Health for the Marshallese


Arkansas might seem like an unlikely landing place for immigrants from the Pacific Islands. In fact, our state has the second largest Marshallese population in the world outside the Republic of the Marshall Islands. 

Check out this recent article from the Arkansas Democrat Gazette that examines the health of Marshallese Arkansans.

Health for the Marshallese

June 23, 2013

Despite being more than 1,500 miles from the Pacific Ocean, Arkansas holds the distinction of serving as home to the largest population of Marshall Islanders in the continental United States, with as many as 6,000 residing in the state. Although the number of Marshallese Arkansans may seem small, they represent approximately 9 percent of the entire population of the Republic of the Marshall Islands. The vast majority reside in Springdale, where they contribute greatly to the local economy and the region’s cultural life.

Although they are legal residents and pay U.S. taxes, the Marshallese are ineligible for many federal safety net programs. Their exclusion from these services not only threatens the health of Marshall Islanders and their neighbors but has resulted in a substantial financial hardship for health care facilities in Springdale and its surrounding communities.

The Marshall Islands consists of a series of widely dispersed coral islands and atolls located about 2,400 miles southwest of Honolulu. Due to the Compact of Free Association (COFA) treaty signed in 1986, Marshall Islanders-as well as citizens of the Federated States of Micronesia and the Republic of Palau-can live and work in the United States without a visa or green card.

In exchange, the United States enjoys exclusive military rights over the more than 2 million square miles of ocean encompassing these three countries. In addition, the U.S. maintains a large military base on Kwajalein Atoll, which includes the strategically important Ronald Reagan Ballistic Missile Defense Site.

Many Marshallese in Northwest Arkansas work in the region’s vast poultry industry, in retail, and in food service. Most who are employed full time are eligible for health insurance. However, for many workers, the cost of covering their spouses and children can be prohibitively expensive. Due to their complex lineage system, Marshallese employees may also be responsible for relatives not typically covered in family health insurance plans like cousins, parents, or their siblings’ children.

Unlike those families, though, U.S.-based Marshall Islanders are ineligible for most federal health care programs like Medicaid, Medicare, and Social Security. Although the original treaty permitted eligible COFA migrants to apply for these programs, welfare reform legislation signed by President Bill Clinton in 1996 explicitly barred them from receiving these benefits. Nonetheless, Marshallese workers continue to subsidize these programs through payroll deductions and income taxes.

Marshall Islanders share some of the same health problems facing other low-income populations in the U.S. Type 2 diabetes, for example, has reached epidemic proportions among Marshallese Arkansans. Likewise, Marshallese suffer from unusually high rates of a variety of cancers. They are also susceptible to ailments that are less common among the general population including tuberculosis, eczema, and Hansen’s Disease. The reasons for this susceptibility are complex but likely include their adopting a Western diet, overcrowding and poor sanitation in the Islands’ urban centers, and a lack of comprehensive health care on the nation’s many far-flung islands and atolls…

Please visit the Arkansas Democrat-Gazette website to view the article “Health for the Marshallese” in its entirety. Abstract reprinted with permission.