Healthy Virgin Islands 2030 
Community Health Improvement 
Plan 
UNITED STATES VIRGIN ISLANDS | DEPARTMENT OF HEALTH 
APRIL 2022 
 
U.S Virgin Islands Community Health Improvement Plan | 1 
The Healthy Virgin Islands 2030 Community Health Improvement Plan was 
produced by the U.S. Virgin Islands Department of Health in collaboration with 
community partners and other territorial agencies. This plan was developed with 
funding by the Centers for Disease Control and Prevention and technical 
assistance from the Association of State and Territorial Health Officials. 
SUGGESTED CITATION 
United States Virgin Islands Department of Health. (April 2022) Healthy Virgin Islands 2030 
Community Health Improvement Plan. Christiansted, USVI. 
For More Information 
Visit doh.vi.gov 
 Photos in this report are within the public domain or licensed for use. 
 
 
U.S. Virgin Islands Department of Health  
9048 Sugar Estate 
St. Thomas, U.S. Virgin Islands 00802 
St. Thomas Office: 340-774-9000 | St. Croix Office: 340-718-1311 | St. John Office: 340-776-6400 
 
U.S Virgin Islands Community Health Improvement Plan | 2 
 
Preface ........................................................................................................................... 3 
Introduction .................................................................................................................. 4 
   What is a Community Health Improvement Plan? ............................................................ 4 
   How Was This Plan Developed? ..................................................................................... 7 
Health Priorities ......................................................................................................... 10 
   Cross-Cutting Strategies .............................................................................................. 11 
   How the Priorities are Presented ................................................................................... 12 
   Priority 1: Access to Primary and Specialty Care ........................................................... 13 
   Priority 2: Chronic Disease Burden ............................................................................... 16 
   Priority 3: Behavioral and Mental Health........................................................................ 20 
   Priority 4: Oral Health ................................................................................................... 23 
   Priority 5: Injury and Violence Prevention ...................................................................... 26 
   Priority 6: Public Health Infrastructure ........................................................................... 29 
Implementation ........................................................................................................... X 
   Improvement in a Time of Pandemic ............................................................................. 34 
   Immediate Next Steps .................................................................................................. 35 
Appendices ................................................................................................................... X 
   Appendix A: Community Health Improvement Plan Steering Committee Charter ........... 37 
   Appendix B: Community Health Improvement Plan Steering Committee  
   Membership ................................................................................................................. 39 
   Appendix C: Summary of Community Survey Results .................................................... 41  
    
 
Table of Contents 
 
U.S Virgin Islands Community Health Improvement Plan | 3 
Preface 
April 2022 
On behalf of the U.S. Virgin Islands Department of Health, I am 
pleased to share the Healthy Virgin Islands 2030 Community 
Health Improvement Plan. This is the third and final strategic 
document that the department of health has developed with its 
partners as part of the Healthy Virgin Islands 2030 health 
planning initiative. 
This plan is the culmination of a collaboration between the 
department, our sister agencies, leaders from community 
organizations, and members of the public. It was designed for 
the community. Every priority, goal, and measure was selected 
for our community so that we can thrive together. We know that 
health is not just about the individual, but is a partnership with providers, families and neighbors. We 
also know that not everyone is as healthy as they would like to be, sometimes because it is difficult 
to access the things that help us attain good health. This plan is designed to embark on breaking 
down the most challenging of those barriers over the tenure of Healthy Virgin Islands 2030 and 
address those social determinants of health that impact population health. 
This improvement effort was created while we were faced with the biggest threat to our health that 
many of us will see in our lifetimes: COVID-19. As commissioner, I saw firsthand what communities 
can do to stay healthy when faced with a common threat. There is power in what we have achieved 
here in the U.S.Virgin Islands. Yet, the pandemic made gaps in our health care even wider, as we 
postponed doctors visits and saw a rise in illnesses, and progression of, chronic diseases. We will 
do better together as we heal, while honoring the lives of those we loved and lost to this disease. 
The Healthy Virgin Islands 2030 Community Health Improvement Plan is a beginning and a living 
document. With my agency as a leader and convener, health improvement is now in our hands, 
supported by community leaders and backed by evidence-based strategies. You are invited to help 
us build a better system that will support better health for all, now and into the future. Join us in 
creating a healthy U.S. Virgin Islands. 
Sincerely,  
Justa E. Encarnacion,  
U.S. Virgin Islands 
Health Commissioner and Chief Public Health Officer 
 
 
U.S Virgin Islands Community Health Improvement Plan | 4 
Introduction 
What is a Community Health Improvement Plan? 
Every public health department aims to improve the health of the community it serves. By fulfilling 
the three core functions of public health—assessment, assurance, and policy development—a 
public health department does its work by engaging in a cycle of improvement. With assessment, 
the public health department identifies inequities in health among residents and determines why 
those differences are present. With assurance, the public health department and partners 
collaborate to develop and implement legal and programmatic remedies to improve community 
health. With policy development, the public health department partners with the community to 
develop and implement solutions to health challenges at a population level for the long term.  
Achieving health for every resident means acknowledging that not every resident has the same 
opportunities to attain their best health. There are many barriers to achieving individual health, 
including economic, social, commercial, and biological factors. For example, persons born with 
physical disabilities require more healthcare and environmental accommodations than those without 
physical disabilities Historically, entire populations with a shared identity—such as people of color 
or people who identify as LGBTQ—have not been able to achieve their best health because of 
structural discrimination.  
Today’s modern public health department pursues health improvement as a 
fundamental approach, understanding that health must be pursued at many levels 
in society—not just within the doors of a hospital or clinic. 
In order to create a more equitable place to become and remain healthy, the public health system 
must commit its resources to improvement. In this sense, the public health system is not just the 
department of public health in a community, but a larger network of government agencies and 
private organizations with responsibilities connected to community health and wellness. A 
community health improvement process is a systematic, multi-year effort to make people healthier. 
High-functioning public health departments lead this long-term cycle of improvement beginning with 
a written community health improvement plan (CHIP), a concrete blueprint for improving health that 
accounts for a community’s current health and established best and promising practices. A CHIP 
belongs to the community and is developed and put into action collaboratively with leaders from the 
public health system. A CHIP answers the question, “How will we reduce health inequities in our 
community?” More than just a plan, the CHIP is a document that enables a community to hold a 
 
U.S Virgin Islands Community Health Improvement Plan | 5 
public health system accountable for creating an environment to achieve personal health and 
wellness.  
What Is Healthy Virgin Islands 2030? 
The Healthy Virgin Islands 2030 Community Health Improvement Plan describes a set of health 
priorities and strategies that USVI will adopt and implement to reduce health inequities and improve 
health outcomes in USVI for its residents. This plan was developed based on the following vision 
and mission established by the U.S. Virgin Islands Department of Health (USVI DOH) and its 
community partners as part of the Healthy Virgin Islands 2030 initiative, a long-term health 
improvement planning process.  
Healthy Virgin Islands 2030 Vision 
Trusted systems supporting healthy people in healthy communities for a healthy Virgin Islands. 
Healthy Virgin Islands 2030 Mission 
To promote public health through healthy behaviors, preventing injury and disease, assuring 
safe environments, and the delivery of quality healthcare for all. 
 
This deliberate process aims to develop an approach to improve the health of USVI residents by the 
year 2030 in alignment with the national Healthy People 2030 initiative. The overarching framework 
for the health planning process is the Mobilizing for Action through Planning and Partnerships 
(MAPP) framework, a community-driven strategic planning process for improving community health 
developed by the National Association of County and City Health Officials (NACCHO). MAPP is a 
six-phase process that emphasizes partnership with community representatives and close 
collaboration with organizations and agencies with responsibility for improving the health and 
wellness of communities. The MAPP framework was adapted to a territorial context (see Figure 1.1). 
For example, USVI DOH does not have a traditional local public health system with separate local 
public health departments. Instead, it operates as two health districts: St. Croix and St. Thomas/St. 
John/Water Island.  
The health planning process was designed to culminate with three strategic products with distinct 
but related goals. Each of these products supports the development of the others and, the products 
are intended to be aligned around a common vision of health improvement.  
 
COMMUNITY HEALTH ASSESSMENT | A community health assessment is a document 
that presents analyses of trends in health of a population. These assessments 
examine the health of an entire community and identify disparities across subgroups 
within that community across a number of health indicators.  
 
U.S Virgin Islands Community Health Improvement Plan | 6 
 
STRATEGIC PLAN | A strategic plan is a roadmap for a public health department to 
improve how it delivers the essential services of public health. The plan describes a 
strategic map identifying several priorities for change that the department must 
pursue in order to achieve organizational excellence. 
 
