Health trends
The provisional crude death rate in 2003 was 4.3 per 1000 population, a slight increase from 4.1 in 2002. However, the provisional infant mortality rate in 2003 was 11.22 per 1000 live births, a significant increase from the 2002 rate of 6.21 per 1000 live births. Although the health status of Guam’s population continues to improve, the five leading causes of death in 2002 remain as follows: diseases of the heart (130.39 per 1000 population), malignant neoplasm (76.99), cerebrovascular disease (32.29), all other accidents (14.28) and suicide (13.66).
Health systems
Guam is faced with the challenge of maintaining a health care system that will adequately meet the needs of a predominantly young and growing population. At the same time, it is also faced with the added challenge of addressing the problems of the rapidly increasing number of older people, forecast to increase from 3.9% of the total population in 1990 to 7.5% in 2010.
A reduction in human and financial resources has severely impacted the health system. An early retirement programme, instituted at the end of 1999, led many experienced health workers to retire. While the vacated positions have continued to be funded, there is not a large enough resource pool to fill all of them. Tightening government budgets have left some less critical positions vacant, and these vacancies have reduced the overall amount of services available to the uninsured and underinsured population. The vacancies have also affected progress in strengthening other health service priority areas, such as disposal of hazardous and toxic materials, environmental protection, vector control, and drug and alcohol abuse services.