Alaskan Communities Research Articles

Estimating Demographic Parameters for Bearded Seals, Erignathus barbatus, in Alaska Using Close‐Kin Mark‐Recapture Methods

ABSTRACTReliable estimates of population abundance and demographics are essential for managing harvested species. Ice‐associated phocids, “ice seals,” are a vital resource for subsistence‐dependent coastal Native communities in western and northern Alaska, USA. In 2012, the Beringia distinct population segment of the bearded seal, Erignathus barbatus nauticus, was listed as “threatened” under the US Endangered Species Act requiring greater scrutiny for management assessments. We sought to estimate requisite population parameters from harvested seals by using close‐kin mark‐recapture (CKMR) methods, the first such application for marine mammals. Samples from 1758 bearded seals harvested by Bering, Chukchi, and Beaufort Sea communities during 1998–2020 were genotyped, genetically sexed, and aged by tooth annuli. After rigorous quality control, kin relationships were established for 1484 seals including two parent–offspring pairs (POPs) and 25 potential second‐order kin pairs. Most of the second‐order kin were half‐sibling pairs (HSPs), but four were potential grandparent‐grandchild pairs (GGPs). There were no full sibling pairs, suggesting a lack of mate fidelity. Mitochondrial DNA analysis identified 17 potential HSPs as paternally related, providing substantial evidence of persistent heterogeneity in reproductive success among adult males. The statistical CKMR model incorporates probabilities associated with POPs, HSPs, and GGPs and assumes known ages and a stable population. Our top model accommodates heterogeneity in adult male breeding success and yields an abundance estimate of ~409,000 with a coefficient of variation (CV) = 0.35, which is substantially greater than the “non‐heterogeneity” model estimate of ~232,000 (CV = 0.21), an important difference for managing a harvested species. Using CKMR methods with harvested species provides estimates of abundance with the added opportunity to acquire information about adult survival, fecundity, and breeding success that could be applied to other species of concern, marine and terrestrial.

Who addresses pollution? Relationships among actors and grant money for waste management efforts in remote Alaskan communities

This study discusses waste-related issues in remote Alaskan villages, focusing on the relationships between the support providers, such as government officials and nonprofits, and the indigenous people, from the perspective of self-determination. With the increasing volume and variety of waste generated by recent lifestyle changes, health and environmental issues have become growing concerns. Each village is responsible for waste management and operating a disposal site. However, challenges exist regarding the current waste management regime, highlighting the importance of grant-funded initiatives and support from non-profit organizations. Based on interviews with supporters and observations of the negotiation process between supporters and indigenous people, this study analyzes the grants and collaborative efforts in Alaska. Through grants and collaborative initiatives, the assimilation of indigenous people into mainstream society is inevitable, although efforts to respect indigenous self-determination and communication are ongoing and serve as a framework for bridging the gap between the waste regime and status quo. However, two unsolved issues remain: the “support-in-waiting” dilemma, and the issues arising from the social, economic, and geographical diversity among settlements. The balance between respect for self-determination in environmental governance and provision of support extending beyond equality of opportunity will be the key to future relationships.

Knowledge is power: Electric vehicle calculator for cold climates

We used crowdsourced data in Alaska and the literature to develop a light-duty electric vehicle model to help policymakers, researchers, and consumers understand the trade-offs between internal combustion and electric vehicles. This model forms the engine of a calculator, which was developed in partnership with residents from three partner Alaskan communities. This calculator uses a typical hourly temperature profile for any chosen community in Alaska along with a relationship of energy use vs. temperature while driving or while parked to determine the annual cost and emissions for an electric vehicle. Other user inputs include miles driven per day, electricity rate, and whether the vehicle is parked in a heated space. A database of community power plant emissions per unit of electricity is used to determine emissions based on electricity consumption. This tool was updated according to community input on ease of use, relevance, and usefulness. It could easily be adapted to other regions of the world. The incorporation of climate, social, and economic inputs allow us to holistically capture real world situations and adjust as the physical and social environment changes.