COMMUNITY HEALTH IMPROVEMENT PLAN | A community health improvement plan is 
a detailed plan that targets health inequities with programmatic and policy changes. 
The plan, developed in collaboration with governmental partners, community 
leaders, and broad community engagement, lays out strategies that are 
implemented and monitored for effectiveness over a specified period of time. 
The Healthy Virgin Islands 2030 Community Health Improvement Plan report completes the cycle 
of strategic documents and details specific strategies that USVI DOH and its partners will implement 
collaboratively to achieve healthier, more equitable outcomes for USVI residents by the end of 2030. 
Figure 1.1 | Framework for the U.S. Virgin Islands Health Planning Process  
 
SOURCE | U.S. Virgin Islands Department of Health (adapted from the National Association of County and City Health Officials) 
 
 
U.S Virgin Islands Community Health Improvement Plan | 7 
How Was This Plan Developed? 
Developing and implementing a community health improvement process is a long-term endeavor 
that requires careful management, identification of health priorities and strategies, community 
engagement, financial and political support, and a commitment by all parties to achieve success. 
The first year of the improvement process is the development of the written CHIP, which requires 
the formation of a partnership between the department of health, leaders from other government 
agencies and private organizations, and the community. The remainder of this document describes 
how USVI DOH implemented this early planning process in preparation of long-term health 
improvement work. 
Overview of the Process 
Community health improvement begins with the development of a long-term partnership. The heart 
of improvement is a collaborative process where many voices are represented and heard over an 
iterative, long-term cycle. Those voices must include both public health department leaders and 
members of the community. USVI DOH began the main part of its CHIP planning process during 
the early throes of the COVID-19 pandemic. The health agency appointed a small internal team to 
serve as the CHIP team to manage the report planning process. Because of uncertainty related to 
the epidemiology of SARS-CoV-2, the health agency made a deliberate decision to keep the 
organizational governance structure of CHIP planning small and included both internal leaders from 
USVI DOH and leaders from community organizations and government agencies (see Figure 1.2). 
Originally, USVI DOH intended to include in-person representation from key population groups, but 
this was not possible due to the pandemic. The entire planning process was conducted virtually. 
Figure 1.2 | U.S. Virgin Islands Community Health Improvement Organizational Structure 
 
SOURCE | U.S. Virgin Islands Department of Health 
 
U.S Virgin Islands Community Health Improvement Plan | 8 
USVI DOH used the stakeholder wheel (see Figure 1.3) to identify government agency and 
community organization stakeholders from different sectors to include in a CHIP steering committee. 
The health agency began recruiting for the USVI CHIP Steering Committee in early 2020 but paused 
at the beginning of the pandemic when health agency resources were redirected temporarily as part 
of the early response to COVID-19. USVI DOH returned to the CHIP process in late summer 2020, 
recruiting a small but diverse group to form the USVI CHIP Steering Committee. In the future when 
pandemic restrictions are lifted, the health agency hopes to broaden the committee and extend its 
improvement coalition. The inaugural meeting of the steering committee took place virtually in 
November 2020. Appendices A and B presents the charter that members developed to guide their 
collaborative work and a list of the members of the USVI CHIP Steering Committee. 
Figure 1.3 | Stakeholder Wheel 
 
SOURCE | U.S. Virgin Islands Department of Health (adapted by ASTHO from the Connecticut Department of Public Health) 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 9 
Health Priority and Strategy Development 
After developing its charter, the CHIP Steering Committee began the process of selecting health 
priorities by reviewing the findings of the Community Health Assessment report, published in 2020. 
The committee also voiced the importance of including USVI resident insights more directly, but 
safely, as strategies such as community forums were not possible. In late February 2021, USVI DOH 
fielded a community survey that gathered 557 responses and provided the committee with both 
quantitative and qualitative community opinions to inform health priority selection. Survey 
respondents were predominantly female and represented every island, with 41% of responses 
coming from St. Croix, 51% from St. Thomas, and 7% from St. John. One in five (21% of) survey 
respondents described their health as fair or poor, and 70% of respondents said that seniors were 
more likely to have worse health than other groups. A summary of survey results is available in 
Appendix C. 
USVI DOH developed a list of 34 potential health priorities based on the community health 
assessment report and the community survey. The CHIP Steering Committee engaged in a 
deliberate and systematic process over three virtual meetings to select and recommend three to six 
health priorities for USVI DOH to adopt. The committee worked in small groups to develop longer-
term strategies for each priority area. The committee also applied a cross-cutting approach to 
developing strategies based on the community health assessment and community survey data to 
1) reduce health inequities and 2) improve the health of priority populations (men, children, and 
seniors). The committee developed strategies for each health priority by creating prevention goals 
that were tied to metrics aligning with either Healthy People 2030 or the goal of improving on the 
2020 community health assessment baseline. Some strategies were deliberately developed to be 
completed by 2030, while other strategies are longer-term and intended to be carried out through 
subsequent improvement cycles. 
Review and Plan Development 
The CHIP team prepared a draft of this report that presented the recommendations of the CHIP 
Steering Committee. Each member of the steering committee reviewed the draft document before 
it was presented to the commissioner and executive committee. During the review process, the 
steering committee sought expertise from external partners in key areas. For example, the 
committee received and incorporated written feedback from experts in oral health to develop the 
strategies for that priority. The commissioner and USVI DOH Executive Committee finalized the 
CHIP health priorities and strategies for publication on the health agency’s website. 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 10 
U.S. Virgin Islands Community Health Improvement Plan 
 
 
 
 
 
Health Priorities 
 
 
U.S Virgin Islands Community Health Improvement Plan | 11 
Health Priorities 
This section of the CHIP outlines the five USVI health priorities for improvement over the first five 
years of Healthy Virgin Islands 2030. This report will be revisited and revised for the final five years 
of the initiative. Each priority area identifies specific goals to achieve by 2030 with measurable 
objectives. Each target has been cross-walked with the Healthy People 2030 objectives and, where 
possible, the U.S. Healthy People 2030 target is presented as a comparison. Each objective lists a 
set of broad-reaching strategies that USVI DOH and its community partners will use to improve 
upon the targeted metrics. These strategies are a starting point and are intended to be revisited, as 
implementation is ongoing.  
Cross-Cutting Strategies 
The CHIP Steering Committee uncovered two approaches that were common to its visioning of the 
health priority areas: 1) reducing health inequities and 2) improving the health of priority populations. 
These approaches, as described below, were applied to the selection of goals, objectives, 
measures, targets, and strategies presented for each priority area.  
1. Reducing Health Inequities 
The community health assessment 2020 report and input from the community survey revealed 
concern about the differences between population groups on measures of health and healthcare 
access, particularly those attributable to structural and systemic problems, such as racism. The 
strategies in this CHIP target populations that have experienced inequities in accessing health 
programs and services, with evidence-based approaches designed for community implementation.  
2. Improving the Health of Priority Populations 
The assessment phase of health planning revealed that some populations—men, children and 
adolescents, and seniors—were at high risk for poor health outcomes. Strategies targeting these 
high-risk groups are identified by icon in the report, as shown below:  
 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 12 
Men 
Children and Adolescents 
Seniors 
How the Priorities are Presented 
In this report, there are five priorities to improve community health and one priority to improve the 
infrastructure needed to achieve improvements toward the other five priorities: 
Priority 1: Access to Primary and Specialty Care 
Priority 2: Chronic Disease Burden 
Priority 3: Behavioral and Mental Health 
Priority 4: Oral Health 
Priority 5: Injury and Violence Prevention 
Priority 6: Public Health Infrastructure 
Each priority area presents a set of goals, objectives, targets, and strategies. Goals are written to 
explain the desired result of improvement work in the priority area. For each goal, the CHIP presents 
objectives aimed at specific diseases, conditions, or populations. Progress toward achieving each 
objective will be assessed by Healthy People 2030 measures. For each measure, the report 
presents data from the community health assessment report (if available) benchmarked against 
national data. Since Healthy Virgin Islands 2030 is a ten-year initiative, many measures presented 
may require ten years or more to achieve. The steering committee selected measures that would 
allow USVI DOH to assess long-term progress toward goals. The graphic below demonstrates how 
this report presents goals, objectives, measures, targets, and strategies for each priority area: 
Sample Goal: Reduce disease 
Sample Objective: Reduce specific disease among a specific population  
 
 
Baseline 
2030 Target 
Strategies 
Measure 
that will 
determine 
whether the 
objective 
has been 
met 
U.S. 
Current national data on 
this measure if available 
(Healthy People 2030 
objective number) 
Desired improvement 
level by Healthy People 
initiative to be achieved 
by 2030 
A list of evidence-based 
strategies that will be developed 
into programs, policies, and 
infrastructure changes in order to 
meet the 2030 target. 
USVI 
Current USVI data on this 
measure from the 2020 
Community Health 
Assessment report or 
other data source if 
available 
Desired improvement 
level by Healthy People 
initiative to be achieved 
by 2025 (5-year target) 
or 2030 and beyond 
(10-year target). 
 
U.S Virgin Islands Community Health Improvement Plan | 13 
Inclusion of Public Health Infrastructure as a Health Priority 
The USVI public health system includes the health agency, public health and private laboratories, 
and our two hospitals, as well as nongovernmental public and private agencies, voluntary 
organizations, and private individuals. Federal agencies are also important partners who provide 
public health support via annual funding and technical assistance. Implementing strategies to 
improve population health is grounded in a strong public health infrastructure, and the key 
components of such an infrastructure include public and private agencies and organizations working 
together synergistically to assess and respond to public health needs and up-to-date data and 
information systems, to include a health information exchange and a qualified and capable 
workforce.  
Public health infrastructure improvement is typically not part of a CHIP, but USVI is not a typical 
setting for improvement work. The public health infrastructure priority proposed for this CHIP 
address planning and partnerships, a high-performing health department and healthcare system, 
continuous workforce development and training, and reliable data and information systems. These 
steps are foundational to achieving all other goals in the CHIP. This priority area is also present in 
our strategic plan, and USVI DOH will be working internally to realize the goals of this important 
priority area. 
Data Gaps in this Report 
USVI DOH recognizes that some of the measures in the CHIP that will be used to assess progress 
toward objectives do not have recent data. One of the major goals of the department’s strategic 
plan is to develop data and surveillance systems that fill these gaps and support long-term 
performance monitoring. As noted, USVI has made improving public health infrastructure a priority, 
and each workgroup responsible for developing priority implementation plans must include a plan 
for collecting data, including a baseline. 
 
