Health Status A. Vital Events 1. Data Problems As is the case with most developing countries, adequately measuring in a quantifiable manner the health status of the population is very difficult. It is even more difficult here in that the entire country has only 30,000 + people thus the total number of vital events occurring in one year are few. Therefore any errors in reporting, data handling, or interpretation cause considerably more populations. change in the rates and percentages than in larger For example, the missing of one or two atolls by a "field ship" doing immunizations (or collecting statistics) can mean that an entire cohort of children can be missed thus dramatically affecting immunization levels, not to mention birth and death statistics. In the economic sector small changes can. cause even greater population data changes. It has been said for instance, that the “laying off" of one Marshallese employee on the Kwajalein Missile Range causes twenty plus individuals to leave Ebeye (the adjacent Marshallese town) for their outer island home atolls. Rapid changes in migration, age/sex composition, geographical distribution, and total population per atoll occur frequently as a result of minor governmental changes in hiring practices and policies (55-65% of the workforce in Ebeye or Majuro are employed by the government, furthermore it is estimated that 50-60% of the available workforce in these centers are not employed). Consequently, any quantitative presentation of the situation must be viewed with caution. Nevertheless the data that is available does provide an estimate of the current status. Most of the data comes from either the 1973 census (the 1980 official census data will not be available until mid1981) or an unofficial census in 1977, done by the Department of Planning and Resource monitors vital Development. events The (births, continuing death, fetal registration deaths) system which and health service utilization statistics also provide data. 2. Demography/Vital Events The total population in 1977 was estimated at 25,457 Table 1 shows the projected population by age categories for 1979, 1981, 1985, 1990, and the year 2000.