Both hypertension and diabetes are multifactorial] disekse complexes, being dependent on a mixture of heredity, diet, obesity, exerdise, etc. The primary factors responsible in the Marshalls have not been ascartained. the exact incidence of each disease is unknown. Even An adequate unflerstanding of the epidemiology of these problems and causative factors in thlis environment will be an important initial step in developing adequate [detection and treatment programs. E. Social Problems With traditional folk ways and family relationshipB undergoing dramatic change over the years, kinship lines and responsibilities have been fragmented for most Marshallese families. The underlying supp t system for all family members has been disintegrating over time and the y@uth, as well as the elders, have become disenchanted and alienated. Tha Marshallese perceive the increasing use of alcohol as one of the most serfous problems in the Islands and identify it as the contributing factof in further fragmentation of kinship ties and in other destructive sodial Arrests for alcoholism (adolescents and adults) have tripled changes. Jn the past 3 years for adolescents (Wally Wotring, Director of Public Safdty) and have already doubled for adults in 1980 (January through Septembar). Drunken behavior has also been involved in the increase of car accidegts on Majuro and the alarming upward trend of suicide throughout the Marghall Islands (suicide rates for adolescents are considered by some local réspondents to be twice the rate found in the United States). Other distressing social problems affecting coping abilfties and the mental health of the local people include dislocation and redigtribution of people, increase in crime rates (especially forgery, burglary and assault and battery), increased prostitution, use of drugs, intrafam#ly violence, divorce, loss boundaries, of understanding and neglect of parenting and communication parenting across skills, [generational laqgk of family planning and enhancement of family life; increase in juvenile|delinquency, homosexual relationships, and lack of employment opportunitieq for al? age groups (adolescence through the aged). Additional mental health problems are evident in the form of apathy, alienation, depression, stress syndromes, confusion and amb@valence, motivation drives, self-identity crises, role dysfuncti and low role identification crises (adolescents and adults), and fear of tMe future and the unknown (economics, health and basic survival). 14