Health Care Needs

image 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.