Southeast Alaskans Want Food Sovereignty and Reimagined Rural Futures

United States federal lands are managed for multiple conservation, social, and commercial goals shaped by the visions of diverse interest groups. The rural economic and food-security needs of local public-lands-based communities have important implications for sustainable natural-resource management but can be obscured by national-scale public comment processes. To better understand local concerns and aspirations for management of the nation’s largest national forest, the Tongass, we use thematic analysis of public testimonies provided by Southeast Alaska community members as part of the federally mandated Roadless Rulemaking Subsistence Hearings in 2019. The six themes we develop explore speakers’ views of an Alaska exemption from the 2001 Roadless Rule, Alaska Native and rural community connections to the forest ecosystem, visions for rural futures, and concerns with the rulemaking process. Explicit consideration of local economic, food sovereignty, and federal rulemaking concerns can inform a broader picture of federal land management.

Using Geographic Disaggregation to Compare Tuberculosis Epidemiology Among American Indian and Alaska Native Persons-USA, 2010-2020.

American Indian and Alaska Native (AIAN) populations are frequently associated with the highest rates of tuberculosis (TB) disease of any racial/ethnic group in the USA. We systematically investigated variation in patterns and potential drivers of TB epidemiology among geographically distinct AIAN subgroups. Using data reported to the National Tuberculosis Surveillance System during 2010-2020, we applied a geographic method of data disaggregation to compare annual TB incidence and the frequency of TB patient characteristics among AIAN persons in Alaska with AIAN persons in other states. We used US Census data to compare the prevalence of substandard housing conditions in AIAN communities in these two geographic areas. The average annual age-adjusted TB incidence among AIAN persons in Alaska was 21 times higher than among AIAN persons in other states. Compared to AIAN TB patients in other states, AIAN TB patients in Alaska were associated with significantly higher frequencies of multiple epidemiologic TB risk factors (e.g., attribution of TB disease to recent transmission, previous diagnosis of TB disease) and significantly lower frequencies of multiple clinical risk factors for TB disease (e.g., diagnosis with diabetes mellitus, end-stage renal disease). Occupied housing units in AIAN communities in Alaska were associated with significantly higher frequencies of multiple measures of substandard housing conditions compared to AIAN communities in other states. Observed differences in patient characteristics and substandard housing conditions are consistent with contrasting syndromes of TB epidemiology in geographically distinct AIAN subgroups and suggest ways that associated public health interventions could be tailored to improve efficacy.

Differences in perceptions of COVID-19 risks in a fishing community in Alaska, 2020–2021

Bristol Bay in Alaska is home to the world’s largest commercial salmon fishery. During an average fishing season, the population of the Bristol Bay region more than doubles as thousands of workers from out of state converge on the fishery. In the months leading up to the 2020 commercial fishery opening, as the COVID-19 pandemic exploded worldwide, great uncertainty existed about the health risks of opening the fishery. Bristol Bay residents had not yet experienced any cases of COVID-19, yet the livelihoods of most were closely tied to the commercial fishery opening. To better understand how COVID-19 risk perceptions affected decisions to participate in the fishery, we administered an online survey to community members and fishery participants. We collected standard socioeconomic data and posed questions to gauge risk perceptions related to COVID-19. We find that COVID-19 risk perceptions vary across race/ethnic groups by residency and income. People with below median income who are members of minority groups—notably, non-resident Hispanic workers and resident Alaska Native respondents—reported the highest risk perceptions related to COVID-19. This study highlights the important linkages among risk perceptions, socioeconomic characteristics, and employment decisions during an infectious disease outbreak.

