The health care system is obligated to deliver equal care to all citizens regardless of their place of residence. This requires a large number of small, cost-effective health centres capable of providing acute care because the expenses for transport of patients and staff are very high.182 Due to their small size and isolation, towns and villages in Greenland often need to be self-sufficient and are very vulnerable to external factors.18 No private providers of health care services exist in Greenland, but private dental care, physiotherapy, psychotherapy and treatment for alcohol and drug abuse are available in Nuuk. In the past, perinatal complications, acute and chronic infectious diseases and injuries dominated as the leading causes of morbidity.184 Recently, chronic and lifestyle diseases and disabilities dominate morbidity concerns despite the fact that the "old" diseases have not decreased to the same low levels found in Western countries.