Oceania's Health ChallengesRecent genetic studies of Pacific Islanders are revealing new insights into Oceania’s health challenges. In turn, these insights may drive sustainable solutions that improve community health and save lives.

Convenience-food diets, obesity, lack of resources and the health challenges that result from these conditions are escalating in many island nations in the Pacific. Worse, the resulting non-communicable diseases (NCDs) are leading to an increase in preventable deaths. Activists from many nations are working to better protect many Pacific Island populations from Oceania’s health challenges.


Oceania is a group of countries and territories that share a border with the Pacific Ocean. These 14 countries and territories are diverse culturally, economically, geographically and demographically. Oceania includes the large and wealthy countries of Australia and New Zealand and smaller and less affluent countries including Figi, Tonga and Palau.


Indigenous people in Oceania are more genetically prone to gut issues and certain NCDs that evolved during colonization. While traditionally, Oceania diets were low-energy-density, the introduction of processed foods and more modern snacks brought obesity and linking issues. Before colonization, there was little to no obesity in the Pacific Islands. According to a 2019 study published in Frontiers in Immunology, “During the period of nutritional transition, the people came to consume energy-dense foods imported from Australia and New Zealand.”

The study reports that certain health conditions disproportionately affect specific indigenous populations including the Polynesians in Hawaii, the Maoris in New Zealand, and the Aboriginal and Torres Straits Islanders in Australia compared to non-indigenous people in the same places.  Mortality rates, NCDs and fertility decline are all issues that disproportionately affect these populations. Studying Pacific Islanders’ health data more closely, as this study did, may lead to sustainable solutions.

Environmental factors such as urbanization, sanitation and pathogen exposure also have the potential to increase disease susceptibility. Genetic vulnerability in the form of microbiome genetic mutations and immune function justifies population-specific medical studies and consideration in regards to nutrition. Accessibility and food insecurity have also driven people to foods that are low in nutrition.


There are several specific solutions to combat the sharp rise in NCDs in the Pacific Islands. One strategy is better health monitoring. Current medical data surrounding nutrition is almost nonexistent and therefore Pacific Islander nutrition lacks proper evaluation. Increasing data and enhancing research in this area can better inform people about their eating habits.

The George Institute for Global Health, Fiji National University, Sydney University and Deakin University have created the Global Alliance for Chronic Diseases project. This effort hopes to collect data on preventable deaths and possible food policy initiatives for the future. The researchers already found that decreasing salt intake by one gram a day for a year would prevent heart attacks and strokes and save 131 lives a year.

A second strategy is creating a sustainable interest and consumer demand for fresh and healthy foods.  Since COVID-19, Fiji’s Ministry of Agriculture has distributed seeds for people to grow their own food at home. Additional countries could benefit from a program like this as well.

Other strategies include projects and policies that focus on building a stronger market for healthy foods. Finally, the study suggests applying a gender lens to improve Oceania’s health challenges.  While more women are joining the workforce, they continue to play the primary role in caring for and feeding their families.  They do not have the time to prepare complicated meals so they are turning to convenience foods.

World Bank Showcases Oceania Women Leaders

The 2019 genetic study, others like it and the projects mentioned above are setting a trend of focus on the nutritional health of Pacific Islanders. Sustainable change and progress are occurring throughout Oceania. This progress prompted the World Bank to showcase some inspiring women who are starting to implement solutions to Oceania’s health challenges. In Samoa, Lenara Tupa’i-Fui is the assistant CEO of Health Information Technology and Communications at the Somoa Ministry of Health. She is helping lead the Samoan eHealth system that will better track medical records and provide accessible health monitoring and data. As program director of the Partnership of Human Development in Timor-Leste, Armandian Gusmão Amaral advocates for better health care, especially for women and children. She also focuses on mentoring women to pursue careers in the medical profession.

Looking Ahead

Advocating for better data tracking and health communication, increasing the understanding of and demand for healthy foods and applying a gender lens to improving eating habits are all steps that are helping the vulnerable in Oceania take action on their health.

