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Advance Your Public Health Career in the Island Jurisdictions

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Who are the Island Jurisdictions?

The five U.S. territories and three freely associated states are collectively referred to Island Jurisdictions or Island Areas. Each island jurisdiction has its unique context, history, needs, and relationship with the United States. To learn more about each jurisdiction's health system, history, and relationship with the United States, please visit ASTHO’s Island Jurisdictions 101 page.

Working in Public Health in the Islands

  • Hands-on learning opportunities! The structure and size of the departments and ministries of health in the island jurisdictions promote cross-training throughout various areas of public health.
  • Make an impact! You will help strengthen existing public health initiatives and work to implement innovative approaches to address island area challenges.
  • Immerse yourself in island life! Appreciate the distinct culture and natural surroundings that the island jurisdictions offer. Participate in the U.S. Virgin Island’s month-long Crucian Christmas Festival. Learn traditional CHamoru history, arts, and cooking in Guam. Explore the ancient Nan Madol ruins in Pohnpei State of the Federated States of Micronesia. Get your scuba diving certification and explore the oceans surrounding the island jurisdictions.

Island Public Health Priorities

Programmatic Priorities

  • Lessen the prevalence and spread of infectious disease
  • Prevent and treat chronic disease
  • Prepare for response to severe weather events
  • Meet the needs of specialized populations

Infrastructure Priorities

  • Strengthen data systems and capacity
  • Strengthen the health workforce
  • Strengthen health agency administrative capacity
  • Build island health equity infrastructure

Health Equity in the Islands

To address health equity in the island jurisdictions is to confront a long history of colonialism. Island communities have many strengths, including emphasizing the wellbeing of community and resilience through challenging times and conditions. Island communities have a pre-colonial history of healthy lifestyles and diets and using data to navigate the oceans. Current health equity efforts build on these strengths. Island jurisdictions’ equity initiatives focus on using data for decision-making, extending health services to all, and engaging communities and partners. To learn more about the islands’ health equity work, please visit the ASTHO’s Islands Health Equity Framework webpage.

Hear from Island Public Health Champions

Halina Palacios, Chief of Clinic Services
“I chose to get into this field of work because I wanted to be a part of the 'better days', but realizing that in order to get 'to the better' there needs to be people to get 'through the challenges'. Our people deserve nothing less, so I wake up everyday striving to give them everything I got.”

Halina Palacios, Chief of Clinic Services, Commonwealth Healthcare Corporation, CNMI

  • Mayra
    Assistant Secretary for Environmental Health
    Puerto Rico Department of Health

Island Frequently Asked Questions

Passport requirements vary across island jurisdictions! Please visit for current requirements.

For U.S. territories, no visa is required. Visa requirements vary in freely associated states. Learn more at Republic of Palau, Republic of the Marshall Islands, and Federated States of Micronesia.

Island jurisdictions cover seven time zones, spanning -6 ET in American Samoa to +17 ET in the Republic of the Marshall Islands. Visit ASTHO island area profiles for information on time zones.

Not necessarily. English is the official language of business in all island jurisdictions except for Puerto Rico. In Puerto Rico, English and Spanish are the official languages. For this reason, Spanish is highly recommended for working in Puerto Rico.

Connect with Local, State, and Territorial Health Departments

To find local governmental public health jurisdictions, see -