People and Society of Palau

Nationality

Palauan(s)

Ethnic Groups

Palauan (Micronesian with Malayan and Melanesian admixtures) 70%, Asian (mainly Filipinos, followed by Chinese, Taiwanese, and Vietnamese) 28%, white 2%

Population

18,024

Population in Major Urban Areas

MELEKEOK (capital) 1,000

Health facilities in Palau are adequate for routine medical care, but the availability and quality of services are limited. Serious medical conditions requiring hospitalizations or evacuation to the United States or elsewhere may cost tens of thousands of dollars. The Belau National Hospital will accept payment by cash, credit or debit card, while private clinics may require cash payment. Please be advised that Palau has occassional outbreaks of Dengue Fever.

Life Expectancy at Birth

Life expectancy at birth in Palau stands at approximately 72 to 74 years, reflecting a modest but steady improvement in health outcomes over recent decades. This figure places Palau in a comparable range to many small island developing states in the Pacific region, though it remains somewhat below the averages seen in high-income nations. As is common globally, a gender gap exists in Palauan life expectancy. Women in Palau generally live longer than men, with female life expectancy estimated at around 75 to 77 years, while male life expectancy typically falls between 69 and 72 years. This disparity mirrors broader Pacific and global trends and is influenced by differences in lifestyle behaviors, occupational risks, and health-seeking habits between sexes. Several factors shape life expectancy outcomes in Palau. Non-communicable diseases, including cardiovascular disease, diabetes, and obesity-related conditions, represent significant health challenges for the population. These chronic conditions have become increasingly prevalent as dietary habits shifted over the latter half of the twentieth century toward processed and imported foods, replacing traditional diets rich in fish, taro, and local produce. High rates of tobacco use and alcohol consumption among certain demographic groups also contribute to premature mortality, particularly among men. On the positive side, Palau has a relatively accessible public health system for its small population of roughly 18,000 people. The government operates the Belau National Hospital, the country's primary medical facility, and residents can access regional medical referrals for complex care. Infant mortality has declined considerably over time, contributing to rising average life expectancy figures. Improvements in maternal and child health, clean water access, and sanitation infrastructure have all supported better survival rates in younger age groups. Palau's geographic isolation and small population size present ongoing challenges for healthcare delivery, and the country relies on medical partnerships with the United States and regional health organizations to supplement domestic capacity. The Compact of Free Association with the United States provides Palauans with access to certain federal health programs and referral services, which has meaningfully supported health outcomes. Despite these constraints, life expectancy trends in Palau have moved in a broadly positive direction over the past several decades, underpinned by continued investment in public health infrastructure and disease prevention efforts.

Infant Mortality Rate

Palau maintains a relatively low infant mortality rate compared to many Pacific Island nations, reflecting the country's access to healthcare services and its close ties with the United States health system. The infant mortality rate for Palau is estimated at approximately 10 to 12 deaths per 1,000 live births, a figure that places it in a moderate range when measured against global averages but is notably better than many of its regional neighbors. Several factors contribute to this outcome. Palau benefits from a functioning public health infrastructure centered around Belau National Hospital in Koror, which serves as the primary medical facility for the island nation. Skilled birth attendants are present for the vast majority of deliveries, and prenatal care is generally accessible to the population. The Compact of Free Association with the United States provides Palauan citizens access to certain U.S. federal health programs, which has historically supported health funding and medical referrals for complex cases. Neonatal conditions, including complications from preterm birth and low birth weight, represent the most common contributors to infant deaths in Palau, consistent with global patterns. Non-communicable disease risk factors affecting mothers, such as diabetes and hypertension, are areas of ongoing concern in Palau's health planning, as these conditions can influence birth outcomes. Palau's small population — numbering around 18,000 people — means that even modest fluctuations in birth and death counts can cause year-to-year variation in reported statistics, making trend interpretation somewhat challenging. Public health officials and international organizations continue to monitor maternal and child health indicators as part of broader sustainable development goals. Overall, Palau's infant mortality rate reflects a healthcare environment that, while limited in scale, has demonstrated meaningful capacity to support child survival outcomes. Continued investment in maternal health services, nutrition programs, and early childhood care remains a priority for sustaining and improving upon these results.

Literacy Definition

age 15 and over can read and write

• Roman Catholic41.6%
• Other26.4%
• Protestant23.3%
• Modekngei8.8%
• Latter-Day Saint (Mormon)0.6%

English and Palauan official in all states except Sonsoral (Sonsoralese and English are official), Tobi (Tobi and English are official), and Angaur (Angaur, Japanese, and English are official)

• English
• Japanese
• Palauan

Crime Information

Although the crime rate in Palau is relatively low, as a foreign resident or visitor, you might be the target of petty and sometimes violent crime as well as other random acts against individuals and property. Please stay alert for your personal safety and protect your valuables. Don’t buy counterfeit and pirated goods, even if they are widely available. Not only are the bootlegs illegal in the United States, if you purchase them you may also be breaking local law.

Criminal Penalties

While you are traveling in Palau, you are subject to its laws even if you are a U.S. citizen. Foreign laws and legal systems can be vastly different than our own. In Palau, it may be illegal to take pictures of certain private buildings and historical sites unless you have been granted permissions or paid the required fees. In Palau, driving under the influence could land you immediately in jail. Certain sites require prior permission and/or payment of a fee prior to visiting or taking photographs. Signs are posted at the relevant sites, and an attendant may be present to collect the fee. There are also some things that might be legal in the country you visit, but still illegal in the United States, and you can be prosecuted under U.S. law if you buy pirated goods. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime prosecutable in the United States. If you break local laws in Palau, your U.S. passport won’t help you avoid arrest or prosecution. It’s very important to know what’s legal and what’s not wherever you go. While some countries will automatically notify the nearest U.S. embassy or consulate if a U.S. citizen is detained or arrested in a foreign country, that might not always be the case. To ensure that the United States is aware of your circumstances, request that the police and prison officials notify the nearest U.S. embassy or consulate as soon as you are arrested or detained overseas.