Extremely Cold Climate and Social Vulnerability in Alaska: Problems and Prospects

Cold exposure remains a significant public health concern, particularly in the Arctic regions prone to extremely cold weather. While the physical health impacts of cold exposure are well documented, understanding the social vulnerability aspects is crucial for effective mitigation and policy development. This study investigates the multifaceted dimensions of social vulnerability in the face of cold temperatures across various communities in Alaska. Alaska, renowned for its extreme cold temperatures and harsh environmental conditions, poses unique challenges to its residents, particularly in the context of social vulnerability. Drawing on a combination of quantitative data analysis and qualitative insights, we examine the factors contributing to social vulnerability, including demographic, economic, geographic, and infrastructural elements, in terms of the Extremely Cold Social Vulnerability Index, for seven Public Health Regions in Alaska. The Universal Thermal Climate Index in two very cold categories (<−27 °C) was used to identify cold exposure. Factors such as income, housing quality, health status, and resilience of the population play crucial roles in determining an individual or community’s sensitivity to, and ability to cope with, cold temperatures. Our analysis reveals that social vulnerability in Alaska is not uniform but varies significantly among regions. The research findings highlight the importance of considering factors of both sensitivity and adaptivity in understanding and addressing social vulnerability, thereby informing the development of targeted strategies and policies to enhance the resilience of Alaskan communities. As cold temperatures are projected to continue to challenge the region, addressing social vulnerability is essential for ensuring the well-being and safety of Alaska’s diverse populations.

Community-scale changes to landfast ice along the coast of Alaska over 2000-2022

Landfast sea ice that forms along the Arctic coastline is of great importance to coastal Alaskan communities. It provides a stable platform for transportation and traditional activities, protects the coastline from erosion, and serves as a critical habitat for marine mammals. Here we present a full assessment of landfast ice conditions across a continuous 7885 km length of the Alaska coastline over 2000–2022 using satellite imagery. We find that the maximum landfast ice extent, usually occurring in March, averaged 67 002 km2 during our study period: equivalent to 4% of the state’s land area. The maximum extent of landfast ice, however, exhibits considerable interannual variability, from a minimum of 29 871 km2 in 2019 to a maximum of 87 571 km2 in 2010. Likewise, the landfast ice edge position averages 22.9 km from the coastline but, at the community-scale, can range from 2.8 km (in Gambell) to 71.1 km (in Deering). Landfast ice breakup date averages 2 June but also varies considerably both between communities (3 May in Quinhagak to 24 July in Nuiqsut) and interannually. We identify a strong control of air temperature on breakup timing and use this relationship to project future losses of ice associated with Paris Climate Agreement targets. Under 2 °C of global air temperature warming, we estimate the average Alaskan coastal community will lose 19 days of ice, with the northernmost communities projected to lose 50 days or more. Overall, our results emphasize the highly localized nature of landfast ice processes and the vulnerability of coastal Arctic communities in a warming climate.

Harvest of waterfowl and Sandhill Crane in rural Alaska: Geographic and seasonal patterns.

We estimated the annual harvest of waterfowl and Sandhill Crane Grus canadensis and their eggs by Alaska's rural residents and described seasonal and geographic patterns. Subsistence in Alaska refers to patterns of resource use typical of rural, remote regions where Indigenous people are a high proportion of the population. Rural communities in Alaska rely on the legally-allowed spring-summer harvest of migratory birds for food and socio-cultural wellbeing, in addition to harvests in the fall-winter general hunting season. We based harvest estimates on a large dataset (637 community-years) composed from multiple sources. The estimated annual average harvest of waterfowl and Sandhill Crane by rural residents was 270,641 birds/year (68% in spring-summer, 32% in fall-winter) and 36,692 eggs/year in the 2004-2015 reference period. Harvest estimates for ducks, swans, and Sandhill Crane were lower than in the 1980s-1990s. Harvest amounts, seasonality, and species composition distinguished regional patterns for the Pacific-Aleutian mainland and islands, Bering Sea mainland, St. Lawrence-Diomede islands, North Slope, and Interior Alaska-Upper Copper River. Rural residents accounted for 79% of the total waterfowl harvest in Alaska and high proportions of the total Pacific Flyway harvest for several species of sea ducks, geese, swans, and Sandhill Crane. Alaska's Indigenous people are important partners in harvest management and conservation of migratory birds. Harvest data are needed to inform efficient and appropriate decisions to achieve management goals. This study can facilitate collaboration for harvest management and conservation across Alaska and the flyways by helping diverse users to understand their contributions to the total harvest.

