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The Federated States of Micronesia and the Republics of Palau and the Marshall Islands signed a series of treaties known as the Compacts of Free Association (COFA) with the United States (U.S.). While the islands became independent nations, certain rights and responsibilities were assigned to the U.S. However since the signing of the treaties, U.S. federal and Hawai'i state policies have reduced health care coverage for COFA migrants living in the U.S. and its territories. This commentary reports the ongoing efforts of the Micronesian community and its allies to rectify a legacy of unjust policies. We outline the need for sound policies that support appropriate health care to all members of society, and highlight the community's strength and ability to mobilize for political action. If health is a human right, providing adequate, equitable health care to all members of society is not up for debate. [ABSTRACT FROM AUTHOR]

Objectives: We compared the age at admission and the severity of illness of hospitalized Micronesians with 3 other racial/ethnic groups in Hawaii., Methods: With Hawaii Health Information Corporation inpatient data, we determined the age at admission and the severity of illness for 162,152 adult, non-pregnancy-related hospital discharges in Hawaii from 2010 to 2012. We performed multivariable linear regression analyses within major disease categories by racial/ethnic group. We created disease categories with all patient refined-diagnosis related groups., Results: Hospitalized Micronesians were significantly younger at admission than were comparison racial/ethnic groups across all patient refined-diagnosis related group categories. The severity of illness for Micronesians was significantly higher than was that of all comparison racial/ethnic groups for cardiac and infectious diseases, higher than was that of Whites and Japanese for cancer and endocrine hospitalizations, and higher than was that of Native Hawaiians for substance abuse hospitalizations., Conclusions: Micronesians were hospitalized significantly younger and often sicker than were comparison populations. Our results will be useful to researchers, state governments, and hospitals, providers, and health systems for this vulnerable group.