 
U.S Virgin Islands Community Health Improvement Plan | 14 
Priority 1: Access to Primary and Specialty Care 
Goal 1.1: Reduce vaccine-preventable disease.  
Objective 1.1.1 Increase rates of recommended vaccinations among young children. 
 
 
Baseline 
2030 Target 
Strategies 
Measles-
mumps-
rubella (MMR) 
vaccination 
coverage for 
children in 
kindergarten 
U.S. 
• 
94.7% of children 
enrolled in 
kindergarten received 
two or more doses of 
MMR for the 2018-
2019 school year (IID-
04). 
• 
90.8% of children 
born in 2015 received 
at least one dose of 
MMR by their second 
birthday (IID-03). 
• 
95.0% 
 
 
 
 
 
• 
90.8% 
• 
Promote prenatal care that 
includes counseling related 
to vaccination. 
• 
Build partnerships with 
community organizations 
to promote receipt of 
recommended 
vaccinations for children. 
• 
Reduce financial barriers to 
seeking vaccination. 
• 
Develop targeted 
strategies based on racial 
and ethnic, age, disability, 
social, economic, cultural, 
and other factors that 
contribute to disparities in 
vaccination rates. 
• 
Expand vaccination sites to 
non-traditional sites such 
as pharmacies, OB-GYN 
practices, other specialty 
healthcare settings, and 
non–healthcare settings 
such as schools, 
workplaces, places of 
worship, and community 
centers. 
• 
Promote vaccination as 
normal and healthy while 
addressing concerns and 
dispelling misinformation 
via social media.  
• 
Adopt community health 
worker strategies to 
increase child vaccination. 
USVI 
• 
Two-dose data is 
unavailable. 
70.5% of children ages 19 
to 35 months received at 
least one dose in 2016. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
All 
recommended 
vaccines by 
35 months  
U.S. 
• 
1.3% of children born 
in 2015 had received 
0 doses of 
recommended 
vaccinations by their 
second birthday (NIS-
Child). 
• 
1.3% (maintain) 
 
 
USVI 
• 
45.7% of USVI 
children got all 
recommended 
vaccinations by 35 
months.  
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Four or more 
doses of the 
diphtheria-
tetanus-
acellular 
pertussis 
U.S. 
• 
80.7 percent of 
children born in 2015 
received four or more 
doses of DTaP by 
their second birthday 
(IID-06). 
• 
90.0% 
USVI 
• 
60.5% of children 
aged 19 to 35 months 
in 2016 (NIS-Child). 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
U.S Virgin Islands Community Health Improvement Plan | 15 
Objective 1.1.1 Increase rates of recommended vaccinations among young children. 
 
 
Baseline 
2030 Target 
Strategies 
(DTaP) 
vaccine 
among 
children by 
age 2  
 
Objective 2.1.2 Increase rates of vaccination among adolescents and adults. 
 
 
Baseline 
2030 Target 
Strategies 
 
HPV 
vaccination 
among 
adolescents 
aged 13 to 15 
U.S. 
• 
48.0% of adolescents 
aged 13 through 15 
years received 
recommended doses 
of the HPV vaccine 
by 2018 (IID-08). 
• 
80.0% 
• 
Build partnerships with 
community organizations to 
promote receipt of 
recommended vaccinations.  
• 
Reduce financial barriers to 
seeking vaccination. 
• 
Develop targeted strategies 
based on racial and ethnic, 
age, disability, social, 
economic, cultural, and 
other factors that contribute 
to disparities in vaccination 
rates. 
• 
Expand vaccination sites to 
non-traditional sites such as 
pharmacies, OB-GYN 
practices, other specialty 
healthcare settings, and 
non–healthcare settings 
such as schools, 
workplaces, places of 
worship, and community 
centers. 
• 
Promote vaccination as 
normal and healthy while 
addressing concerns and 
dispelling misinformation via 
social media.  
• 
Promote pneumococcal 
vaccination among adults 
65 and older. 
USVI 
• 
No baseline data 
available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
COVID-19 
Vaccination 
among adults 
U.S. 
• 
38.4% of adults with 
one dose; 32.7% of 
adults fully 
vaccinated (as of 
June 29, 2021). 
• 
70% of adults with 
one dose by July 4, 
2021. 
USVI 
• 
34.6% of adults with 
one dose; 28.5% of 
adults fully 
vaccinated (as of 
May 23, 2021). 
• 
Target will be 
defined in Year 1 of 
implementation. 
Pneumonia 
hospital 
admission rate 
among adults 
65 or older 
U.S. 
• 
713.9 hospital 
admissions for 
pneumonia per 
100,000 adults 65 
years and older 
occurred in 2016 
(0A-06). 
• 
642.5 hospital 
admissions for 
pneumonia per 
100,000 adults. 
USVI 
• 
No data on hospital 
admissions is 
available.  
• 
41.7% of adults 65 or 
older received the 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
U.S Virgin Islands Community Health Improvement Plan | 16 
Objective 2.1.2 Increase rates of vaccination among adolescents and adults. 
 
 
Baseline 
2030 Target 
Strategies 
pneumococcal 
vaccine in 2016.  
 
Goal 1.2: Reduce inequities in access to primary and specialty care. 
Objective 1.2.1 Increase access to primary care among populations at risk of delaying preventive care. 
 
 
Baseline 
2030 Target 
Strategies 
Prenatal 
care 
initiation 
in first 
trimester 
U.S. 
• 
76.4 percent of 
pregnant females 
received early and 
adequate prenatal care 
in 2018 (NVSS-N). 
• 
77.6% of live births 
occurred to women 
who received prenatal 
care in the first 
trimester. 
• 
80.5% 
• 
Increase access to 
telemedicine services.  
• 
Enable expansion of clinic 
hours of primary and 
preventive care services. 
• 
Invest in training and 
supporting programs with 
community health workers to 
increase access to care, 
improve care navigation, and 
increase health literacy. 
• 
Integrate fire services and 
emergency medical services 
to increase access to 
emergency care. 
• 
Develop a coordinated 
system of care. 
• 
Develop pilot programs for 
targeted groups (e.g., 
behavioral health, men’s 
health).  
• 
Create an integrated system 
of care for specific groups 
(e.g., behavioral health, 
men’s health, aging 
population). 
 
USVI 
• 
63.7% of pregnant 
women received 
prenatal care in the 
first trimester in 2017. 
• 
78.5% (level in 2015). 
No 
prenatal 
care 
U.S. 
• 
6.4% of live births 
occurred to women 
with no prenatal care in 
2019. 
• 
No Healthy People 
2030 objective has 
been established 
USVI 
• 
16.6% of pregnant 
women received no 
prenatal care in 2017. 
• 
Target will be defined 
in Year 1 of 
implementation. 
Delayed 
care  
U.S. 
• 
4.1 percent of persons 
were unable to obtain 
or were delayed in 
obtaining necessary 
medical care in 2017 
(MEPS) (AHS-04). 
• 
12.1% of U.S. adults 
report delaying medical 
care in the past year 
(BRFSS). 
• 
3.3% 
 
U.S Virgin Islands Community Health Improvement Plan | 17 
Objective 1.2.1 Increase access to primary care among populations at risk of delaying preventive care. 
 
 
Baseline 
2030 Target 
Strategies 
USVI 
• 
21.6% of adults report 
in the past 12 months 
that they could not see 
a doctor when they 
needed one because of 
cost (BRFSS). 
• 
16.4% of USVI adults 
reported delaying 
medical care in the 
past year (BRFSS). 
• 
Target will be defined 
in Year 1 of 
implementation. 
Health 
insurance 
coverage 
U.S. 
• 
89.0% of persons 
under 65 had medical 
insurance in 2018 
(NHIS) (AHS-01). 
• 
92.1% 
USVI 
• 
81.5% of adults ages 
18-64 report that they 
have any kind of 
healthcare coverage.  
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Objective 1.1.2 Increase access to specialty care.  
 
 
Baseline 
2030 Target 
Strategies 
Receipt of 
specialty 
treatment for 
a substance 
use problem 
in the past 
year 
U.S. 
• 
11.1% of persons 
aged 12 years and 
over who needed 
substance use 
treatment received 
treatment at a 
specialty facility in the 
past 12 months in 
2018 (SU-01). 
• 
14.0% 
• 
Improve data on provider 
credentials to treat 
specialized conditions, 
particularly mental health 
and substance abuse.  
• 
Increase access to 
specialty and other 
demand-type providers—
conduct assessment to 
determine provider gaps.  
• 
Provider retention and 
recruitment strategies for 
pediatric specialty care. 
• 
Increase the proportion of 
children and adolescents 
with special health care 
needs who receive care in a 
family-centered, 
comprehensive, 
and 
coordinated system 
USVI 
• 
No baseline available 
• 
Target will be defined 
in Year 1 of 
implementation 
Availability of 
pediatric 
mental health 
providers 
U.S. 
• 
No baseline available 
• 
Not applicable 
USVI 
• 
There are fewer than 
9 psychiatrists 
practicing in the USVI 
and few with pediatric 
credentials. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
U.S Virgin Islands Community Health Improvement Plan | 18 
Objective 1.1.2 Increase access to specialty care.  
 