– Karen Krosky
Photo: Flickr

The Correlation between Poverty and Obesity in NauruObesity may be the farthest topic from anyone’s mind when it comes to poverty, but it has greater relevance in today’s society than expected. The small island country of Nauru is home to little more than 10,000 people; however, the prevalence of obesity in Nauru and obesity-related diseases in that population is one of the most severe in the world. Globally, trends in malnutrition and obesity tightly interlace. While the resulting health issues may differ in their effect, the source is the same: a lack of accessibility. The civilians of Nauru are experiencing a significant lack of access to affordable but healthy food. Consuming highly processed food and not having enough space to grow crops has caused Nauruans to deviate from their traditional diets of seafood and vegetables, leaving the island in the grip of a dangerous obesity epidemic.

However, there are several related factors that also contribute to the health crisis Nauruans face today. While the island originally imported food from Australia and New Zealand, it has now spread farther to the west, such as China and Malaysia. The difference in language is a barrier that prevents the proper interpretation of food labels and consequently presents a hazard in maintaining food safety. Additionally, phosphate mines largely comprise the island, leaving the already small country with even fewer viable means to grow and sustain crops. As a result, the only option for the civilians of Nauru to gain their meals is to rely on cheap Western imports.

Poverty’s Role in Obesity

While Nauru may suffer from similar economic disadvantages as low-and-middle-income countries, its primary challenge is that the most accessible food is extremely detrimental to civilians’ health. Inexpensive, imported food from Western culture is now featured in Nauruan diets, often consisting of instant noodles, white rice and soda. Even worse, the existence of mutton flaps has been pinpointed by health experts as one of the main causes of obesity in the Pacific Islands because of its regular consumption by citizens, but it is still eaten on a regular basis in Nauru.

From a young age, the education system teaches children in Nauru about healthy eating and balanced diets; yet obesity is still a rampant problem. Amy McLennan, an Oxford University anthropologist who spent 11 months in Nauru, noted that “there’s a lot of desire to achieve better health, [but] at the moment, there’s a lack of tools and resources and the environment to do that.” The problem of obesity is an endless cycle that Nauru’s collapsed economy and years of unhealthy practices make difficult to erase.

Health Complications from Nauru’s Obesity Crisis

By assimilating the negative aspects of the Western diet and neglecting proper exercise, an overwhelming majority of Nauruans have seen a decline in their health. The World Health Organization denotes that 75% of all deaths on the Pacific archipelago are the result of diabetes, cardiovascular disease and hypertension. Notably, all of the aforementioned conditions are related to a spike in obesity and high blood pressure. A BMI, or a Body Mass Index, is a range that measures body fat in proportion to height and weight. With Nauru’s average BMI falling around 34, it is above the BMI for an average obese person of 30 which highlights the need to turn around these troubling statistics.

Diabetes, however, is the most prominent of these obesity-risen conditions on the island, a situation that has gotten significantly worse according to Eva, a diabetes care manager in Nauru. Eva asserted in an interview, “I have seen so many funerals for such a small island. So many people are dying at an early age because of diabetes.” The combined effect of unhealthy meals and the absence of exercise has exacerbated the number of diabetes cases on the island.

Awareness about Obesity in Nauru and Solutions

Raising awareness about the obesity epidemic that the Pacific islands have struggled with for many years is important for increasing the well-being of Nauruans’ lives and creating a more stable environment. Although there is a lack of viable land to yield more crops and fresh food, increasing fitness in Nauru will aid in reducing the chances of cardiovascular disease and cases of type 2 diabetes. At a societal level, implementing healthy practices can instill beneficial practices into individuals’ lifestyles in the long run. The food industry also has a significant role in international obesity rates. Addressing these issues and stopping companies that import fatty and greasy foods to developing countries, such as Nauru, is a step toward initiating crucial change.

– Esha Kelkar
Photo: Flickr

Obesity in the Pacific Islands
Picture this: it’s trivia night, and one question confuses the teams: “What country has the highest rate of obesity in the world?” When the whiteboards come up, the answer “the United States,” floods the guessing pool. The real answer? Nauru, a tiny country in the Pacific Ocean with only 12,704 people. The next nine countries are also all Pacific Island nations – and the problem of obesity in the Pacific Islands is getting out of hand.

