Temporal trends of food consumption patterns in Tuvalu under the context of climate change: COMmunity-based Behavior and Attitude survey in Tuvalu (COMBAT) since 2020.

AIM: The aim of this study was to analyze temporal trends of food consumption patterns, attitudes, and health-related knowledge in Tuvalu, a small Pacific Island country facing the triple threat of obesity, climate change, and food insecurity. METHODS: Two waves of the COMmunity-based Behavior and Attitude (COMBAT) survey were conducted in 2020 and 2022. Descriptive characteristics of changes in obesity proportion, food intake, and sociodemographic factors were assessed. Additionally, this study also integrates individual climate data utilizing satellite-based prediction models, and estimates historical temperature, precipitation, and sea level trends among all islands in Tuvalu. RESULTS: The study revealed a high obesity proportion among adults (69.5% in 2020, 73.2% in 2022) and an increase in the percentage of adolescents with a high waist circumference. Variations in food intake were also observed between the two waves of the survey. CONCLUSIONS: The data collected in the COMBAT study provides valuable insights for future epidemiological research to elucidate the associations and causal relationships between climate change, food security, and non-communicable diseases in Tuvalu.

Prevalence and correlates of psychological distress among national community-based adult populations in Nauru, Tukelau and Tuvalu.

AIMS: The aim of the study was to estimate the prevalence and correlates of psychological distress (PD) in three small Pacific Island countries. METHOD: National cross-sectional data (pooled sample N = 3,088, 18-69 years) of participants from the STEPS surveys in Nauru (2015/16; N = 1382), Tukelau (2014; N = 554) and Tuvalu (2015; N = 1152) were analysed. RESULTS: In the pooled sample 30.4% participants had PD (⩾20 scores), 18.1% mild (20-24 scores), 7.8% moderate (25-29 scores) and 4.4% severe (30-50 scores) PD. The prevalence of PD in Nauru was 41.5%, in Tukelau 5.0% and in Tuvalu 22.7%. In the adjusted logistic regression analysis with the pooled sample, younger age (18-39 years), alcohol family problems, heart attack/stroke, current smoking, high salt intake and high sedentary behaviour were positively associated with PD, while male sex and being from Tukelau and Tuvalu were negatively associated with PD. CONCLUSION: Almost one in three participants reported PD and several associated factors were found that can be targeted in population interventions.

The mental health impacts of climate change: Findings from a Pacific Island atoll nation.

BACKGROUND: Climate change is anticipated to have profound effects on mental health, particularly among populations that are simultaneously ecologically and economically vulnerable to its impacts. Various pathways through which climate change can impact mental health have been theorised, but the impacts themselves remain understudied. PURPOSE: In this article we applied psychological methods to examine if climate change is affecting individuals' mental health in the Small Island Developing State of Tuvalu, a Pacific Island nation regarded as exceptionally vulnerable to climate change. We determined the presence of psychological distress and associated impairment attributed to two categories of climate change-related stressors in particular: 1) local environmental impacts caused or exacerbated by climate change, and 2) hearing about global climate change and contemplating its future implications. METHODS: The findings draw on data collected in a mixed-method study involving 100 Tuvaluan participants. Data were collected via face-to-face structured interviews that lasted 45 min on average and were subjected to descriptive, correlational, and between-group analyses. RESULTS: The findings revealed participants' experiences of distress in relation to both types of stressor, and demonstrated that a high proportion of participants are experiencing psychological distress at levels that reportedly cause them impairment in one or more areas of daily life. CONCLUSIONS: The findings lend weight to the claim that climate change represents a risk to mental health and obliges decision-makers to consider these risks when conceptualizing climate-related harms or tallying the costs of inaction.

Distressing encounters in the context of climate change: Idioms of distress, determinants, and responses to distress in Tuvalu.

Across the globe there is a critical need for culturally informed and locally valid approaches to mental health assessment and intervention, particularly among disadvantaged and marginalized populations. To be optimally effective, such approaches must be informed by a sound understanding of locally relevant idioms of distress and its determinants, including those caused or exacerbated by global power disparities and structural inequities. Climate change, arising due to anthropogenic sources located predominantly in industrialized nations, is one potential determinant of distress having disproportionate adverse impacts on already marginalized populations. The present study formed part of a broader project examining the intersections of culture, climate change, and distress in the Polynesian nation of Tuvalu - a focal point of global concern over the human costs of climate change. The study explored determinants and idioms of distress and culturally prescribed responses to coping with distress. Results are based on fieldwork conducted in 2015 entailing semi-structured interviews with 16 key informants and 23 lay residents of Funafuti atoll, recruited using maximal variation purposive sampling. Findings are examined in consideration of the unfolding impacts of climate change and the threat it portends for the future, both of which were identified as salient determinants of distress, in keeping with theorized relationships between climate change and mental health. The study underscores the necessity of attending to the relationships between global forces, local cultures, and individual experiences of distress, as efforts to provide access to culturally informed social and mental health services expand globally.

Measuring progress towards achieving Millennium Development Goals in small populations: is under-five mortality in Tuvalu declining?

