American Samoa

American Samoa is a United States territory in the western Pacific. It lies on the same side of the international date line as the continental U.S.

Government

The U.S. president is considered the head of state and the governor is the head of government. While American Samoa is a U.S. territory, its residents are U.S nationals instead of U.S. citizens; however, neither citizens nor nationals of U.S. territories vote in federal elections or pay federal taxes.

Geography

American Samoa is geographically isolated from the rest of the U.S.-Affiliated Pacific Islands (USAPI): the territory is located in the southern region of the Pacific (Polynesia), while the rest of the USAPI are in the northern region (Micronesia).

American Samoa maintains significant ties with the independent nation of Samoa, which is only a thirty-minute flight west, across the international date line. Because of their cultural and historical links, Samoans share a special affinity for their “brothers and sisters” in the U.S. territory of American Samoa; nearly one-third of American Samoa’s workforce hails from Samoa, and the two jurisdictions engage in frequent cultural exchange.

Healthcare and Facilities

American Samoa’s healthcare system is administered and subsidized by the government. American Samoa has a Department of Public Health and a Hospital Division; these operate as two separate systems. American Samoa has one hospital, the LBJ Tropical Medical Center, which is a 128-bed general acute care hospital, and five primary health centers.

American Samoa operates a Medicaid program to support care for low-income residents. Territorial Medicaid programs are underfunded relative to the states. Unlike state Medicaid programs, territorial Medicaid programs have (1) a cap on total federal contributions and (2) a federal funding match set by law rather than based on per-capita incomes. Learn more about the need for equitable Medicaid funding for the territories via ASTHO's Permanent, Sustainable Medicaid Funding for U.S. Territories Policy Statement.

Key Priorities

American Samoa, like the rest of the Pacific, faces a noncommunicable diseases crisis and a significant communicable disease burden. According to the 2018-2022 Country Cooperation Strategy, American Samoa, in partnership with the World Health Organization, is working to:

• Improve health policy development mechanisms.
• Identify emerging and re-emerging diseases.
• Implement effective interventions to decrease the burden of chronic diseases related to unhealthy lifestyles, especially cardiovascular disease, cancer, and diabetes mellitus.

Disease Burden

As of 2019, heart disease, diabetes, and stroke were the top three health issues for the islands.