There are hospitals in each state center. In 1986, a community health center was established in Pohnpei and in 1987, a medical school was started. In the outer islands, primary medical services are provided through dispensaries staffed by health assistants. In 1982, a superdispensary was initiated in the Lower Mortlock Islands to serve 3,769 people scattered on seven atolls. Tertiary medical treatment is provided through patient referral to hospitals in Guam and Hawaii. All of Micronesia had access to safe water and sanitation in 1993.
The infant mortality rate in 1999 was 33.9 per 1,000 live births, and the life expectancy was 68.5 years. In the same year, the general mortality rate was 6 deaths per 1,000 people and the fertility rate was 3.9 children per woman. The maternal mortality rate was 121 per 100,000 live births in 1991–93. Immunization rates for Micronesian children under one year of age in 1994 were as follows: measles, 80%; tuberculosis, 50%; polio, 77%; and diphtheria, tetanus, and pertussis, 78%. Although polio has been eradicated, there have been cases of tuberculosis (173 in 1994) and measles (905 in 1994). Anemia was seen in 33% of children under the age of five in 1993.