 
Baseline 
2030 Target 
Strategies 
• 
There are 16 
pediatricians in 
practice in USVI. 
• 
Assessment is needed 
in this area 
 
 
 
Availability of 
services for 
children with 
special health 
care needs 
US 
• 
15.7 percent of 
children and 
adolescents under 18 
years with special 
health care needs 
received care in a 
family-centered, 
comprehensive, and 
coordinated system in 
2016-17 
• 
19.5% 
 
USVI 
• 
Baseline not available 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Priority 2: Chronic Disease Burden 
Goal 2.1: Prevent chronic disease among children and adolescents. 
Objective 2.1.1 Create healthy eating and safe activity environments for children and adolescents. 
 
 
Baseline 
2030 Target 
Strategies 
Youth access 
to unhealthy 
food and 
beverages 
U.S. 
• 
Increase the 
proportion of schools 
that do not sell less 
healthy foods and 
beverages (ECBP-
D02). 
• 
No Healthy People 
2030 objective has 
been established. 
• 
Train early care and 
education center 
professionals to promote 
consumption of healthy 
food and beverages and 
opportunities for physical 
activity. 
• 
Increase access to 
nutritious and appealing 
foods and beverages on 
school campuses. 
• 
Provide professional 
development to school staff 
on how to incorporate 
enhanced physical activity 
programs and policies 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
Adolescent 
U.S. 
• 
26.1% of students in 
grades 9 through 12 
were physically active 
for at least 60 minutes 
on all 7 days of the 
• 
30.6% 
 
U.S Virgin Islands Community Health Improvement Plan | 19 
Objective 2.1.1 Create healthy eating and safe activity environments for children and adolescents. 
 
 
Baseline 
2030 Target 
Strategies 
physical 
activity 
past week in 2017 
(PA-06). 
before, during, and after 
school. 
• 
Expand out-of-school 
programs. 
• 
Invest in built environment 
plans and policies that 
encourage physical activity. 
• 
Implement health 
community design and land 
use policies and practices 
that promote access to 
physical activity and healthy 
food. 
• 
Improve community access 
to affordable, preferably 
locally-grown fruits and 
vegetables. 
• 
Establish policies promoting 
healthy food environments 
in schools and early child 
care centers. 
• 
Establish surveillance 
systems to monitor and 
track child and adolescent 
health at the population 
level. 
USVI 
• 
20.4% of high school 
students were 
physically active for a 
total of at least 60 
minutes per day; 
25.1% had no days 
where they were 
physically active for a 
total of at least 60 
minutes per day.  
• 
Target will be defined 
in Year 1 of 
implementation. 
Child and 
adolescent 
obesity 
U.S. 
• 
17.8% of children and 
adolescents aged 2 to 
19 years had obesity 
from 2013-2016 
(NWS-04). 
• 
15.5% 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Goal 2.2: Reduce the burden of chronic disease among adults. 
Objective 2.2.1 Reduce the burden of metabolic disease and its complications among adults.  
 
 
Baseline 
2030 Target 
Strategies 
Diabetes 
incidence  
U.S. 
• 
6.5 new cases of 
diabetes per 1,000 
adults aged 18 to 84 
years occurred in the 
past 12 months as 
reported in 2016-
2018. 
• 
10-year target: 5.6 
new cases of 
diabetes per 1,000 
adults. 
• 
Improve access and quality 
of prediabetes healthcare 
delivery.  
• 
Develop culturally 
appropriate prediabetes and 
diabetes prevention and self-
management education 
programs. 
• 
Develop a community-driven 
wellness plan that includes 
promotion of healthy living 
and evidence-based 
strategies. 
• 
Improve data collection and 
monitoring surveillance 
USVI 
• 
16.8% prevalence 
among adults in 2016 
(BRFSS). 
• 
Target will be 
defined in Year 1 of 
implementation. 
Blood sugar 
monitoring 
among 
U.S. 
• 
89.0% of adults aged 
18 years and over with 
diagnosed diabetes 
using insulin 
• 
94.4% 
 
U.S Virgin Islands Community Health Improvement Plan | 20 
Objective 2.2.1 Reduce the burden of metabolic disease and its complications among adults.  
 
 
Baseline 
2030 Target 
Strategies 
people with 
diabetes  
performed self-
monitoring of blood 
glucose at least once 
daily in 2017. 
systems to monitor and track 
the health status of adults. 
 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Annual 
urinary 
albumin test 
U.S. 
• 
48.7 percent of 
Medicare beneficiaries 
with diabetes mellitus 
had urinary albumin 
testing in 2016 (D-05). 
• 
66.6% 
USVI 
• 
No data available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Objective 2.2.2 Improve adult cardiovascular health.  
 
 
Baseline 
2030 Target 
Strategies 
Obesity 
prevalence 
U.S. 
• 
38.6% of adults aged 
20 years and over had 
obesity in 2013-16 
(NWS-03). 
• 
36.0% 
• 
Implement policies and 
programs that increase 
active transportation and 
transit use.  
• 
Develop and implement 
culturally diverse territory-
wide public service 
announcements and social 
media campaigns about 
resources that address 
chronic disease. 
• 
Plan improvements to the 
built environment to enable 
and encourage physical 
activity. 
• 
Implement healthy 
community design and land 
use policies and practices 
that promote access to 
physical activity and healthy 
food. 
• 
Improve community access 
to affordable, preferably 
USVI 
• 
32.2% adult obesity 
prevalence in 2016.  
• 
Target will be defined 
in Year 1 of 
implementation. 
Coronary 
heart 
disease 
mortality 
U.S. 
• 
90.9 coronary heart 
disease deaths per 
100,000 population 
occurred in 2018 
(HDS-02). 
• 
71.1 coronary heart 
disease deaths per 
100,000 population. 
USVI 
• 
54.9/100,000 (2017-
2019) 
• 
Target will be defined 
in Year 1 of 
implementation. 
U.S. 
• 
29.5% of adults aged 
18 years and over had 
hypertension between 
2013-2016. 
• 
27.7% 
 
U.S Virgin Islands Community Health Improvement Plan | 21 
Objective 2.2.2 Improve adult cardiovascular health.  
 
 
Baseline 
2030 Target 
Strategies 
Hypertension 
prevalence 
USVI 
• 
26.1% of adults were 
ever told they had 
hypertension (2009). 
• 
Target will be defined 
in Year 1 of 
implementation. 
locally-grown fruits and 
vegetables. 
• 
Promote adoption of 
Supplemental Nutrition 
Assistance Program 
acceptance by farmer’s 
markets. 
 
Chronic 
kidney 
disease 
prevalence 
U.S. 
• 
14.1% of adults aged 
18 years and over had 
chronic kidney 
disease between 
2013-2016. 
• 
12.8% 
USVI 
• 
No data available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Goal 2.3: Reduce mortality associated with cancer. 
Objective 2.3.1 Reduce mortality associated with prostate cancer. 
 
 
Baseline 
2030 Target 
Strategies 
 
Prostate 
cancer 
mortality 
U.S. 
• 
18.8 prostate cancer 
deaths per 100,000 
males in 2018 (C-08). 
• 
16.9 prostate cancer 
deaths per 100,000 
males. 
• 
Promote early screening of 
prostate cancer among men 
according to their age and 
risk. 
• 
Conduct targeted outreach 
and education to men at high 
risk for developing prostate 
cancer. 
USVI 
• 
26.1% of all cancer 
deaths were due to 
prostate cancer; there 
were 100 prostate 
cancer deaths 
between 2003-2013. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Prostate 
specific 
antigen 
testing 
U.S. 
• 
39.0% of men aged 
55-69 years had a 
prostate specific 
antigen test within the 
past year. 
• 
No Healthy People 
2030 target 
established. 
USVI 
• 
54.3% of men aged 40 
and older had a 
prostate specific 
antigen test within the 
past two years. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
 
U.S Virgin Islands Community Health Improvement Plan | 22 
Objective 1.3.2 Reduce mortality associated with breast cancer. 
 
 
Baseline 
2030 Target 
Strategies 
Breast 
cancer 
mortality 
U.S. 
• 
19.7 breast cancer deaths 
per 100,000 females in 
2018 (C-04). 
• 
15.3 breast 
cancer deaths 
per 100,000 
females. 
• 
Promote mammography 
among women according to 
their age and risk.  
• 
Increase public and 
professional awareness 
about breast cancer 
inequities in diagnosis and 
mortality. 
• 
Conduct targeted outreach 
and education to women at 
higher risk of developing 
breast cancer. 
USVI 
• 
There were 9 deaths due to 
breast cancer in 2020 
• 
Target will be 
defined in Year 1 
of 
implementation 
Breast 
cancer 
screening 
U.S. 
• 
72.8% of females aged 50 
to 74 years received a 
breast cancer screening in 
2018.  
• 
77.1% 
USVI 
• 
70.2%% of women aged 
50-74 reported they had 
had a mammogram within 
the past two years (2016, 
BRFSS). 
• 
Target will be 
defined in Year 1 
of 
implementation. 
 
Priority 3: Behavioral and Mental Health 
Goal 3.1: Enhance mental health care infrastructure. 
Objective 3.1.1 Improve access and quality of mental health treatment. 
 
