Abstract
The Asia Pacific Academic Consortium for Public Health (APACPH) was founded on the Island of Hawaii and has maintained an interest in the health of island communities. This is consistent with the aims of APACPH and Asia Pacific Journal of Public Health to promote health for all, with a particular emphasis on disadvantaged and remote communities. APACPH held a special conference on Island Health in Okinawa in 2009 with selected papers published in this journal. Now we are able to bring to you the third issue of the Asia Pacific Journal of Public Health with a special emphasis on Island Health.
Island communities have particular public health problems that are related to isolation and communication. We have previously discussed many of these in our journal. Some islands were devastated by outbreaks of infectious diseases including smallpox, measles, and leprosy brought by explorers and colonizers. Many of the ships that entered the Pacific were little more than sexually transmitted disease “time bombs” spreading diseases from island to island. The population of Hawaiian Islands was estimated to be 500 000 when Captain James Cook arrived to explore the area and had declined to fewer than 90 000 by 1848, probably from the introduction of syphilis. Other island communities were similarly devastated.
More recently, the islands have been hit by a new epidemic, the dramatic change in diet with the introduction of an abundance of Western foods. This brought an excess of high fat, sugar, salt, and energy. The last half century has seen an epidemic of obesity, heart disease, and diabetes. For some island communities, traditionally up to 50% of their diet came from marine sources. 1 It is rather ironic that island economies exported their healthy fish, or more often fishing rights, to Western countries who are striving to overcome their own nutrition problems. Commercial exploitation at the expense of island health continues.
Climate change is the latest threat to emerge as a threat to island communities. Changes in the climate affect the ocean through warming and increased acidification causing a change in variety and quantity of fish stocks. Rising sea levels with decrease in arable land on islands, the variety and prevalence of vector-borne diseases will increase. 2 The increasing frequency of adverse weather events, ranging from drought to cyclones and typhoons, will have major impacts on survivability and health. The vulnerable populations that are a special focus of public health, particularly infants, children, pregnant women, and the elderly, will be at increasing risk. Many other factors that affect island health are changing including migration and many are discussed in this supplement and in past issues of the journal. They will provide special challenges to public health teaching, research, and program implementation. We thank Professor Judith McCool and her team for their efforts in coordinating this selection of papers. We look forward to continuing to include papers on island public health in our journal.