Advancing Public Health Actions to Prevent and Control Chronic Disease in the U.S. Territories and Freely Associated States

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Six out of ten adults living in the United States have at least one chronic disease. The cost of managing individuals with chronic conditions is a significant portion of the nation’s healthcare expenses. The United States has made progress in chronic disease prevention and control over recent decades. However, similar advancements have not been made in the U.S. territories and freely associated states.The U.S. territories and freely associated states include:American SamoaThe Commonwealth of the Northern Mariana Islands (CNMI)The Federated States of Micronesia (FSM)GuamPuerto RicoThe Republic of the Marshall Islands (RMI)The Republic of PalauThe U.S. Virgin IslandsThe unique challenges these islands face make addressing chronic disease particularly complex. These challenges include:High disease burden.Dispersed populations.Limited infrastructure.Diverse cultures and languages.Vulnerability to natural disasters.Strained healthcare systems.High healthcare costs.This cooperative agreement will support integrated, evidence-based strategies and activities to prevent and manage chronic disease in the U.S. territories and freely associated states. This notice of funding opportunity (NOFO) aims to reduce disability and death rates associated with chronic diseases by decreasing the prevalence of modifiable risk factors that contribute to chronic diseases in these islands. Focus areas include: ​Preventing and reducing tobacco use and secondhand smoke exposure.​Preventing and managing diabetes.​Improving oral health disparities.There are two components to this NOFO. The first is a required Core Component, which uses evidence-based strategies to promote health and reduce chronic disease. The second is an optional, competitive Oral Health Component, which addresses oral disease with evidence-based interventions and practices.