Pago Pago, AMERICAN SAMOA — February is Heart Health Month – a time to shine a light on cardiovascular disease, the leading cause of death in American Samoa, according to Make American Samoa Healthy Again (MASHA).

“Our communities face a serious NCD crisis: obesity affects over 90% of adults, diabetes and CKD impact far too many, and NCDs (including heart disease, stroke, and related conditions) drive 70-90% of deaths. High blood pressure, obesity, and high blood sugar are major drivers – but we CAN turn this around with prevention, policy changes, and community action!” the organization states.

#MASHA has compiled our Top 10 Priorities for improving heart health right here in the Territory. Together, these could reduce the NCD burden by 20-30% in 5 years.

Read the following list and join us in making American Samoa healthy again.

Top 10 Priorities for Improving Heart Health in American Samoa During Heart Health Month 2026

The leading cause of death in many communities including our own — American Samoa — continues to face a severe Non-Communicable Disease (NCD) crisis.

Recent data highlights ischemic heart disease as a top cause of poor health and early death, driven by high blood pressure, obesity, and high blood sugar.

Drawing from global sources, regional Pacific strategies, and U.S. initiatives like the MAHA movement, MASHA has compiled a prioritized list of top 10 recommendations for our Territory.

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.

Priorities are ordered by potential for rapid implementation and broad impact during this awareness month and beyond, beginning with policy levers for quick wins in heart protection.

These priorities could collectively reduce the NCD burden by 20-30% within 5 years if implemented multi-sectorally, drawing on successful models in the region and MAHA-driven U.S. changes. They emphasize vulnerable groups like youth and low-income families, while still respecting our Fa'aSamoa cultural values.

1.        Implement NAP Waivers to 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 sodas or sugary drinks) and other natural, healthy options. This could immediately reduce sugar intake, a key driver of obesity and diabetes, potentially cutting consumption by 20-30% 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.

This addresses physical inactivity (a factor in 80% of NCD risks) and could halt rising childhood obesity rates, which are among the highest globally.

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 (not turkey tail of lamb flaps), healthy fats, and vegetables over refined carbohydrates (like white bread and rice).

This promotes traditional Samoan foods while reducing reliance on imported processed items, targeting the dietary risks behind 50% of diabetes and CKD cases.

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.