 
Baseline 
2030 Target 
Strategies 
Provider 
capacity to 
provide 
integrated 
behavioral 
healthcare 
U.S. 
• 
Increase the ability of 
primary care and 
behavioral health 
professionals to 
provide more high-
quality care to 
patients who need it 
(AHS‑R01). 
• 
No target has been 
established for this 
new Healthy People 
2030 objective. 
• 
Attract sufficient mental 
health professionals to meet 
the need (with an emphasis 
on psychiatrists and 
psychiatric advanced 
registered nurse 
practitioners).  
• 
Establish residential 
services within the territory. 
• 
Enhance partnership with 
the National Alliance on 
Mental Illness chapter and 
partner with private partners 
to extend services. 
• 
Reconvene the Behavioral 
Health Advisory Committee 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
U.S. 
• 
Increase the 
proportion of public 
schools with a 
counselor, social 
• 
No target has been 
established for this 
new Healthy People 
2030 objective. 
 
U.S Virgin Islands Community Health Improvement Plan | 23 
Objective 3.1.1 Improve access and quality of mental health treatment. 
 
 
Baseline 
2030 Target 
Strategies 
Support 
capacity of 
public 
schools  
worker, and 
psychologist 
(AH‑R09). 
for partnership and 
coordination. (Partnerships 
exist, but need to be 
activated.) 
• 
Convene the 
Interdepartmental 
Behavioral Health 
Assessment and Transition 
Teams. 
• 
Enhance coordination 
between hospitals and 
primary and specialty care 
for persons with mental 
health conditions. 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
U.S. 
• 
Increase the 
proportion of children 
and adolescents who 
get appropriate 
treatment for anxiety 
or depression 
(EMC‑D04). 
• 
No target has been 
established for this 
new Healthy People 
2030 objective. 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
Mental health 
cross-
organization 
coordination 
U.S. 
• 
No baseline available. 
• 
Not applicable. 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Objective 3.1.2 Improve quality of mental health early detection and treatment. 
 
 
Baseline 
2030 Target 
Strategies 
Community 
support 
U.S. 
• 
No baseline available. 
• 
Not applicable. 
• 
Provide education and 
training in mental health first 
aid, including peer training. 
• 
Train private and community 
health providers on 
screening for depression 
and substance abuse. 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Early 
detection 
U.S. 
• 
8.5 percent of primary 
care office visits 
included screening for 
depression in persons 
aged 12 years and 
over in 2016 (MHMD-
08). 
• 
13.5% 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
 
U.S Virgin Islands Community Health Improvement Plan | 24 
Goal 3.2: Address mental health comorbidities, including substance use, chronic 
disease, and violence. 
Objective 3.2.1 Address the interdisciplinary nature of mental health causes and impacts, 
 
 
Baseline 
2030 Target 
Strategies 
Access to 
school-based 
preventive 
mental health 
care 
U.S. 
• 
Increase the 
proportion of children 
and adolescents who 
get preventive mental 
health care in school 
(EMC‑D06). 
• 
No target has been 
established for this 
new Healthy People 
2030 objective. 
• 
Address substance use and 
its impact on behavioral 
health by disrupting this 
pathway in adolescence and 
youth using evidence-based 
strategies (pediatric vs. 
adult). 
• 
Develop a multidisciplinary 
crisis management team 
trained in de-escalation in 
the community, provide 
intervention, linkages to 
hospitals if needed. 
• 
Provide law enforcement 
with education, resources, 
protocols regarding 
behavioral health issues, 
and crisis and intervention 
training. 
• 
Clarify and strengthen 
emergency/involuntary 
hospitalization procedures 
across governmental and 
private healthcare 
organizations. 
• 
Enhance referral and follow-
up treatment for children 
and adolescents with 
trauma-related symptoms. 
• 
Improve data collection, 
analysis and use of 
evidence-based, culturally 
relevant interventions for all 
agegroups. 
 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
Access to 
mental health 
and 
substance 
use 
treatment 
among adults 
U.S. 
• 
3.4 percent of adults 
aged 18 years and 
over with co-
occurring substance 
use disorders and 
mental health 
disorders received 
both mental health 
care and specialty 
substance use 
treatment in 2018 
(HP2030 MHMD-07). 
• 
8.2% 
 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
Access to 
treatment for 
trauma 
among 
children and 
adolescents 
U.S. 
• 
Increase the 
proportion of children 
and adolescents with 
symptoms of trauma 
who get treatment 
(AH‑D02) . 
• 
No target has been 
established for this 
new Healthy People 
2030 objective. 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
Serious 
psychological 
distress 
among adults 
U.S. 
• 
8.7% of adults with 
disabilities aged 18 
years and over 
experienced serious 
psychological distress 
in 2018 (age adjusted 
• 
7.6% 
 
U.S Virgin Islands Community Health Improvement Plan | 25 
Objective 3.2.1 Address the interdisciplinary nature of mental health causes and impacts, 
 
 
Baseline 
2030 Target 
Strategies 
with 
disabilities 
to the year 2000 
standard population) 
(CH-02). 
USVI 
• 
No baseline available. 
• 
Target will be defined 
in Year 1 of 
implementation. 
 
Goal 3.3: Normalize mental health conditions. 
Objective 3.3.1 Reduce stigma associated with having mental health conditions and seeking or participating in 
treatment for mental health conditions. 
 
 
Baseline 
2030 Target 
Strategies 
Availability of 
social support 
to adults 
U.S. 
• 
86.9 percent of adults 
aged 18 years and 
over reported having 
social support (i.e., 
having friends or 
family members 
whom they talk to 
about their health) in 
2017 (HC/HIT-04). 
• 
92.3% 
• 
Use evidence-based 
strategies grounded in 
behavioral health to reduce 
the stigma of mental health 
care. 
• 
Develop partnerships 
between schools and 
community representatives 
to ensure all children have 
access to trusted adults. 
• 
Develop a public education 
campaign for mental illness 
targeting adolescents. 
 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Availability of a 
trusted adult 
among 
adolescents 
aged 12 to 17 
U.S. 
• 
79.0 percent of 
adolescents aged 12 
to 17 years had an 
adult in their lives with 
whom they could talk 
about serious 
problems in 2018 
(AH-03). 
• 
82.9% 
USVI 
• 
No baseline available 
• 
Target will be 
defined in Year 1 of 
implementation 
 
U.S Virgin Islands Community Health Improvement Plan | 26 
 
Priority 4: Oral Health 
Goal 4.1: Increase capacity to prevent oral health disease. 
Objective 4.1.1 Improve primary prevention of oral health disease. 
 
 
Baseline 
2030 Target 
Strategies 
Access to 
fluoridated 
water 
U.S. 
• 
72.8% of persons 
were served by 
community water 
systems with 
optimally fluoridated 
water in 2016 (OH-
11). 
• 
10-year target: 
77.1%. 
• 
Develop programs that use 
evidence-based disease 
prevention approaches for 
oral health such as 
fluoridation, fluoride 
varnish, and dental 
sealants. 
• 
Increase the health literacy 
of parents using culturally 
competent messages that 
emphasize the importance 
of early oral health care. 
 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Access to 
dental sealants 
U.S. 
• 
37.0% of children 
and adolescents 
aged 3 to 19 years 
had received dental 
sealants on 1 or more 
of their primary and 
permanent molar 
teeth in 2013-16 
(OH-10). 
• 
42.5% 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Objective 4.1.2 Improve oral health workforce and surveillance capacity. 
 
 
Baseline 
2030 Target 
Strategies 
Oral and 
craniofacial 
surveillance 
system 
U.S. 
• 
Increase the number 
of states and the 
District of Columbia 
that have an oral and 
craniofacial health 
surveillance system 
(OH-D01). 
• 
No target has been 
established for this 
new Healthy People 
2030 objective. 
• 
Implement a robust oral 
and craniofacial 
surveillance system in 
partnership with dental 
providers and healthcare 
providers. 
 
U.S Virgin Islands Community Health Improvement Plan | 27 
Objective 4.1.2 Improve oral health workforce and surveillance capacity. 
 
 
Baseline 
2030 Target 
Strategies 
USVI 
• 
No territory-wide oral 
and craniofacial 
surveillance system 
available. 
• 
Implementation of a 
functioning oral and 
craniofacial 
surveillance system. 
• 
Develop programs that 
promote oral health career 
opportunities for high 
school students. 
• 
Create and develop a 
college level dental 
assistant training program  
• 
Develop a liaison between 
local oral health advocacy 
groups and local leadership 
(senators, commissioners, 
directors, and the 
executive team) to highlight 
and prioritize the oral health 
needs of the territory.  
Trained dental 
health care 
professionals 
U.S. 
• 
No baseline available. 
• 
No established 
Healthy People 2030 
objective. 
USVI 
• 
There were 78 
dentists and 32 
dental hygienists with 
active licenses in 
2020 (pg. 30, USVI 
community health 
assessment). 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Objective 4.1.3 Remove barriers to accessing dental services. 
 
