Health in small island communities: the UK's South Atlantic colonies

Abstract

Three main factors constrain life, including health matters, on a small island: scale, isolation and access to finance and development. Island populations may have a restricted gene pool, with potential problems of inbreeding and/or minimal resistance to introduced diseases. Regarding health service provision, population mass can be insufficient for high order services to be provided, whilst isolation leads to high costs for on-island services and in taking patients to off-island facilities. This paper deals with these issues for islands at the extreme end of the continuua of scale and isolation by considering the mid-oceanic islands of the South Atlantic. In financial terms, the islands vary from the comfortable, potentially wealthy Falkland Islands, to aid-dependent St Helena. The effects of aid-dependency are discussed.