-US took control of islands -established military base -concentrated poverty -water shortages -segregated from US -discrimination-quality of life -crowded environment -power outages -nuclear weapon testing -lack of hygiene/sanitation -urbanization = more infectious disease -not enough $ to go to hospital -limited access- doctors traveled to them -malnourishment/ change in diet -environment controls them -compromised immune systems -rate of TB = 23x US -relocated =disrupts their lifestyle