Make American Samoa Healthy Again (MASHA) has identified 10 priorities for improving heart health.
Obesity affects over 90% of adults, diabetes and Chronic Kidney Disease (CKD) impact 20-40% of the population, and NCDs (including heart disease, stroke, and related conditions) account for 70-90% of deaths. Drawing from global sources, regional Pacific strategies, and U.S. initiatives like the Make America Healthy Again (MAHA) movement, MASHA has compiled a prioritized list of top 10 recommendations for American Samoa.
These focus on immediate, high-impact actions feasible in American Samoa, with special emphasis on prevention, policy changes, and lifestyle improvements to combat heart disease, obesity, diabetes, hypertension, and related conditions.
1. Eliminate Sugary Drinks and Junk Food from Benefits: Leverage MAHA-inspired USDA waivers (already adopted in states like Utah, Iowa, Hawaii and Nebraska as of January 2026) to ban purchases of soda, candy, and ultra-processed snacks with Nutrition Assistance Program (NAP) benefits. Also, continue to explore options to utilize NAP benefits at roadside stands for the purchase of niu (as an alternative to soda or sugary drinks) and other natural, healthy options. This could immediately reduce sugar intake, a key driver of obesity and diabetes, potentially cutting consumption by20-30% among low-income families reliant on NAP.
2. Mandate Daily Physical Education (PE) in Every School Grade:Require at least 60 minutes of daily PE from kindergarten through high school, incorporating culturally relevant activities like traditional dances or team sports.
3. Integrate Mandatory Nutrition Education in Schools Aligned with the New HHS Food Pyramid:Embed regular nutrition classes emphasizing the 2025-2030 inverted pyramid (prioritizing healthy proteins like seafood and meats healthy fats, and vegetables over refined carbohydrates (like white bread and rice). This promotes traditional Samoan foods while reducing reliance on imported processed items,
4. Significantly Increase DOH Budget Allocation for Prevention Programs: Triple the prevention budget to fund community screenings, wellness clinics, and anti-obesity campaigns .This builds on the 2025-2030 NCD plan’s pillars but accelerates impact, potentially reducing premature NCD deaths by 15-20% through early interventions
5. Ban Junk Food from School Canteens, Vending Machines, and Events: Enforce a territory-wide policy removing sugary snacks, sodas, and fried foods from schools, replacing them with fresh, local options like fruits and vegetables. This immediate step could lower youth sugar intake by 25%, directly combating adolescent diabetes rates that have risen 5-10% annually in the Pacific.
6. Introduce Taxes on Sugary Drinks and Ultra-Processed Foods:Implement a 20% excise tax on imported sodas, chips, and high-sugar items, with all revenues funding prevention and health initiatives. This policy change, proven in other Pacific islands, could reduce obesity by 5-10% over five years by making healthier local alternatives more affordable.
7. Promote Community-Based Infrastructure for Physical Activity :Invest in safe walkways, parks, and village parks & gyms, integrated with cultural events, to encourage daily movement. This supports lifestyle changes against sedentary behavior, which contributes to 70% of Cardiovascular Disease (CVD) cases, and could be rolled out immediately via public works partnerships.
8. Enhance Mental Health Integration with NCD Care:Expand access to counseling and substance use programs (targeting alcohol and tobacco for example, which are linked to 30% of NCD risks) through DOH clinics, addressing the interconnected rise in depression and obesity. Immediate training for providers could improve outcomes, as mental health gaps exacerbate chronic conditions.
9. Reform Food Import Policies to Favor Local Nutrient-Dense Options:Prioritize subsidies for local farming and fishing (taro, seafood) over cheap imports, aligning with MAHA’s focus on whole foods. This policy shift could reduce dietary risks for CKD and diabetes, which have increased 10-15% since 2019 due to processed food reliance.
10. Conduct Updated Territory-Wide Health Surveys and Surveillance: Launch a 2026 STEPS survey (updating 2004 data) with digital tracking for obesity, diabetes, and CKD metrics. This foundational step ensures evidence-based adjustments, addressing data gaps that hinder progress toward a 25% NCD mortality reduction by 2030.
Photo: Heart Health Run/Walk-BlueSky
