ZAGREB, 20 Oct (Hina) - Croatia has 53 permanently inhabited islands with around 127,800 residents, and although islanders live longer on average than mainlanders, they also face greater risks of overweight, high blood pressure and mental illness, according to data from the Croatian Institute of Public Health (HZJZ).
HZJZ director Krunoslav Capak said islanders are generally more physically active and consume fish and olive oil more often -- five times more frequently than mainlanders -- but their intake of red and processed meat and sweets has risen to near mainland levels. Hypertensive patients on islands are less likely to receive treatment or keep their condition under control, while visits to primary care are fewer.
Epidemiological studies over the past fifty years have shown longer life expectancy among islanders, mainly due to the Mediterranean diet and favourable environmental conditions. However, research conducted in 2007 and 2008 also revealed a high prevalence of overweight and hypertension, as well as mental health risks linked to isolation and inbreeding on some islands.
The demographic picture is another concern: children under 14 make up 12.7% of the island population compared with 14.3% on the mainland, while those aged over 65 account for 28.1%, rising to more than a third on some islands. This makes the islands some of the oldest areas in Croatia, creating additional strain on the health system.
Transport isolation adds to the challenge. A catamaran journey from Mala Rava to Zadar takes 75 minutes, while the ferry takes two and a half hours. Any hospital examination or emergency intervention therefore requires time and coordination, which can affect health outcomes.
Capak said telemedicine and virtual clinics could be part of the solution, enabling family doctors to consult specialists remotely. He cited Primorje-Gorski Kotar County, which has introduced extra specialist services on Krk, Cres, Lošinj and Rab, reducing the need for mainland visits.
Research shows that 44% of islanders engage in physical activity more than once a week, compared with 26% of mainland residents. Some 80% eat fish at least weekly, compared with 32% on the mainland, and 73% use olive oil daily, compared with only 15% of continental Croatians.
Genetic studies have shown islanders are more prone to hypertension and mental disorders, and on southern Dalmatian islands, to certain cancers, especially ovarian cancer. Rare hereditary diseases such as "mal de Meleda" and short stature on Krk have also been recorded.
Data from the Health Ministry and the Croatian Institute for Emergency Medicine show that emergency services are vital for islanders: in the first eight months of 2025, there were 1,564 helicopter and 759 maritime interventions, mostly due to cardiovascular problems, strokes or trauma.
The HZJZ has organised public health campaigns on islands, including blood pressure screenings on Brač and Dugi Otok, where nearly half of participants had elevated readings. Capak proposed annual island health check-ups, virtual consultations, incentive packages to attract medical staff and mobile diagnostic units such as ultrasound and mammography services.
He concluded that Croatian islands once embodied the "blue zone" concept -- areas where people live longest thanks to healthy diets, physical activity and strong social bonds -- and that with proper measures, they could become such places again.
