To determine the prevalence of anaemia, identify the predictors of anaemia, compare the prevalence of anaemia among children living in American Samoa to those found in children living in the USA, and compare the growth patterns obtained from this study to Centers for Disease Control and Prevention (CDC) data and data obtained earlier in American Samoan children.

Cross-sectional.

American Samoa, a Pacific Island.

In all, 208 children aged 5–10 years.

Anaemia (Hb < 11·5 g/dl) prevalence was 17·3 %. There was a significant difference in mean Hb levels in children within American Samoa as compared to National Health and Nutrition Examination Survey III data (P < 0·05). In children with BMI Z-score (BMIZ) (P < 0·05) and weight-for-age Z-score (WAZ) (P < 0·05) >2·0, females had a significantly higher prevalence of anaemia than males. Females with a WAZ > 2·0 had a significantly higher prevalence of anaemia than females with a WAZ ≤ 2·0 (P < 0·03). Risk factors for anaemia were mother having less than a high school education (P = 0·02), no car (P < 0·01) and no phone (P = 0·02). The BMIZ (P < 0·000), height-for-age Z-score (P < 0·000) and WAZ (P < 0·000) were significantly different from the distribution of CDC reference data and that found in children previously assessed in American Samoa.

Anaemia is high among children aged 5–10 years living in American Samoa. Growth pattern Z-scores reveal that American Samoan children are, on average, taller, heavier and more overweight. Further examination into the causes of anaemia and overweight is warranted.