Serving Remote Native Alaskans: A Geospatial Analysis of the History of Remote Alaskan Libraries and Opportunities to Connect with Alaskan Native Culture Through Public Libraries

ABSTRACT Geographic information systems (GIS) allow spatial analyses of both historic and current library locations in rural and remote communities, offering insight into underserved communities. The purpose of this study is to conduct geospatial analysis of historic and known current library locations in remote interior Alaska and to identify ways in which remote, primarily Native Alaskan communities can be better served by libraries in those isolated communities. The study emphasizes the history and impact of The Village Library Project, an effort to bring public library services to remote communities in the early 1980s. Utilizing publicly available American Community Surveys Census data, this study also discusses current public library locations, finding that over 50 percent of Native Alaskan residents of remote Alaska are without library access.

FORWARD STEPS AND MISSTEPS: WHAT WE’VE LEARNED THROUGH THE PROCESS OF COMMUNITY-ENGAGED RESEARCH

Abstract Historically, research with Indigenous populations has disregarded community input, creating mistrust among tribal communities toward researchers, and resulting in communities limiting their involvement in research projects. Today, Indigenous communities are becoming more engaged in the research process, including developing their own tribal review boards, partnering with researchers throughout entire research process, as well as exercising their tribal sovereignty and housing their own data. These efforts have resulted in the development of rigorous Indigenous approval processes, increased engagement of Indigenous people and communities in research, and studies that have direct impacts on those engaged, as well as future generations, as well as protect both the Indigenous communities and the researchers. As a researcher trained to conduct culturally respectful and culturally safe research with Indigenous communities in Alaska, my team and I have gained first-hand experience with tribal research protocols, research processes, and the iterative process of developing relationships, navigating research ethics, as well as ensuring that findings are reflective of the community, its individual members, and the region. Despite our best efforts, research does not go as written in our grant proposals. This presentation will outline the complexities of navigating tribal approval processes in Alaska, highlight some of the challenges we have faced while conducting community-engaged research in Alaska; our lessons learned by doing it incorrectly. We will also share recommendations for researchers interested in working with Indigenous communities and how to work collaboratively with to avoid pitfalls, but also how to get back on track and develop lasting relationships.

Bycatch Mitigation Strategies in the Gulf of Alaska

Commercial fishing is a crucial industry in Alaska’s economy, but unsustainable fishing practices, especially bottom trawling, lead to excessive bycatch and economic discards. This poses a major threat to marine ecosystems and their biodiversity, which puts the resources within Alaska’s fisheries at risk of diminishing to a point where they cannot meet human demand. Through extensive research and evaluation of this issue and existing legislation that governs Alaska’s fisheries, we recommend the full implementation of two specific measures across all of Alaska’s fisheries. One is electronic monitoring on all vessels in the form of deep learning cameras, and the other is a “freeze the footprint” approach on bottom trawling, which protects key seafloor habitats within the existing area that has been damaged by previous trawling activity. These efficient methods are a safer alternative to on-site observation, and they will lead to a healthier seafloor ecosystem, which is essential for marine life. Alaskan communities rely on their fisheries, and maintaining healthy marine ecosystems is critical to economic stability.

Climate-induced hydrological fluctuations shape Arctic Alaskan peatland plant communities

