Health Care Needs
Kosraechc...

Chronic shortfalls in resources result in poor access to care and poor care
at the point of access. This is one area that deserves particular attention
in this application. Unlike the vast majority of communities in the mainland
U.S., Kosrae is simply unable to generate the funds needed to adequately
finance a primary medical care system. With so many people operating outside
of the cash economy, user fees are a more serious disincentive to access
than they are in the rest of the U.S. 2 Per capita health care expenditures
were $317 per year in Kosrae in 2011, compared with more than
$7000/capita/year in the US.3
Kosrae is designated as a medically
underserved population group. Health Professional Shortage Areas (HPSA)
scores are 20 and 21, for Primary Care and Dental Services, respectively.
There is one mental health counselor. These HPSA scores are evidence of
Kosrae’s struggle to provide adequate care to its population. As indicated
above, health issues affecting the population include high rates of
cardiovascular disease, early onset and high rates of diabetes, low prenatal
care rates, high childhood and adult asthma rates, poor oral health care,
and high alcohol and tobacco use among adults and teens.
Kosrae is for
the most part culturally and linguistically homogeneous. Kosraean is spoken
as the first language by 94% of the population. English is spoken as a
second language by most residents. All CHC staff will be bilingual in
English and Kosraean, except for those few who may be recruited from
off-island. CHC staff will be readily on-hand to translate for off-island
providers, as needed.