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Twenty-five European overseas countries and territories (OCTs) are associated with the European Union (EU) through four Member States of the European Union (EU): Denmark, France, the Netherlands and the United Kingdom. Citizens of OCTs are European citizens, unless they decide to renounce their respective European Member State citizenship. The OCTs are neither part of the EU nor considered as third countries but maintain a special relationship with the EU Member State with which they are constitutionally linked. OCTs should not be confounded with European outermost regions. The European outermost regions have a different legal status from OCTs and constitute an integral part of the EU where Community law is fully applicable [1]. They include the four French overseas departments Guadeloupe, French Guyana, Martinique and La Réunion, the Canary Islands that are part of Spain, and the Azores and Madeira as parts of Portugal.

Public health in the European overseas countries and territories: New perspectives for Europe