Rapidly increasing temperatures in high-latitude regions are causing major changes in wetland ecosystems. To assess the impact of concomitant hydroclimatic fluctuations, mineral deposition, and autogenous succession on the rate and direction of changing arctic plant communities in Arctic Alaska, we conducted detailed palaeoecological analyses using plant macrofossil, pollen, testate amoebae, elemental analyses, and radiocarbon and lead (210Pb) dating on two replicate monoliths from a peatland that developed in a river valley on the northern foothills of the Books Range. We observed an expansion of Sphagnum populations and vascular plants preferring dry habitats, such as Sphagnum warnstorfii, Sphagnum teres/squarrosum, Polytrichum strictum, Aulacomnium palustre and Salix sp., in recent decades between 2000 and 2015 CE, triggered by an increase in temperature and deepening water tables. Deepening peatland water tables became accentuated over the last two decades, when it reached its lowest point in the last 700 years. Conversely, a higher water-table between ca. 1500 and 1950 CE led to a recession of Sphagnum communities and an expansion of sedges. The almost continuous supply of mineral matter during this time led to a dominance of minerotrophic plant communities, although with varying species composition throughout the study period. The replicate cores show similar patterns, but nuanced differences are also visible, depicting fine spatial scale differences particularly in peat-forming plant distribution and the different timings of their presence. In conclusion, our study provides valuable insights into the impact of hydroclimatic fluctuations on peatland vegetation in Arctic Alaska, highlighting their tendency to dry out in recent decades. It also highlights the importance of river valley peatlands in paleoenvironmental reconstructions.

Mobile Health School Screening and Telemedicine Referral to Improve Access to Specialty Care in Rural Alaska: Integrating Mixed Methods Data to Contextualize Trial Outcomes.

To understand factors associated with outcomes in a cluster-randomized controlled trial that evaluated a telemedicine specialty referral intervention for school hearing screenings in 15 rural Alaskan communities. Hearing Norton Sound was a mixed methods cluster-randomized controlled trial that compared a telemedicine specialty referral pathway (intervention) to a standard primary care referral pathway (control) for school hearing screenings. As a mixed methods trial, both quantitative and qualitative data were collected, analyzed, and integrated. Main trial results are published elsewhere, but integration of community-specific quantitative outcomes and qualitative results have not yet been reported. The constant comparative method was used to analyze qualitative data from semistructured interviews with six stakeholder groups across all 15 communities. Descriptive statistics were used to describe community-specific proportions of follow-up in both trial years. Qualitative and quantitative results were integrated to reveal relationships between contextual factors and follow-up outcomes across communities. The Hearing Norton Sound trial enrolled 1481 children from October 2017 to March 2019, with a total of 790 children requiring referral. Of the children who referred in the telemedicine specialty referral pathway communities (intervention), 68.5% received follow-up (268/391), compared to 32.1% (128/399) in primary care referral communities (control)(previously reported). When broken down by community, the mean proportion receiving follow-up was 75.26% (SD 22.5) and 37.9% (SD 11.4) for the telemedicine specialty referral communities and primary care referral communities, respectively. For qualitative data collection, semistructured interviews were conducted with 101 individuals between December 2018 and August 2019. Six stakeholder groups participated: elders (n = 14), parents (n = 25), children (n = 11), teachers/school staff (n = 18), principals (n = 6), and healthcare providers/clinic staff (n = 27). Six overall factors related to the outcomes of the telemedicine specialty referral pathway emerged during analysis: clinic capacity, personnel ownership and engagement, scheduling, telemedicine equipment/processes, communication, and awareness of the need for follow-up. We integrated these factors with the community-specific follow-up percentages and found associations for four of the six qualitative factors: clinic capacity, personnel ownership and engagement, communication, and awareness. An association was not seen for scheduling and telemedicine equipment/processes, which had variable relationships with the follow-up outcome. The Hearing Norton Sound trial demonstrated that a telemedicine specialty referral pathway can close the gap on children lost to follow up after school hearing screening. As a whole, the intervention profoundly increased the proportion of children receiving follow-up, but there was variability in outcomes within and between communities. To understand this variability, we analyzed community-specific intervention outcomes alongside community member feedback on factors related to the intervention. We identified four key factors that contributed to the success of the intervention. Attention to these factors will be essential to successful adaptation and implementation of this telemedicine specialty referral intervention and other similar interventions in future work in rural Alaska and beyond.

