 97 million; and Japan has 6000 islands and 127 million people. There are numerous islands in the Pacific with 20 000 to 30 000 scattered over distances of thousands of kilometers. Examples of small island states include Niue (population
