Date of Graduation

Fall 12-2015

Document Type


Degree Name

Master of Arts in International Studies (MAIS)


College of Arts and Sciences


International Studies

First Advisor

Christopher Loperena


Despite moving to the United States for better healthcare, among other benefits, Marshallese Compact of Free Association (COFA) migrants residing in Springdale, Arkansas continue to face similar acute health problems as Marshallese living in the Republic of the Marshall Islands (RMI), and often without access to health services. These problems include high rates of noncommunicable diseases, such as type 2 diabetes and thyroid cancer, as well as rare conditions such as Hansen’s Disease.

To research this, I studied the limited texts surrounding the Marshallese diaspora, as well as relevant bodies of literature: postcolonialism, Pacific migration theory, and global health and structural violence. I also conducted topical interviews with Marshallese and non-Marshallese community members, health workers, and government officials in Springdale, Arkansas.

The two biggest barriers to healthcare in the Springdale Marshallese community are poverty and a lack of health insurance. These and the Springdale Marshallese’ biggest health problems can be traced to the structural violence caused by the continuing colonial relationship between the United States (US) and the RMI. Many existing health conditions carried over from the RMI are a result of the poverty, slum conditions, displacement, and irradiation present there, all of which can be traced back to US military occupation and intervention. Current US social services laws have stripped COFA migrants of the publicly funded health benefits (e.g., Medicaid) they were promised in the original COFA. While Marshallese COFA migrants are eligible for subsidized health insurance plans offered by the Affordable Care Act (ACA) of 2010, the Marshallese

community’s low income qualifies them for the health plan bracket reserved for the poorest: Medicaid expansion. Due to their COFA migrant status, however, they are ineligible for Medicaid in Arkansas. Practically, the ACA does little for Marshallese COFA migrants living in Springdale, of which even those with health insurance struggle to afford healthcare.

I recommend reinstating federally-funded social services such as Medicaid and the Department of Agriculture’s Supplemental Nutrition Assistance Program to COFA migrants, as this was prematurely removed from the first Compact between the US and the RMI to the continuing detriment of Marshallese COFA migrants in the US.