Much of America thinks about community health as being about access to medical care. However, recently sociologists have been following the lead of rural and indigenous communities and broadening their ideas about community health. The term "community health" actually means the health and well-being of an entire community, not just about individuals' health. In rural Alaska, community health includes such elements as: availability of safe water; sanitary system; access to healthy foods; lack of pollutants and toxic elements in the land, water, and air; effective garbage management; accessible medical and traditional health care; vibrant community traditions and rituals; access to adequate education; access to reproductive health care. In this section, students will explore community health and wellbeing in Alaska from these broad perspectives. Here are some of the questions we will pursue:
- what are the markers of "good" community health? What makes up a sense of community "well-being"?
- Is there a locally available medical facility in all rural Alaska communities? If not, how do rural residents obtain medical care? How much does it cost? Who picks up the tab?
- What role do Alaska Native corporations play in providing for community health?
- How are traditional and cultural practices integrated into community health?
- Does every village have safe water? Sanitation? Garbage management? If not, why not? What are the barriers to providing safe water and sanitation to all rural Alaska communities?
- What toxins and pollutants threaten the health and well-being of rural Alaska communities? What is causing the problems, and how are the problems being addressed?
- What kinds of illnesses and diseases are common in rural Alaska? Are there "cancer clusters" or other markers of cultural disruption and/or environmental pollutants and toxins that disproportionately affect certain rural areas?
- How does age, sex, race/ethnicity, and age shape community well-being?
http://www.alaskacenters.gov/alaskan-diseases.cfm
ReplyDeleteThis websiste lists the four diseases in found in Alaska and warns visitors against them: Giardia, Tularemia, Trichinosis, and Paralytic Shellfish Poisoning.
The first, Giardia, is a highly irritating parasite found in unfiltered drinking water in Alaska. It is not fatal but can cause debilitating diarrhea, stomach cramps, gas, and nausea.
Tularemia is a bacterial disease which is carried by the snowshoe hare. Slightly more serious, the bacteria can cause skin ulcers, swollen lymph glands, inflamed eyes, sore throat, mouth sores, diarrhea and pneumonia.
"Trichinosis is a dangerous disease caused by the infestation of a worm parasite. Humans can get this parasite from consuming undercooked meat, typically from pigs, but wild, meat-eating animals can also spread the disease.Nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort are all very common symptoms of Trichinosis."
The most serious of the four is Paralytic Shellfish Poisoning (PSP). It is caused by a toxin in shellfish that acquire it from bacteria and algae. The toxin is not neutralized during the cooking process, so the only way to avoid it is to gather shellfish in certified areas. After the toxin is ingested, a person's lips, fingers, and toes may start to go numb. They may also experience a loss in muscle coordination. Death from respiratory paralysis may occur within 3-12 hours after ingestion.
http://anthctoday.org/about/serve.html
ReplyDeleteThe Alaska Native Tribal Health Consortium (ANTHC) "is a not-for-profit health organization that provides statewide services in specialty medical care; operates the 150-bed, state-of-the-art Alaska Native Medical Center hospital; leads construction of water, sanitation and health facilities around Alaska; offers community health and research services; is at the forefront of innovative information technology; and offers professional recruiting to partners across the state". It is owned in part by all Alaska Natives through either their tribal government or their regional non-profit organization.
Their medical facility, the Alaska Native Medical Center, is located in Anchorage. Unfortunately the cost of travel is up to the individual.
Successful Aging Through the eyes of Alaska Native Elders. What It Means to Be an Elder in Bristol Bay, AK
ReplyDeleteThis article talks about successful aging by interviewing respected Elders in the community. The concept of Elders as valuable in Native and Rural Alaska is very different from Western views of the elderly, so when thinking about community health, these views are important to consider. Elders have seen so much change in their lives, and looking at what they must do in the community in order to gain "Eldership" is indicative of the role they play in community well-being. This is the first study of Alaska Native "Eldership".
Findings:
"During the analysis of the interview data, four elements emerged, each of which highlighted important aspects of successful aging, referred to as Eldership in this paper. These elements define Eldership in Bristol Bay: (a) emotional well-being, (b) community engagement, (c) spirituality, and (d) physical health. It is important to distinguish between successful aging and Eldership in this study. The term “successful aging” served as the foundation of this study in that I wished to establish an AN definition of successful aging to gain a clearer picture of what this means to Elders in Bristol Bay. As I worked with the Elders and analyzed the interviews, it became clear that rather than defining successful aging for themselves, they were describing characteristics of Elders in their communities they felt demonstrated what they believed to be successful aging. Rather than provide one definition of successful aging for Bristol Bay Elders, this study highlights the characteristics found admirable in Elders who served as role models, or attained Eldership, and were considered as successful elders by their community."
With regards to emotional well-being, a recurring topic that came up was abstaining from alcohol and drugs, in order to be good role models for youth and participate in their grandchildren's lives.
Working with youth, and teaching them traditional ways mixed with modern technology also was an important part of emotional well-being for the Elders.
Social Determinants of Health
ReplyDeleteAs someone who has worked in addiction and harm reduction, the social determinants of health inform my work. Model of Social Determinants of Health It is important to acknowledge that our social conditions affect our ability to be healthy, as individuals and communities. Many health promotion programs emphasize personal choice, and personal action as determining all our of health, inadvertently demonizing those who are not "healthy".
Alaskan Natives and Alcohol: A Sociocultural and Epidemiological Review
ReplyDeletePublished by researchers at the Center for Alcohol and Addiction Studies at the University of Alaska, Anchorage, this review offers important historical context for alcohol use and misuse.
This paper looks at literature from a wide variety of views, including social deviance, interactionist, acculturation, power, religion, addiction as a response to environmental stress, and many, many others. It's only 42 pages, and is well worth a read to anyone interested in addiction and community health in Alaska. What I find so striking about this paper is all the different theories, most with an element of truth in them, yet each so focused on a specific cause.
Village Safe Water Program
ReplyDeleteFrom the pdf about the Grant Program:
"In 1994 only 37% of rural Alaska households had adequate sanitation facilities. Today, 77% of rural Alaskan homes have running water and flush toilets"
"Sanitation conditions in most Alaska villages have vastly improved. Yet one family in three still does not have access to a sanitary means of sewage disposal or an adequate supply of safe drinking
water in their homes. For members of these families, buckets or pit privies are the only methods for disposing of human waste, and water must be hauled by individuals from community watering points or untreated sources such as creeks or rivers."
http://www.alaskadispatch.com/article/20130803/alaska-s-std-rates-decrease-will-progress-continue
ReplyDeleteThis is a link to an article on sexually transmitted diseases in rural Alaska. Rural Alaska has some of the highest rates of gonorrhea and chlamydia. This may be related to a inadequate sex education, a small community, drug and alcohol use, etc.
http://ncfy.acf.hhs.gov/sites/default/files/docs/21215-Alaska_Native_and_Rural_Youth.pdf
DeleteHere is a link to a study done on a group of Alaska natives. They found that living in a small community made it difficult for many to seek help due to a lack of privacy. There is limited healthcare and transportation making access to help difficult. Better sex education and more private methods of dealing with sexually transmitted diseases are needed.