Date of Award

Spring 5-20-2023

Document Type

Honors Project

University Scholars Director

Dr. Christine Chaney

First Advisor/Committee Member

Dr. Charlotte Pratt

Second Advisor/Committee Member

Dr. Cara Wall-Scheffler


Cultural impact, epidemiology, health risk factors, Guam, type 2 diabetes, chronic kidney disease, global burden of disease, non-communicable diseases


Non-communicable diseases (NCDs), including chronic and metabolic diseases, are responsible for 74% of global mortality and are strongly influenced by health risk factors. Geographical differences in NCDs have been identified in several countries but have not been completely explained through cultural factors, specifically island and mainland cultures. This study aimed to develop an epidemiological framework for determining diseases with the highest mortality for further investigation regarding different health risk factors rooted in a specific population’s cultural foundations. Preliminary findings indicated diabetes type II (D2) and CKD caused by hypertension and D2 to have the highest risk factor and mortality percentage in both island and mainland populations. Further analysis indicated the potential for each population’s culture as a harmful influence regarding non-communicable, chronic, and metabolic diseases. The study suggests family-based educational programs implemented in each population’s respective healthcare systems to manage and prevent the heavy disease burden of diabetes type II and chronic kidney disease.


A project submitted in partial fulfillment of the requirements of the University Scholars Honors Program.

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