Obesity in the Pacific Islands is an epidemic. While Pacific Islanders used to live off traditional island diets – fresh fish and vegetables – the introduction of processed fast food set the countries on a dangerous path of malnutrition. According to the CIA World Factbook, obesity levels are above 45% in all 10 of the Pacific island nations, topping the world’s BMI index. In addition, “about 40 percent of the Pacific island region’s population of 9.7 million has been diagnosed with a noncommunicable disease, notably cardiovascular disease, diabetes and hypertension.” These obesity-related illnesses account for “three quarters of all deaths across the Pacific archipelago.”

How America Plays a Key Role in the Pacific Islands

While the United States ranks number 12 behind Kuwait, the Pacific Islands still dominate the world in obesity rates. However, guessing America to be the world’s most obese nation is not naive; world obesity rates have skyrocketed in recent years due to the mass exports of American diets and products. Worldwide free trade organizations are allowing America to export fast food, sugary sodas and foods rich in high fructose corn syrup to other countries which is causing a “globesity” epidemic.

According to the World Health Organization, “worldwide obesity has nearly tripled since 1975.” This is largely attributed to the invention of high fructose corn syrup, a cheap sweetener that makes foods last for long periods of time. U.S. soda and processed food companies quickly integrated the ingredient into a majority of their recipes due to the high trade costs of real sugar.

In another snowball effect, cheaper ingredients created cheaper products. Therefore, Americans began to buy more processed food, succumbing to a wicked combination of addictiveness and low price. Noticing the high profits from this processed food, the U.S. started to export it to developing countries via various worldwide trading organizations.

A Slippery Slope

As developing countries plagued by the various contributing factors of poverty (most notably major infectious diseases, population density, environmental poverty and lack of fertile agriculture), the Pacific Islands are vulnerable nations. Due to their isolation within Oceania and a lack of economic wealth and resources, these nations are often perfect targets for wealthy nations to sluff off unwanted, cheap and highly profitable products like processed foods.

International trading organizations are often seen as the key to climbing out of poverty in developing nations. Through worldwide trade, Pacific island nations can buy cheap food for their people who struggle so immensely from a lack of food and unsustainable agriculture. While this agreement sounded idyllic, in its unregulated form it has caused these countries to suffer from devastating obesity.

However, the Pacific island nations are now caught between a rock and a hard place with trade organizations. Due to their lack of power and money, they cannot request better food from more powerful countries, and they also cannot afford to pull out of these organizations due to the helpful non-food goods that the organizations give them.

Let’s take Samoa as an example. After WWII, the country’s obesity rates skyrocketed due to “turkey tail” meat sold to them by the United States. This backend of the turkey, after being outed in America for its “fat,” “cholesterol” and “far from nutritious” nature, was shunned by the U.S. and sold to Samoa.

In 2012, the University of Michigan published a report on the problem of obesity in the Pacific Islands.  After eating this fatty turkey for years, many Pacific island nations banned the product in their countries due to the rapid increase in obesity. However, “the bans [were] lifted in order for these nations to join the World Trade Organization.” Samoa is now the eighth most obese country in the world and serves as a perfect example of how poorer countries can sometimes be manipulated for economic growth in richer nations.

Helping Obesity

Combating obesity in the Pacific Islands also becomes difficult after its initial onset. Since healthy food is often not available at cheap prices, in-school nutrition campaigns often do no good when there is no healthy food being offered in the cafeteria. In addition, nutrition labels are often not written in English, the language most widely read and spoken in the Pacific Islands.

However, many Pacific island nations have implemented ways to decrease obesity. Nauru “introduced a 30 percent tax on imported sugar, confectionery, carbonated soft drinks, cordials, flavored milks, sugar-sweetened drink-mix beverages, and high-sugar foods” in 2007. Tonga also places higher taxes on sugary drinks and lowered “import duties” on fresh fish and food goods.

While malnutrition, obesity and diabetic health issues plague the Pacific Islands, taxes on unhealthy foods and potential obesity education programs are looking to aid the situation in Oceania. However, WHO states that “tackling such widespread health problems in the region will require changes in food imports and agricultural policy.” In addition, wealthy countries must aid in systemic change to limit their exports of unhealthy, processed foods in order to combat malnutrition for their trading partners.

Grace Ganz
Photo: Wikipedia