The Republic of Palau, like other small, island, developing states, is particularly vulnerable to climate change due to a number of factors, including: (1) small size; (2) remoteness; (3) limited natural resources; and (3) vulnerability to disasters and extreme weather events. Other factors include social and economic factors such as: (1) economies sensitive to external shocks; (2) high population growth rates and densities; (3) poorly developed infrastructure; (4) limited financial and human resources; and (5) emigration. The (US) Centers for Disease Control and Prevention (CDC) partnered with the Republic of Palau Ministry of Health (MoH) and Southern Illinois University (SIU) to investigate public health consequences in Palau. The goal of the project is to reduce morbidity and mortality due to climate change in Palau by improving awareness using three tools: (1) a photojournalism book to document the local experience in Palau; (2) a marketing campaign to increase awareness in Palau about climate change as it relates to human health; and (3) a Website to raise regional and international awareness of the findings, and act as a forum for discussion and resource-sharing.

The CDC, SIU, and Palau MoH conducted interviews with community members including government officials, traditional leadership, fishermen, gardeners, physicians, scientists and local residents to explore their experiences concerning climate change in their community. Photojournalists took thousands of images documenting locally identified effects of climate change that were perceived as having direct or indirect health consequences for the people of Palau.

Coral bleaching, beach erosion, irregular rainfall, sea level rise, and salt water inundation directly impact food security and tourism in Palau, while other less obvious, but important consequences, such as potential loss of traditional practices and cultural identity were also identified.

The people of Palau reported significant impact from climate change on agriculture, economics, health, and culture.