The epidemic of diabetes, heart disease, cancer and other diseases afflicting Pacific islanders is a tragedy for the individuals and families involved and a growing threat to the vitality of Hawaii's taxpayer-funded health care system for the poor.

The Pacific Island Health Officers Association's declaration of a health emergency for U.S.- affiliated islands, including Palau, the Marshall Islands and the Federated States of Micronesia, should be taken as an urgent call to action to fight these pervasive diseases with the same intensity associated with campaigns to combat communicable diseases such as HIV/AIDS, influenza and tuberculosis.

Although not contagious in the conventional sense, lifestyle-related disorders such as Type 2 diabetes, cancer and heart disease exacerbated by poor diets, smoking, binge drinking and lack of exercise can be “;handed down”; through the generations and among families that may lack the information, money and time to make healthier choices.

Governments, policymakers, medical professionals and the patients themselves must address the many reasons these diseases have taken such hold in Pacific island populations, and do more to treat and prevent them.

The stakes are devastatingly high for individual patients, of course, hobbled by symptoms that might have been prevented. But the stakes also are high for Hawaii as a whole, as thousands of Pacific islanders seek subsidized medical treatment here, entitled to live in the United States under compacts of free association.

Already the state has limited the free medical coverage provided to poor people who are not U.S. citizens, overwhelmed by ballooning costs unreimbursed by the federal government.

In making the emergency declaration, Michael Epp, executive director of the Pacific Island Health Officers Association, noted that some Pacific island populations have the highest rates of noncommunicable diseases in the world.

“;In 20 to 25 years, if things continue as they are, it will be a social catastrophe,”; he told the Star-Bulletin's Helen Altonn.

It is a catastrophe that can be averted, but only with intense outreach, and only if the U.S. government recognizes that it has a greater obligation to states such as Hawaii that are home to thousands of Pacific island immigrants with serious health-care needs.