 
Baseline 
2030 Target 
Strategies 
 
Use of oral 
health system 
U.S. 
• 
43.3 percent of 
children, adolescents, 
and adults used the 
oral health care 
system in 2016 (OH-
08). 
• 
45.0% 
• 
Develop and enhance 
existing programs to 
promote oral health care, 
emphasizing community-
based approaches. 
• 
Create and develop public 
service announcements  
using local children or 
teens to educate and bring 
awareness about oral 
health programs, events, 
and activities in the 
community.  
• 
Develop a policy to expand 
dental services to high-risk 
populations.  
• 
Promote integration of oral 
health into other settings, 
such as community clinics, 
schools, home visits, 
nursing homes and 
telehealth practice. 
• 
Simplify the Medical 
Assistance Program (MAP) 
approval process. Create 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Medicaid 
reimbursement 
for dental 
services 
U.S. 
• 
No baseline available. 
• 
No established 
Healthy People 2030 
objective. 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Dental 
insurance 
coverage 
U.S. 
• 
54.4% of persons 
under 65 years had 
dental insurance in 
2018 (AHS-02). 
• 
59.8% 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
U.S Virgin Islands Community Health Improvement Plan | 28 
Objective 4.1.3 Remove barriers to accessing dental services. 
 
 
Baseline 
2030 Target 
Strategies 
satellite sites 
(Christiansted) to access 
more patients and promote 
the program for the low 
income and financially 
challenged population. 
Create direct MAP referral 
for children and elderly 
patients.  
• 
Provide MAP providers with 
competitive reimbursement 
and create transparent 
oversight of the program.  
 
Goal 4.2: Reduce the burden of dental disease  
Objective 4.2.1 Reduce active and untreated tooth decay among adults, children, and adolescents. 
 
 
Baseline 
2030 Target 
Strategies 
 
Active 
untreated 
tooth decay 
among adults 
U.S. 
• 
22.8% of adults aged 
20 to 74 years had 
active or currently 
untreated tooth 
decay in 2013-2016 
(OH-03). 
• 
17.3% 
• 
Create a territory-wide, 
cross-sector initiative to 
eradicate early childhood 
caries. 
• 
Create collaborative virtual 
education programs with 
the USVI Department of 
Education and Department 
of Health and various 
agencies (e.g., Colgate’s 
Bright Smiles Bright Future 
program) to educate and 
give access to young 
people, families, single 
parents, educators, and 
program directors.  
• 
Create systems to detect 
child abuse and child 
neglect cases based on 
rampant caries, abscessed 
teeth, and significant oral 
trauma in children. 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Active 
untreated 
tooth decay 
among 
children and 
adolescents 
U.S. 
• 
13.4% of children 
and adolescents 
aged 3 to 19 years 
had active and 
currently untreated 
tooth decay in their 
primary or permanent 
teeth in 2013-16 
(OH-02). 
• 
10.2% 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
U.S Virgin Islands Community Health Improvement Plan | 29 
Objective 4.2.1 Reduce active and untreated tooth decay among adults, children, and adolescents. 
 
 
Baseline 
2030 Target 
Strategies 
Moderate and 
severe 
periodontitis 
among adults 
aged 45 and 
older 
U.S. 
• 
44.5 percent of adults 
aged 45 years and 
over had moderate 
and severe 
periodontitis in 2015-
16 (OH-06). 
• 
39.3% 
• 
Create and implement 
community wellness plans 
that include oral health 
promotion. 
 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Children with 
significant oral 
health disease 
and trauma 
U.S. 
• 
No baseline available. 
• 
No established 
Healthy People 2030 
objective. 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Loss of all 
natural teeth 
among adults 
aged 45 and 
older 
U.S. 
• 
7.9% of adults aged 
45 years and over 
had lost all of their 
natural teeth in 2013-
16 (OH-05). 
• 
5.4% 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Objective 4.2.2 Improve oral health of pregnant women and children under 2. 
 
 
Baseline 
2030 Target 
Strategies 
Periodontal 
disease among 
pregnant 
women  
U.S. 
• 
No baseline available. 
• 
No established 
Healthy People 2030 
objective. 
• 
Adopt Protect Tiny Teeth 
as a part of prenatal care. 
• 
Adapt current prenatal 
health promotion programs 
targeting health and dental 
professionals to include 
training about 
communicating the safety 
and importance of dental 
care during pregnancy and 
in the neonatal period.  
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Consumption 
U.S. 
• 
13.5% was the mean 
percentage of 
calories from added 
sugars consumed by 
persons aged 2 years 
• 
11.5% 
 
U.S Virgin Islands Community Health Improvement Plan | 30 
of sweetened 
beverages by 
children aged 
2 years and 
older 
and over in 2013-16 
(NWS-10). 
 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Priority 5: Injury and Violence Prevention 
Goal 5.1: Prevent accidents. 
Objective 5.1.1 Reduce unintentional injury and death. 
 
 
Baseline 
2030 Target 
Strategies 
Intimate 
Partner 
violence 
 
• 
Non available 
• 
Developmental-a 
high-priority public 
health issue that has 
evidence-based 
interventions to 
address it, but 
doesn’t yet have 
reliable baseline 
data. 
• 
Reduce 
intimate 
partner 
violence (i.e., contact sexual 
violence, physical violence, 
and stalking) across the 
lifespan 
by 
increasing 
access to evidence-based 
interventions for all ages 
Unintentional 
injury mortality 
rate 
U.S. 
• 
48.0 deaths per 
100,000 population 
were caused by 
unintentional injuries 
in 2018 (age adjusted 
to the year 2000 
standard population) 
(IVP-03). 
• 
43.2 deaths. 
• 
Reduce impaired driving by 
increasing the use of 
screening, brief 
interventions, and referral to 
treatment in hospitals and 
primary health settings 
across the territory. 
• 
Increase helmet use among 
motorcycle and moped 
riders by supporting 
universal helmet laws. 
 
USVI 
• 
24 people died from 
unintentional injury in 
2016 (Pg.107, USVI 
CHA). 
• 
Target will be 
defined in Year 1 of 
implementation. 
Motor vehicle 
mortality rate 
U.S. 
• 
11.2 motor vehicle 
traffic-related deaths 
per 100,000 
population occurred 
in 2018 (age adjusted 
to the year 2000 
standard population) 
(IVP-06). 
• 
10.1 deaths. 
 
U.S Virgin Islands Community Health Improvement Plan | 31 
Objective 5.1.1 Reduce unintentional injury and death. 
 
 
Baseline 
2030 Target 
Strategies 
USVI 
• 
No baseline available, 
but the overall trend 
in number of deaths 
from motor vehicle 
accidents of all age 
groups has been 
increasing—from 4 
deaths in 2005 to 11 
deaths in 2017. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
Goal 5.2: Reduce fatal and nonfatal intentional injuries. 
Objective 5.2.1 Reduce injuries among children relating to maltreatment.  
 
 
Baseline 
2030 Target 
Strategies 
Emergency 
department 
visits for 
nonfatal 
physical 
assault injuries 
among 
children 
U.S. 
• 
511.1 emergency 
department visits for 
nonfatal physical 
assault injuries per 
100,000 population 
occurred in 2017 
(age adjusted to the 
year 2000 standard 
population). 
• 
264.1 visits. 
 
• 
Provide parent education 
and family supports to 
strengthen families and 
reduce social isolation and 
stressors that may place 
families at risk for child 
abuse and neglect.  
• 
Screen individuals for 
domestic violence and refer 
to domestic violence 
resources or services by 
home visiting program 
personnel. 
USVI 
• 
No baseline available, 
but the child 
maltreatment rate in 
2015 was 11.0 per 
1,000 children under 
age 18, a decrease 
from 2013 (13.5 per 
1,000 children). 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
 
Objective 5.2.2 Reduce homicide. 
 
 
Baseline 
2030 Target 
Strategies 
 
U.S. 
• 
25.2 deaths among 
children and 
adolescents aged 1 
to 19 years per 
100,000 population 
• 
18.4 deaths. 
• 
Establish child fatality 
review teams to review 
every death in USVI.   
 
U.S Virgin Islands Community Health Improvement Plan | 32 
Objective 5.2.2 Reduce homicide. 
 
 
Baseline 
2030 Target 
Strategies 
Child and teen 
mortality rate 
due to 
intentional 
injury 
occurred in 2018 
(MICH-03). 
• 
Increase educational 
attainment and literacy 
levels.  
• 
Screening for domestic 
violence and referring to 
domestic violence 
resources/services in 
primary care settings to 
include maternal and child 
health clinics. 
• 
Promote the Strengthening 
Families cross-sector 
system to strengthen 
families’ protective factors 
and mitigate the impact of 
adverse experiences. 
• 
Expand community-based 
opportunities, such as 
mentoring, peer support 
and after-school programs, 
to build resilience and 
protective factors among 
youth. 
• 
Promote strategies that 
enable secure firearm 
storage. 
• 
Provide training and 
technical assistance to 
organizations on the 
implementation of physical 
and sexual violence 
prevention strategies. 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Contact sexual 
assault 
incidence 
U.S. 
• 
Reduce contact 
sexual violence by 
anyone across the 
lifespan (IVP-05). 
• 
No target has been 
established for this 
new Healthy People 
2030 objective. 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
Intentional 
injury rates, 
fatal and 
nonfatal 
U.S. 
• 
70.1 deaths per 
100,000 population 
were caused by 
injuries in 2018 (age 
adjusted to the year 
2000 standard 
population) (IVP-01). 
• 
63.1 deaths per 
100,000. 
USVI 
• 
No baseline available. 
• 
Target will be 
defined in Year 1 of 
implementation. 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 33 
Priority 6: Public Health Infrastructure 
Goal 6.1: Develop and sustain a five-year health planning process.   
Objective 6.1.1: Strengthen health system planning and partnerships.  
2030 Target 
Current Status and 
Assets 
Desired Result 
Initial Strategies 
Functioning, 
sustainable 
health planning 
• 
Completed 
community health 
assessment in 2020. 
• 
Completed CHIP 
report. 
• 
Implementation 
plans and 
performance 
monitoring system 
for CHIP. 
• 
Sustainable process 
for health planning 
in a five-year cycle. 
• 
Engage ASTHO and other experts 
for support and guidance to develop 
a sustainable health planning system 
and process. 
• 
Create a permanent health planning 
team and leadership charge to 
conduct planning. 
Healthcare 
facilities 
• 
Healthcare facilities in 
various stages of 
disrepair and/or 
development. 
• 
State of the art 
healthcare facilities 
(including primary, 
secondary, and 
tertiary care 
facilities). 
• 
Assess the need for healthcare 
facilities to meet current and future 
population healthcare needs.  
• 
Continue progress on plans to repair 
damaged facilities. 
• 
Conduct repairs and construction of 
facilities. 
Quality 
improvement 
systems  
• 
Limited quality 
improvement as a 
way to increase 
efficiency and 
effectiveness in the 
USVI DOH. 
• 
Established quality 
improvement 
processes and 
adoption of quality 
improvement into 
the culture of USVI 
DOH. 
• 
Participate in quality improvement 
training at all levels of USVI DOH. 
• 
Develop a quality improvement plan. 
 