OBJECTIVES: Infant mortality rates (IMR) and under-five mortality rates (U5MR) in Tuvalu (2010 population 11,149) for 1990-2011 were evaluated to determine best estimates of levels and trends. METHODS: Estimates were graphed over time to identify trends/inconsistencies, and censored for reliability/plausibility. Where possible, 95% confidence intervals (CIs) and tests for linear trend were calculated. RESULTS: Ministry of Health (MoH) data indicates IMR and U5MR (per 1,000 live births) declined over 1990-2008: IMR 62 (95%CI 46-81) for 1991-93 (51 deaths) to 19 (95%CI 10-33) for 2006-08 (12 deaths); U5MR 67 (95%CI 50-87) for 1991-93 (55 deaths) to 19 (95%CI 10-33) for 2006-08 (12 deaths). The 2007 Demographic and Health Survey (DHS) suggests recent trends are increasing: IMR 24 for 1998-2002 to 31 (95%CI 20-42) for 2003-07; U5MR 29 for 1998-2002 to 36 (95%CI 30-43) for 2003-07 (deaths not provided). Tests for linear trend and 95%CIs indicate MoH declines are statistically significant, but recent increased estimates from DHS are not, and could be affected by recall bias. CONCLUSIONS: Small populations provide challenges in interpretation of IMR/U5MR trends. To ensure the correct interpretation of rates, CIs (95%) and tests for trend should be calculated. Tuvalu has experienced steady decline in IMR/U5MR over the past 20 years.

New WHO member hopes to remain AIDS-free.

PIP: Tuvalu is a country of slightly more than 8000 inhabitants spread over 3 small reef islands and 6 atolls approximately 1000 km north of Fiji. It gained independence from the United Kingdom in 1978 and was admitted to the World Health Organization (WHO) in May 1993. Although Tuvalu had a national AIDS program before being admitted to WHO, WHO's Western Pacific Regional OFfice now supports the program. No case of HIV infection has been reported in Tuvalu, but an active AIDS committee nonetheless oversees health education and promotion activities. For example, the 300 seamen being trained at the Tuvalu Maritime School to work on ships internationally are taught on sexually transmitted disease and HIV prevention education as part of their coursework. Youth leaders and Sunday school teachers have also been recruited to spread the word on AIDS prevention. Finally, WHO expresses its approval of Tuvalu's policy against restricting people infected with HIV, including short-term travellers.^ieng

Third Development Plan, 1984-1987.

PIP: This document contains provisions of Tuvalu's Third Development Plan (1984-87) relating to population policy, family planning, health care, and health education. Excerpts from chapter 6 (Population and Employment) call for effective control of population growth to strengthen the economy and improve the standard of living of the people. Efforts to strengthen the family planning (FP) program will include: 1) intensifying health education programs, 2) including unmarried women and men in the target population, 3) encouraging staff to communicate with acceptors more regularly, and 4) intensifying activities in identified problem areas. Excerpts from chapter 7 (Rural Development) delineate the problems associated with the fact that young people are migrating to the capital island in the vain hope of securing jobs. Therefore, development activity is planned for the outer islands to achieve balanced development. Sections from chapter 30 (Health and FP) report that the percentage of female targeted acceptors increased from 28.7 to 37.4 from 1982 to 1983. Health goals will continue along the lines of those presented in the Second Development Plan and will seek to develop and maintain preventative health services on all islands, to improve the quality of basic health services on all islands, to strengthen FP and maternal/child health services, and to develop and maintain dental services.^ieng

Behind the results: hand processing the recent Kiribati and Tuvalu censuses.

PIP: In October of 1975, the independent nations of Kiribati and Tuvalu were formed from the Gilbert and Ellice Islands colony. A decision was made to hold full population censuses in 1978 and 1979 for Kiribati and Tuvalu respectively, where the 2 nations' censuses would be as similar as possible, and would be repeated at 5 year intervals. Island geography caused many problems during data collection, due to wide population dispersal over many scattered islands, and difficulties in interisland communication. Hand processing of the census data had some advantages and many disadvantages. The main advantages of this system included that it was locally labor intensive and inexpensive, and no less time consuming than sending data to a computer center in another country for processing. Disadvantages included that it was prone to human error, tedious, required extensive planning and preparation, and a commitment to using predetermined tabulations. Additionally, storage of the collected data was unacceptably bulky and unwieldy, making the sorting of the data for further analysis nearly impossible. The author suggests that the full potential of the census data cannot be realized unless, in the future, the data are captured and stored on magnetic disks or tapes. Minicomputers are suggested as a more appropriate means of processing data for Kiribati, Tuvalu, and other small Pacific countries.^ieng

Progress in Pacific islands.

PIP: The article announces the formation of family planning associations on the Tonga, Tahiti, Gilbert and Ellice Island groups. The administrative structures of the Associations are briefly described and organizational methods and directions to involve all islands of a particular groups are reported. All of the territories are within the area served by the South Pacific Commission which has set up a family planning seminar for the areas involved.^ieng