The Pacifi c island region, as conventionally defi ned, includes almost a thousand language and cultural groups and over three hundred populated islands. The larger Melanesian states in the west can loosely be characterized by internal migration, the Polynesian states to the east by extensive international migration and the smaller Micronesian states to the north by both internal and increasingly international migration. The most substantial emigration streams in the region have come from the central Polynesian states (Tonga, Samoa, Niue, the Cook Islands and Tokelau), Fiji and, increasingly, the Micronesian states of Palau, the Marshall Islands and the FSM. Health status is best in those states that remain politically dependent, notably the French territories (New Caledonia, French Polynesia and Wallis and Futuna), and least adequate in the larger states of Melanesia, where there are proportionately fewer health workers and smaller budgets.