Living the health transition among the Chamorros of Guam.

Health transition in the Pacific islands reflects the richness of diversity created by varied socio-cultural, ecological, and politico-economic systems and, therefore, requires the inclusion of the local cultural context in health assessment, planning, and program development. This paper focuses on the health transition of the Chamorros of Guam, blending assessment of health trends with the cultural contexts associated with them. The review of health trends reveals that the Chamorros are experiencing a mixed transition, including a combination of infectious and chronic diseases, in addition to the increasing impact of health risk behaviors, which have led to increasing rates of injury-related mortality. The cultural review presents Chamorro perceptions and values in their extended, multigenerational family system, in traditions of caring and sharing within their communities, and in the continued use of their traditional healers. By paying attention to the Chamorro's cultural perspectives and concerns, a "window" is provided to understand the interaction of changing population trends with their actual lives as well as an opportunity to integrate culture and health in our understanding of the health transition.