Result of the latest health hybrid survey show that Palau health outcomes and behaviors are worse than that of United States except for general alcohol use and fruit and vegetable consumption. Results were reported at the town hall meeting conducted by ministry of health.
The Palau Hybrid Survey (integrated adult based survey) was designed to simultaneously assess prevalence of substance abuse, mental health and NCD risk factors such as cigarette smoking, alcohol consumption, unhealthy diet and lack of physical exercises.
The report seeks to inform Palauan public of the extent of these health issues and to use the data collected to develop and prioritize prevention program.
In addition, the data will be used for monitoring progress and help to reduce sickness and death rate in Palau. According to the survey results, almost half i.e. 47% of adults in Palau report their health to be fair or poor. Only 5% says that they have excellent health and 15% says very good. 52% of adults in Palau have had medical checkup in the last year and only 12% within last 2 years. Furthermore, report shows 20% have never had medical checkup.
33% of adults are over weighted and 37% are classified obese. Report also shows that women are more likely to be over weighted than man and Palauans are more likely to be over weighted and obese compared to non-Palauans.
The survey also shows that 14% of adults smoke cigarettes everyday and males have higher number of smokers than females. Most smokers in Palau are between ages of 18 to 34. 
47% of adults in Palau chews betel nuts and more women chew betel nuts than men. 63% of Palauans don't drink alcohol but those that do drink, binge drink with number of binge drinkers higher with males than females and also higher among the younger age groups between ages of 18 to 44.
The survey also looked at food consumption behaviors and the result shows that one out of two adults in Palau eat at least one processed meat a day, and this is more prevalent in younger age groups with 31% of adults 18 to 24 years old consuming 2 or more serving of processed meat a day.
61% of women report low level of physical activities while only 37% of men report low physical activity. 46% of adults age 18-24, 25-34 and 35-44, all shows low level of physical activity. Over all 49% of adults show low level of physical activity and 19% show moderate level of physical activity.
Dr. Annette David of Health Partners, LLC explained the need for the survey stating that date and information collected will be used to develop targeted solutions and prevention program in order for us to reach the goals we set here in 2013 and to fulfill the vision formulated, "Healthy Palau with people living long, healthy and purposeful lives."
"Health is shaped by behavior and behavior is shaped by the environment. Environment is shaped by policies and system," added Dr. David.
Given the data and information from the survey, policies and system could be tailored in order to affect changes in the environment (physical environment, social and economic) and that in turn encourage healthy behavior.
Some of the example cited include making healthy food available, accessible, affordable, accepted and attractive. Environment shape our choices, according to Dr. David. An example of McDonald's fast food restaurants showcase how the fast food chain had made their food accessible, affordable and attractive, making their not healthy food, the choice of many.
Another example of policy affecting charge shows States in US with very few parks or playground having higher rate of obesity among children. States with more playground shows less percentage of obese children.
Results of the study enable Ministry of Health and its agencies to identify risk factors and design preventive measures. Policy markers can use the information make policies and system changes that support healthy choices.

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