Site suitability analysis of hydrokinetic river energy resources at community microgrids on the Kuskokwim River, Alaska

A simple multiparameter tool for quantifying site suitability for riverine hydrokinetic (HK) energy project development is presented and applied to sites in Alaska. Given the high energy costs and diesel fuel dependence of small islanded microgrid communities and adjacent river energy resources, many communities in Alaska are excellent candidates for early adaptation of HK technologies. Seven isolated communities located along the Kuskokwim River in southwest Alaska are evaluated using this method to determine whether riverine HK projects are likely to succeed. While similar models have been developed for wave and tidal energy, to our knowledge, no such tool exists for riverine HK energy. Factors considered in the analysis include the economic viability, energy demand, distance to power distribution lines, HK resource, presence of environmentally sensitive areas, population, and climate change risk or usteq at each community. Modeling of the technical resource adjacent to each community indicates that HK technology could meet or even exceed the energy requirements of the communities during the ice-free open water season (June to October). Although the communities have similar characteristics, the site suitability varies due to variations in the economic, environmental, and technical constraints among the communities. Based on these factors, the most promising community for a riverine HK installation is Aniak, although the highest resource was observed at Chuathbaluk. The approach is easily adaptable to other regions of Alaska or elsewhere with similar hydrologic and geographic constraints.

Simulating spatio-temporal dynamics of surface PM2.5 emitted from Alaskan wildfires

Wildfire is a major disturbance agent in Arctic boreal and tundra ecosystems that emits large quantities of atmospheric pollutants, including PM2.5. Under the substantial Arctic warming which is two to three times of global average, wildfire regimes in the high northern latitude regions are expected to intensify. This imposes a considerable threat to the health of the people residing in the Arctic regions. Alaska, as the northernmost state of the US, has a sizable rural population whose access to healthcare is greatly limited by a lack of transportation and telecommunication infrastructure and low accessibility. Unfortunately, there are only a few air quality monitoring stations across the state of Alaska, and the air quality of most remote Alaskan communities is not being systematically monitored, which hinders our understanding of the relationship between wildfire emissions and human health within these communities. Models simulating the dispersion of pollutants emitted by wildfires can be extremely valuable for providing spatially comprehensive air quality estimates in areas such as Alaska where the monitoring station network is sparse. In this study, we established a methodological framework that is based on an integration of the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model, the Wildland Fire Emissions Inventory System (WFEIS), and the Arctic-Boreal Vulnerability Experiment (ABoVE) Wildfire Date of Burning (WDoB) dataset, an Arctic-oriented fire product. Through our framework, daily gridded surface-level PM2.5 concentrations for the entire state of Alaska between 2001 and 2015 for which wildfires are responsible can be estimated. This product reveals the spatio-temporal patterns of the impacts of wildfires on the regional air quality in Alaska, which, in turn, offers a direct line of evidence indicating that wildfire is the dominant driver of PM2.5 concentrations over Alaska during the fire season. Additionally, it provides critical data inputs for research on understanding how wildfires affect human health which creates the basis for the development of effective and efficient mitigation efforts.

Barrier Island Reconfiguration Leads to Rapid Erosion and Relocation of a Rural Alaska Community

Barrier Island Reconfiguration Leads to Rapid Erosion and Relocation of a Rural Alaska Community

Prevalence of Childhood Hearing Loss in Rural Alaska.

