This is a press release issued in response to the WHO report Preventing Chronic Disease: A Vital Investment, published in October 2005.
Alaska Natives comprise the largest minority population in Alaska, at 18% of the state population. The majority of Alaska Natives reside in over 200 geographically isolated rural communities, and they are accustomed to dealing with hardships every day in order to survive the harsh climate. Health disparities between Natives and non-native Alaskans have been addressed in the public-health sector and, while great progress has been made in some areas, many disparities still exist. Rural Alaska in 2005 is very different from other parts of the United States. Most communities are not on a road system and cannot be accessed without a small plane or a boat. Many villages do not have running water or sewer systems. Interventions planned for other parts of the United States cannot be transferred to Alaska without much alteration because the circumstances are so different. The area has many of the same problems that are experienced in the rest of the world: an increase in the rates of obesity and cancer, and an increasing prevalence of diabetes.
The health of Alaska Natives has undergone a rapid change over the last 100 years. During the first part of the 20th century, cancer was not a major cause of death among Alaska Natives, but by the early 1990s cancer had become the leading cause of death. While in the United States, the overall cancer death rate declined during the 1990s, in contrast the Alaska Native cancer death rates increased. The number of new patients diagnosed with cancer each year continues to climb. Alaska Native women have the highest cancer death rates of all racial and ethnic groups. This is linked to high levels of tobacco use – in Western Alaska, 57% of women use spit tobacco during pregnancy. Lung cancer accounts for one in three cancer deaths among Alaska Natives. The situation is similar for diabetes, unknown among Alaska Natives in the early part of the 20th century. The current prevalence is increasing more rapidly than any other part of North America, surpassing even that of the American Indians in other states, with as much as a 76% rate of increase in the last 13 years.
These negative changes in health coincide with the rapid change from traditional subsistence activities to more western foods and tobacco use, and decreases in physical activity in daily life. Traditionally, the diet was primarily meat and fish, high in polyunsaturated and monounsaturated fats. As in other areas, unhealthy store bought foods containing sugar and saturated fat are replacing healthy traditional foods, and modern labour-saving devices reduce the need for physical activity in daily life. Rural Native Alaskans cannot turn to the methods usually recommended in other states for increasing exercise – the weather can be very harsh and cold in Alaska, especially in the winter, with long hours of darkness making outdoor exercise impractical. Rural Alaska needs to come up with different solutions. Improvements in the built environment and sanitation take time and a large amount of money in rural areas. In the meantime, increasing education and advocacy at the local level can improve the quality of people’s lives.
The World Health Organisation’s recommendations to prevent chronic disease point to the critical need for immediate action. In Alaska, the Alaska Native Tribal Health Consortium has partnered with Yale University School of Public Health / Oxford Health Alliance’s CAPCoD project to work with rural Alaskans to improve their own health by training local people to become peer educators – to live and work in the community and help others make healthier choices, increase their exercise and decrease tobacco use. The Aleutian Chain and the Pribilof Islands, with the help of the Aleutian Pribilof Island Association and the Eastern Aleutian Tribes, will be the first partners for this project. We hope with this bottom-up approach we can have an impact on the rising tide of chronic diseases in rural Alaska.
Contact in Alaska: Teresa Hicks, RD CDE
Alaska Native Tribal Health Consortium
(907)729-3925
Email: tahicks@anthc.org
* * * * *
Other press releases from CAPCoD projects issued in response to the WHO report can be found here.