 
 
 
 
 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 34 
Goal 6.2: Develop public health infrastructure and service capacity. 
Objective 6.2.1: Strengthen health system planning and partnerships.  
2030 Target 
Current Status and 
Assets 
Desired Result 
Initial Strategies 
Increase 
laboratory 
diagnostic 
testing 
capacity, 
surveillance, 
and reporting 
• 
Some laboratory 
diagnostic testing 
capacity. 
• 
Gaps in surveillance 
and reporting. 
• 
Larger capacity for 
laboratory 
diagnostic testing. 
• 
Gaps in surveillance 
and reporting. 
• 
Assess current public health 
laboratory capacity. 
• 
Identify laboratory service needs. 
 
Maintain 
healthcare 
facilities with no 
disrepair that 
impedes or 
limits the 
expansion of 
patient care 
services 
• 
Healthcare facilities 
in various stages of 
disrepair and/or 
development. 
• 
State of the art 
healthcare facilities 
(include primary, 
secondary, and 
tertiary care 
facilities). 
• 
Assess need for healthcare facilities 
to meet current and future 
population healthcare needs. 
• 
Continue progress on plans to repair 
damaged facilities. 
• 
Conduct repairs and construction of 
facilities. 
Increase the 
number of 
programs 
aimed at 
improving 
health in people 
with disabilities 
• 
Limited number of 
programs. 
• 
Programs on every 
island that meet the 
needs of people 
with disabilities. 
• 
Conduct assessment of current 
programs aimed at improving health 
in people with disabilities. 
• 
Identify gaps in services by age and 
develop targeted strategies to 
improve health. 
• 
Develop and implement plans to 
address gaps in services. 
 
Objective 6.2.2: Increase skills of the public health workforce.  
2030 Target 
Current Status and 
Assets 
Desired Result 
Initial Strategies 
Increase the 
number of 
individuals 
trained globally 
to prevent, 
detect, or 
respond to 
public health 
threats 
• 
This objective is 
developmental and 
will be assessed in 
the first year of CHIP 
implementation. 
• 
Increase in the 
number of 
individuals trained to 
prevent, detect, or 
respond to public 
health threats. 
 
• 
Assess the current level of trained 
individuals. 
• 
Identify gaps in training.  
• 
Develop or identify appropriate 
training programs to fill gaps. 
• 
Develop and implement a 
comprehensive training plan. 
• 
Monitor the number of individuals 
trained to prevent detect or respond 
to public health threats. 
 
U.S Virgin Islands Community Health Improvement Plan | 35 
Objective 6.2.2: Increase skills of the public health workforce.  
2030 Target 
Current Status and 
Assets 
Desired Result 
Initial Strategies 
Increase the 
use of core 
public health 
competencies 
in continuing 
education for 
the USVI public 
health 
workforce 
• 
This objective is 
developmental and 
will be assessed in 
the first year of CHIP 
implementation. 
• 
Increase in the use 
of core public health 
competencies in 
continuing 
education for the 
public health 
workforce 
 
• 
Assess current use of core public 
health competencies in continuing 
education for the USVI public health 
workforce. 
• 
Identify gaps in use of core public 
health competencies in continuing 
education for the USVI public health 
workforce. 
• 
Develop a comprehensive plan to 
increase the use of competencies. 
• 
Ensure implementation of the plan. 
• 
Monitor use of the core public health 
competencies in continuing 
education for the USVI public health 
workforce. 
Explore public 
health pipeline 
programs to 
include service 
or experiential 
learning 
• 
University of the 
Virgin Islands School 
of Nursing students 
rotate through 
hospitals and public 
health clinics as part 
of course of study to 
earn the BSN 
degree. 
 
• 
Implementation of at 
least two public 
health pipeline 
programs to 
increase service or 
experiential 
learning. 
 
• 
Identify pipeline programs that may 
be suitable for the territory. 
• 
Partner with the University of the 
Virgin Islands to develop a plan for 
undergraduate and graduate 
students. 
• 
Partner with the USVI Department of 
Education to explore pipeline 
programs for middle and high school 
students. 
 
Objective 6.2.3: Improve health data and informatics. 
2030 Target 
Current Status and 
Assets 
Desired Result 
Initial Strategies 
Increase the 
use of health 
informatics in 
the public 
health system in 
USVI 
• 
Health data systems 
are partially manual 
and not 
interconnected 
electronically. 
• 
An integrated health 
data system that 
includes broad 
implementation of 
telehealth and 
telemedicine 
platforms. 
 
• 
Convene a data users group with 
representation across key agencies 
and communities. 
• 
Assess current data systems and 
their use that enables future 
assessment of programs.  
• 
Identify gaps in current data systems 
and develop and implement a 
comprehensive plan to create an 
integrated health data system 
 
U.S Virgin Islands Community Health Improvement Plan | 36 
Objective 6.2.3: Improve health data and informatics. 
2030 Target 
Current Status and 
Assets 
Desired Result 
Initial Strategies 
inclusive of telehealth and 
telemedicine systems.  
Increase the 
proportion of 
people with 
vaccination 
records in an 
information 
system 
• 
The immunization 
registry is in final 
stages of 
revitalization. 
 
• 
A fully functional 
immunization 
registry. 
 
• 
Continue efforts to rebuild the 
immunization registry. 
• 
Identify resource needs to ensure the 
immunization registry is fully 
functional. 
• 
Ensure that the immunization registry 
has redundant backup systems. 
• 
Launch the immunization registry. 
 
Implement the 
standard 
module on 
sexual 
orientation and 
gender identity 
in the 
Behavioral Risk 
Factor 
Surveillance 
System 
• 
This objective is 
developmental and 
will be assessed in 
the first year of CHIP 
implementation. 
• 
Adoption of 
standard module on 
sexual orientation 
and gender 
identifies included in 
Behavioral Risk 
Factor Surveillance 
System. 
 
• 
Convene a data users group with 
broad representation across 
agencies and the community. 
• 
Ensure that this module is included in 
the Behavioral Risk Factor 
Surveillance System.  
• 
Disseminate findings from the 
Behavioral Risk Factor Surveillance 
System to the public. 
 
 
 
 
 
 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 37 
U.S. Virgin Islands Community Health Improvement Plan 
 
 
 
 
Implementation 
 
 
U.S Virgin Islands Community Health Improvement Plan | 38 
Implementation 
Health improvement is intended to be iterative, where process and outcomes are examined for their 
effectiveness and course correction is applied where appropriate. This focus on quality improvement 
should be continuous and embedded in health planning. However, this shift toward quality 
improvement is an adjustment and requires time and training. USVI DOH is committed, as part of 
its strategic plan, to create an organizational culture where decisions are driven by data and 
evidence and quality improvement is at the top of the public health toolbox.  
The development and implementation of the CHIP is a collaborative effort between community 
partners and USVI DOH, with the health agency playing the roles of leader and convener of partners. 
This health planning process is USVI’s first in over a decade, and it will be the first cycle of health 
planning to apply the MAPP framework as part of a coordinated, collaborative effort. Bumps in the 
road are anticipated and welcomed as opportunities for learning and growth as the partnership 
between the health agency and the community deepens through this improvement initiative. As part 
of USVI DOH’s organizational growth, it is expected that the CHIP will lead to the development of a 
quality improvement plan that will set the stage for USVI’s next cycle of health assessment and 
improvement planning. Community partners are invited to contribute their experience and expertise 
to help improve the quality of health improvement work in USVI. 
Improvement in a Time of Pandemic 
In early 2020, USVI began shifting resources toward its response to the emerging COVID-19 
pandemic, rapidly developing emergency procedures and policies to prevent the spread of SARS-
CoV-2 and instituting a data tracking system to get out information to the public. The agency created 
and implemented a large number of public health directives in the span of a few months to ensure 
public safety. These included deploying targeted public health information, collaborating with 
government agencies and organizations to develop appropriate policy, implementing contact 
tracing and testing sites, and supporting Virgin Islanders in adopting measures such as social 
distancing, mask wearing, and quarantine. These efforts were complemented by an unprecedented 
transparent deployment of pandemic-related data to the community at large. 
As we emerge on the other side of this pandemic, we have learned that we are capable of adapting 
to extraordinary circumstances. We learned from our hurricane recovery work that partnerships and 
building trust with the community are foundational activities in public health. We also learned that 
much of what we assessed in our community health assessment in 2020 may not be the true 
baseline for our improvement work. In fact, that baseline may be worse, as the pandemic only made 
more obvious to us the existing health inequities in our communities. The good news is that we 
learned we can move swiftly to respond to emergencies, and we can do so while responding to the 
emergency of inequitable health for our most vulnerable residents. 
 