Childhood hearing loss has well-known lifelong consequences. Certain rural populations are at higher risk for infection-related hearing loss. For Alaska Native children, historical data on hearing loss prevalence suggest a higher burden of infection-related hearing loss, but updated prevalence data are urgently needed in this high-risk population. Hearing data were collected as part of two school-based cluster-randomized trials in 15 communities in rural northwest Alaska over two academic years (2017-2019). All enrolled children from preschool to 12th grade were eligible. Pure-tone thresholds were obtained using standard audiometry and conditioned play when indicated. The analysis included the first available audiometric assessment for each child (n = 1634 participants, 3 to 21 years), except for the high-frequency analysis, which was limited to year 2 when higher frequencies were collected. Multiple imputation was used to quantify the prevalence of hearing loss in younger children, where missing data were more frequent due to the need for behavioral responses. Hearing loss in either ear was evaluated using both the former World Health Organization (WHO) definition (pure-tone average [PTA] > 25 dB) and the new WHO definition (PTA ≥ 20 dB), which was published after the study. Analyses with the new definition were limited to children 7 years and older due to incomplete data obtained on younger children at lower thresholds. The overall prevalence of hearing loss (PTA > 25 dB; 0.5, 1, 2, 4 kHz) was 10.5% (95% confidence interval [CI], 8.9 to 12.1). Hearing loss was predominately mild (PTA >25 to 40 dB; 8.9%, 95% CI, 7.4 to 10.5). The prevalence of unilateral hearing loss was 7.7% (95% CI, 6.3 to 9.0). Conductive hearing loss (air-bone gap of ≥ 10 dB) was the most common hearing loss type (9.1%, 95% CI, 7.6 to 10.7). Stratified by age, hearing loss (PTA >25 dB) was more common in children 3 to 6 years (14.9%, 95% CI, 11.4 to 18.5) compared to children 7 years and older (8.7%, 95% CI, 7.1 to 10.4). In children 7 years and older, the new WHO definition increased the prevalence of hearing loss to 23.4% (95% CI, 21.0 to 25.8) compared to the former definition (8.7%, 95% CI, 7.1 to 10.4). Middle ear disease prevalence was 17.6% (95% CI, 15.7 to 19.4) and was higher in younger children (23.6%, 95% CI, 19.7 to 27.6) compared to older children (15.2%, 95% CI, 13.2 to 17.3). High-frequency hearing loss (4, 6, 8kHz) was present in 20.5% (95% CI, 18.4 to 22.7 [PTA >25 dB]) of all children and 22.8% (95% CI, 20.3 to 25.3 [PTA >25 dB]) and 29.7% (95% CI, 27.0 to 32.4 [PTA ≥ 20 dB]) of children 7 years and older (limited to year 2). This analysis represents the first prevalence study on childhood hearing loss in Alaska in over 60 years and is the largest cohort with hearing data ever collected in rural Alaska. Our results highlight that hearing loss continues to be common in rural Alaska Native children, with middle ear disease more prevalent in younger children and high-frequency hearing loss more prevalent with increasing age. Prevention efforts may benefit from managing hearing loss type by age. Lastly, continued research is needed on the impact of the new WHO definition of hearing loss on field studies.

Bridging Isolation with Crisis Support: Lessons from the Maniilaq Family Crisis Center in Kotzebue, Alaska

The Maniilaq Family Crisis Center, founded by volunteers in 1984, has evolved over decades to become a pivotal Domestic Violence and Sexual Assault emergency shelter serving individuals aged 18 and older across remote Alaskan communities. Relocating to its dedicated facility in Kotzebue in 1998, the center provides critical support to 11 outlying villages, including Ambler, Kobuk, Shungnak, Noatak, Selawik, Kiana, Noorvik, Kivalina, Deering, Buckland, and Point Hope. This paper offers a unique perspective on the center's expansion, informed by the author’s nine years of managerial experience in a region where access to crisis services is extremely limited. It explores the substantial growth in service scope, staff roles, and employee retention, along with the challenges and innovations required to deliver these services in isolated, culturally diverse communities. By presenting comparative statistics on domestic violence and sexual assault across Alaska, Texas, and California, the paper contextualizes the distinct challenges faced in Alaska's rural areas. It further addresses the leadership approach that has been essential in managing the center effectively, emphasizing the strategic balance of cultural sensitivity and operational sustainability. Concluding with future objectives for maintaining and advancing resources in this remote region, the paper underscores the indispensable role that the Maniilaq Family Crisis Center plays in safeguarding the welfare of some of Alaska's most geographically and socially isolated communities.

Rural Psychiatrists Know Multidisciplinary Care and Cultural Sensitivity

Rural Psychiatrists Know Multidisciplinary Care and Cultural Sensitivity