2023 Hybrid Survey Highlights Rising Health Risks

By: Eustoria Marie Borja

Palau falls short of its goal to reduce mortality from Non-Communicable Diseases (NCD) by 2025 by 25% despite efforts, with nearly all chronic conditions worsening over the past seven years.  The 2023 Adult Hybrid Survey in Palau reveals concerning trends in chronic conditions and risk factors for non-communicable diseases (NCDs), highlighting a significant public health challenge.

Chronic Conditions on the Rise

Three out of four adults in Palau are either overweight or obese, marking a slight increase from 73% in 2016 to 76% in 2023. Similarly, hypertension prevalence surged to 48%, up from 33% in 2016, with over half of those affected undiagnosed and not on medication.

Diabetes rates have climbed to 31%, with 60% of individuals unaware of their condition or untreated. Meanwhile, high cholesterol levels, measured as 240 mg/dL or higher, dropped from 5% to 2.4%.

Risk Factors for NCDs

The survey outlines various lifestyle factors contributing to the rise in NCDs:

• Tobacco use: One in five adults smokes cigarettes, with 47% using some form of tobacco, including smokeless products.
• Alcohol consumption: More than one-third of Palauan’s consume alcohol, with an average intake of six alcoholic drinks daily.
• Poor nutrition: Alarmingly, nine out of ten adults consume less than five servings of fruits and vegetables per day.
• Oral health: Two-thirds of adults in Palau have missing teeth due to decay or disease, while nearly two out of three residents did not visit a dentist in the past year.
• Healthcare access: Only 43% of adults reported having had a medical check-up in the past year, indicating gaps in preventive care.

Female Cancer Screening

While progress has been made in some areas, female cancer screening rates remain low:

• 65% of women aged 21-65 meet the guidelines for Pap smear or VIA tests every three years.
• Only 37% of women aged 50-74 meet the guidelines for mammograms every two years.

Progress Made in Some Areas

While Palau faces increasing health challenges, the 2023 survey highlighted a few areas where measurable improvements have been made:

• High Cholesterol: High cholesterol levels decreased significantly, from 5% in 2016 to 2.4% in 2023. This positive trend suggests that efforts to promote healthier diets or the use of cholesterol-lowering medications may be contributing to better outcomes.
• Female Cancer Screening (Pap Smear/VIA Test): The proportion of women aged 21-65 who meet the guidelines for Pap smear or VIA tests every three years improved, reaching 65% in 2023. This indicates progress in preventive care for cervical cancer, although there is still room for improvement.
• Medical Check-ups: The number of adults receiving an annual medical check-up slightly improved compared to previous years, with 43% reporting having had a check-up in the past year. While this is still less than half of the population, it reflects an improvement in health-seeking behavior.
• Nutrition Awareness: Though still concerning, there has been a modest improvement in nutrition awareness, with a slight increase in the number of people consuming more than five servings of fruits and vegetables daily compared to earlier years. However, 9 out of 10 adults still fall short of the recommended intake, indicating that further efforts are needed.

Trends from 2016 to 2023

A comparative analysis between 2016 and 2023 shows mixed results in key health indicators:

• Tobacco use and alcohol consumption have remained largely unchanged.
• Nutrition and healthcare check-up rates saw slight improvements, though significant gaps persist.
• Oral health worsened, with more adults experiencing permanent tooth loss due to decay or disease.
• Cancer screening rates improved marginally but remain below targets.

Palau’s Ministry of Health and Human Services acknowledges the unmet target to reduce NCD mortality by 25% by 2025. The report reveals the urgent need for comprehensive strategies focusing on preventive care, healthier lifestyles, and improved access to health services to curb the escalating NCD burden.

References: Palau Adult Hybrid/ Community Health Assessment Survey (2023)