People's health in Oceania

Minato NAKAZAWA, Ph.D.
(Yamaguchi Prefectural University)

Oceania
Hawaii
SaipanGuamYap
Palau Islands

Micronesia
Caroline Islands

Kiribati

Nauru

Papua New
GuineaNew Guinea

TuvaluSolomon Islands

New Caledonia

Polynesia

Ellice Islands

WesternSamoa American
Samoa

Melanesia
VanuatuTokelau Islands

Iles de la Societe

Fiji
Tonga

Australia

New Zealand

Niue

Cook Islands

Tahiti

Iles de la Tuamotu

Regional Characteristics
RegionMelanesia (1):
PNG andSolomon Islands

Melanesia (2):Vanuatu, Fiji, New
Caledonia
Polynesia

First Human 60000~40000 yrs 5000~2000 yrsArrivalago
ago
Majority

Non-Austronesian Austronesian

Micronesia

3000~2000 yrs 3500~2000 yrs
agoago
AustronesianAustronesian /Core Micronesian

Christianity Late
Modernizatio
nLate

Middle

Early

Early

Middle

Early

Early

Geology

VolcanoVolcanoCoral

Volcano / Coral

Anopheles

existspartly exists

none

none

Statistics (Source: WHO, 2001)
Region / Items
GDP per capita (Intl $)

PNG
Samoa
Palau(Melanesia1) (Polynesia) (Micronesia)
3567

3328

7559

Life expectancy at birth (m/f) 58.4 / 61.3

67.0 / 69.9

66.9 / 70.5

Healthy Life expectancy (yr)at birth (m/f)

47.9 / 51.8

56.0 / 59.5

55.5 / 59.9

Child (<5 yr) mortality per1000 (m/f)

100 / 9324 / 1924 / 22Per capita healthexpenditure ($)

3181263% Health Expenditure per
GDP

4.1

6.6

6.4

Leading causes of death
PNG1977
Fiji 1978
Samoa 1980 Palau 1999
(Melanesia1) (Melanesia2) (Polynesia) (Micronesia)
Respiratory
1
27.7%
2

Infection
24.4%

Circulatory
29.4%

Circulatory
32%

Circulatory
32.1%

Heart disease
28.3%

Undiagnose Respiratory
d 17.4%11%

Neoplasms
16.8%

Neoplasms
14.8%

Undiagnosed Respiratory
313.5%
8.9%
4

Perinatal
6.0%

Guam 1999(Micronesia)

Perinatal
7.4%

Accidents
11%

Endocrine,
metabolic, Cerebrovascularetc. 8.4%
9.4%

Neoplasms
10%

Ill-defined
7.6%

Suicide 5.0%

Melanesia
People in PNG and Solomon Islands villages– Mostly suffering from ARI, malaria, filariasis,
typhoid, hookworm infection, HB.
– G6PD deficiency is frequently seen in malaria
endemic area.
– There were some endemic diseases. Kuru in PNG
highland (Fore), endemic cretinism, etc.
● People in PNG towns and Fiji, Vanuatu and New
Caledonia– Cardiovascular / Cerebrovascular disease areprevailing. Diabetes / Obesity are frequently seen.
●Polynesia / Micronesia
Cardiovascular / Cerebrovascular disease andCancer mortalities are high.
● Diabetes / Obesity / Hypertension are frequently
seen especially in town: relating with
Westernized lifestyle coupled with “thrifty”
genotype.
● Malaria is absent. Filariasis, Dengue, and someother mosquito-borne diseases are still present:
Vector mosquito differs.
●Malaria
Only seen in PNG, Solomon Islands, Vanuatu due togeographical distribution of Anopheles mosquito. PNG
mountainous area higher than 2100 m a.s.l. has nomalaria due to the lack of Anopheles mosquito.
● Hypoferremia was seen in some of the Gidra-speaking
population, despite that they had extraordinary high ironintake (particularly cycad seeds).
● Mosquito-net is not readily acceptable partly because
community meeting after sunset is necessary in culturalcontext.
● Deforestation brought new water pools for larva/pupa,
to increase Anopheles mosquito and malaria epidemics(e.g., Malaita, Solomon Islands).
●

Diabetes / Obesity
Much more seen in Polynesia / Micronesia than inMelanesia.
● “Thrifty” genotype (Neel, 1960) selected byfrequent starvation / lower ambient temperatureduring ancient travels expanding over Pacificislands.
● Westernization brought– lower activity in daily life
– high fat and high energy diet●

CNS degeneration
Like Kuru (Fore), CNS degeneration is sometimes
seen in Oceania.
● One possible etiology is the complex of– excess Mn and Al intakes (from soils)– shortage of Ca, thiamine, vitamin C intakes– genetically metal accumulative tendency●