U.S Virgin Islands Community Health Improvement Plan | 39 
Immediate Next Steps 
In the first year of our CHIP, we plan to undertake change and begin early implementation. Our 
immediate next step is to develop action plans for each priority area. In its role as leader and 
convener of this process, USVI DOH’s CHIP team will provide project management to ensure 
implementation of each health priority action plan. Each priority area will have a designated leader 
responsible for implementing the area’s overall action plan, and each area will have action planning 
teams for each goal of that priority to  carry out implementation, monitor progress toward goals, and 
mitigate challenges for their assigned goals.  
The first step for each action plan is to develop an implementation work plan with clear milestones. 
These work plans will be approved by the USVI DOH CHIP Steering Committee, which will develop 
a quarterly meeting schedule to facilitate routine monitoring of CHIP implementation. The committee 
will assess progress toward the desired outcomes for each priority area and ensure community 
engagement throughout implementation. 
Transparency during implementation is essential to ensure community engagement and input 
throughout the process. The CHIP DOH team will develop quarterly and annual reports about 
progress in each action plan that will be posted on the USVI DOH website. Action teams will also 
hold community forums periodically to share progress with the community. 
Performance monitoring and evaluation will be conducted by the CHIP DOH team. USVI DOH will 
consider creating a public dashboard showing progress toward key metrics in the CHIP. If feasible, 
USVI may engage an external evaluator to assess the implementation of the CHIP and to develop 
recommendations for improvement during its next improvement cycle. The work plan below 
presents the high-level steps that Healthy Virgin Islands 2030 intends to achieve in its first year. 
Activity 
Months 
USVI DOH identifies a lead for each priority area and recruits members of each 
priority area action planning team. 
1 
USVI DOH convenes action planning teams for each goal and refines metrics 
and targets.  
2-3 
Action planning teams develop a health priority action plan (implementation work 
plan) for each priority area goal. 
4-6 
CHIP Steering Committee reviews and approves health priority action plans. 
7-8 
USVI DOH commissioner and executive committee review and approve health 
priority action plans. 
6-9 
USVI DOH develops a performance monitoring and evaluation plan. 
9 
Action planning teams begin implementation. 
9-12 
USVI prepares and publishes a first-year progress report. 
12 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 40 
U.S. Virgin Islands Community Health Improvement Plan 
 
 
 
 
Appendices 
 
 
U.S Virgin Islands Community Health Improvement Plan | 41 
Appendix A 
U.S. Virgin Islands Community Health 
Improvement Plan Steering Committee Charter 
Purpose 
This charter outlines the aim and strategies of the U.S. Virgin Islands (USVI) Community Health 
Improvement Plan (CHIP) Steering Committee (SC) in our effort to improve the health of all Virgin 
Islanders. The USVI CHIP SC is a subcommittee of a larger health planning initiative led by the USVI 
Department of Health (DOH) to achieve a vision of creating a trusted system that supports a healthy 
USVI. The committee includes partners from many sectors that pledge to collaborate in planning 
this cross-sector improvement work for the Healthy Virgin Islands 2030 initiative.  
Primary Role and Responsibilities 
The primary role of USVI CHIP SC is to develop a written community health improvement plan by 
the end of June 2021 that identifies three to five health priorities through a process informed by the 
2020 community health assessment and meaningful, authentic input from the USVI community at 
large. Each committee member is responsible for: 
• Participating in a series of meetings to identify these priorities and strategies.  
• Contributing to and reviewing the written CHIP. 
• Actively engaging the communities that they represent to ensure those voices are heard 
and elevated throughout this work.  
USVI CHIP SC is not charged with implementing, monitoring, or evaluating the CHIP but is invited 
by USVI DOH to participate in and amplify those efforts once the written CHIP is finalized and shared 
with the community. 
USVI CHIP SC embraces the values that underpin this initiative, including: 
• Equity 
• Results-Oriented Performance  
• Community-Focused  
• Integrity  
• Compassion  
• Accountability  
• Teamwork  
• Inclusiveness & Respect  
 
U.S Virgin Islands Community Health Improvement Plan | 42 
Our Aim and Approach 
USVI CHIP SC, in consultation with the community, will create a CHIP that will work toward creating 
a trusted public health and healthcare system for all Virgin Islanders. Using an adaptation of the 
Mobilizing for Action through Planning and Partnerships model for community health improvement, 
USVI CHIP SC will achieve this aim by: 
• Reviewing key gaps and limitations in the public health system and inequities in USVI health 
outcomes and communicating this assessment to the community to enhance its 
understanding of population health. 
• Identifying, in consultation with our community, three to five health priorities that will reduce 
health risks, improve access to high quality healthcare services, and enforce health 
standards across USVI. 
• Developing a written CHIP that includes priority-based strategies for achieving measurable 
outcomes by the end of 2024. 
• Creating a process to implement priority-based teams that will develop priority-area action 
plans based on the strategies presented in the CHIP. 
• Developing procedures to monitor and adjust implementation of the priority-area action 
plans. 
• Developing a plan to evaluate our improvement effort for future learning and health 
planning. 
Measuring Success 
USVI CHIP SC will propose indicators that enable monitoring of the CHIP in alignment with USVI 
DOH key performance indicators. These indicators will be detailed, measurable outcomes and 
targeted thresholds that will signal that success has been achieved within each priority area. 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 43 
Appendix B 
Steering Committee Membership  
U.S. Virgin Islands Department of Health 
Justa Encarnacion, Commissioner   
Nicole Craigwell-Syms, Assistant Commissioner, Management and Operations  
**Janis Valmond, Deputy Commissioner, Health Promotion Disease Prevention  
Tai Hunte-Caesar, Medical Director 
**Donna Christensen, Public Health Advisor  
Shanna O’Reilly, Chief of Staff  
**Berlina Wallace-Berube, Director, Primary Care Office 
 
Office of the Governor of the U.S. Virgin Islands 
Julia Sheen, Policy Advisor 
Julien Henley Sr., Territorial ADA Coordinator for the U.S. Virgin Islands 
 
Office of Senator Novelle Francis 
Shawna Richards, Chief of Staff 
 
Gov. Juan F. Luis Hospital and Medical Center 
Dyma Williams, Acting CEO 
Hazel Philbert, Chief Operating Officer 
 
USVI Department of Human Services 
Kimberly Causey-Gomez, Commissioner 
Michelle M. Francis, Director of Strategic Planning and Operations 
Gary Smith, Director, Medical Assistance Program 
 
Frederiksted Health Care, Inc. 
Masserae Sprauve Webster, CEO 
Camille Paul, Physician Assistant  
 
St. Thomas East End Medical Center Corporation 
Moleto Smith, Executive Director 
Nyra Stout, Finance/Special Projects 
 
U.S Virgin Islands Community Health Improvement Plan | 44 
Rene D. Crawford, Executive Assistant for Policy and Administration 
 
University of the Virgin Islands  
Noreen Michael, Research Director, Caribbean Exploratory Research Center of Excellence 
David Hall, President, University of the Virgin Islands1 
 
 
 
1 **VIDOH Core Planning Team 
 
U.S Virgin Islands Community Health Improvement Plan | 45 
Appendix C 
Summary of Community Survey Results 
Response Rate and Characteristics  
A total of 557 individuals responded to the community survey over a six-week period between mid-
February and March 2021. Among the 326 survey respondents who indicated their island of 
residence, the majority were from St. Thomas (166 or 51%). 
 
A majority (63%) of respondents to the survey identified as Black or Afro-Caribbean if they resided 
on St. Croix or St. Thomas. Almost all respondents from St. John (91%) identified as White. A 
majority (89%) of respondents to the survey did not identify as Hispanic.   
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 46 
 
Most (27%) respondents identified their age as being 45 to 64 years, and most (81%) respondents 
indicated they were female and had an income between $50,000 and $74,999 (24%). Most 
respondents (59%) reported having full-time, year-round employment. Almost all (96%) 
respondents spoke English as a primary language, and most (83%) respondents held a high school 
diploma or had completed some graduate schoolwork or degree. A small percentage (19%) of 
respondents were healthcare professionals. 
 
 
U.S Virgin Islands Community Health Improvement Plan | 47 
 
 
 
 
Health Care Provider 
 
 
U.S Virgin Islands Community Health Improvement Plan | 48 
Health Priorities 
When asked what were the most important health challenges facing people living in their 
community, a majority of respondents (58%) chose chronic health conditions (obesity, diabetes, 
hypertension, high cholesterol, etc.) as their top challenge. Delaying medical care and not having 
insurance were also among the respondents’ top challenges. 
 
Respondents also named seniors as their top population of concern, followed by people with 
disabilities and men. 
 
 
 
U.S Virgin Islands Community Health Improvement Plan | 49 
 
When asked about pressing health issues besides COVID-19, a quarter or more of respondents 
identified diabetes and access to care as important to them.