Rural Alaska Research Articles

Suicide among young Alaska Native men: community risk factors and alcohol control.

I examined community risk factors that explained variation in suicide rates among young rural Alaska Native men, evaluating the effectiveness of local alcohol control as a public health policy to reduce this population's historically high vulnerability. I compiled suicide data, alcohol control status, and community-level social, cultural, and economic characteristics for Alaska Native men aged 15 to 34 years in 178 small Alaska communities from 1980 to 2007. Poisson regression equations explained variation in suicide rates as a function of endogenous alcohol control and community characteristics. Suicide rates were higher in communities prohibiting alcohol importation under state law, but the effect was not significant after controlling for other community characteristics. More remote communities, those with fewer non-Natives, and those with evidence of cultural divides had higher suicide risks. Communities with higher incomes, more married couples, and traditional elders had lower risks. Alcohol control is ineffective in preventing suicide among Alaska Natives; suicide instead appears related to particular complex community characteristics that are either protective or increase risk. Communities have limited means to pursue economic and cultural development strategies that might offer more protection.

Why an alternative to suicide prevention gatekeeper training is needed for rural Indigenous communities: presenting an empowering community storytelling approach

The need for effective youth suicide prevention is uncontested, and is particularly urgent for Indigenous populations. The Indigenous youth suicide rates in some North American communities can be 18 times greater than for other young people. Despite the clear need, evidence in support of Indigenous youth suicide prevention strategies remain mixed. The most common approach to youth suicide prevention – gatekeeper training – may have limited effects in Indigenous communities. Based on recent work undertaken with Indigenous leaders in rural Alaska, we describe culturally grounded, practical alternatives that may be more effective for Indigenous communities. We highlight the ways in which research informed, grassroots interventions can address cultural, practical and systemic issues that are relevant when addressing risks for suicide on a community level. Built on a transactional-ecological framework that gives consideration to local contexts, culture-centric narratives and the multiple, interacting conditions of suicide, the innovative approach described here emphasizes community and cultural protective factors in Indigenous communities, and extends typical suicide prevention initiatives in ways that have important implications for other ethnically diverse communities.

The Fcc's Tribal and Remote Areas Broadband Programs: What's Wrong with this Picture?

During the past five years, the FCC has introduced several new funding programs targeting remote and tribal (indigenous) regions, and other programs that provide significant funding for these regions. The objectives of these programs are to increase broadband access in remote and indigenous areas, and in some cases, to empower tribal organizations and other new entrants to become providers of broadband facilities and services.These programs include the recently established Office of Native Affairs and Policy (ONAP), and Connect American Fund (CAF) programs including the Rural Mobility Fund, Tribal Mobility Fund, Remote Areas Fund, and the Broadband Lifeline Pilot Program. In addition, the E-rate and Rural Health Care universal service funds provide significant support for these regions. This paper presents a preliminary assessment of these programs, including participation by targeted entities, populations served or to be covered, and funds expended or committed. The analysis is based primarily on data and experience from Alaska, but also includes information from other rural and tribal regions. Programs analyzed include:Mobility Fund Reverse Auctions: Two Alaska carriers won subsidies to provide mobile broadband in rural Alaska in phases 1 and 2 of the Mobility Fund reverse auctions. There was no competition among carriers to serve these regions. The paper examines the prices paid per pop, and the utility of the reverse auction model when there are no competitive bids.Broadband Lifeline Pilot Program: Although ONAP sought participation from carriers serving tribal regions and included outreach to Alaska, no carriers serving Alaska submitted proposals. The paper examines reasons for this lack of participation based on interviews with Alaska carriers.E-Rate: Alaska continues to be a major beneficiary of the E-rate program. From 1998 through 2012, Alaska schools and libraries received finding commitments totaling $330.9 million. Of course, Alaska’s land mass is huge and its rural communities small and isolated, and therefore costly to serve. Nevertheless, in 2012, Alaska ranked 14th among the states in total E-rate funding with $45.8 million, while 47th in population. The paper examines reasons for Alaska’s high levels of funding compared to other states with significant tribal and remote regions.Rural Health Care: From 2008 through 2012, Alaska received $318.6 million from the Rural Health Care fund. This is the largest allocation to any state in both absolute terms and in funding per capita, and reflects not only expansion of services covered, but growing gaps between urban rural connectivity prices on which the subsidy is based. The paper examines the impact of a formula based on differentials between rural and urban prices for connectivity in the context of continuing lack of rural competition combined with increasing urban competition. The paper also addresses potential barriers to entry in new Connect America Fund programs. For example, participation in these programs requires certification as an Eligible Telecommunications Carrier (ETC). No new tribal entrants in Alaska and few new entities across the U.S. have become certified as ETCs. The paper discusses strategies to increase participation such as modification of requirements or waivers. The paper concludes with recommendations to address identified policy and regulatory issues for rural and tribal broadband programs based on the above analysis, with the goal of improving future participation, cost-effectiveness and impact of these programs. These recommendations could also apply to the new Remote Areas Fund, which will allocate up to $100 million per year, but is still under review and has not yet been implemented.

Household reporting of childhood respiratory health and air pollution in rural Alaska Native communities

BackgroundAir pollution is an important contributor to respiratory disease in children.ObjectiveTo examine associations between household reporting of childhood respiratory conditions and household characteristics related to air pollution in Alaska Native communities.DesignIn-home surveys were administered in 2 rural regions of Alaska. The 12-month prevalence of respiratory conditions was summarized by region and age. Odds ratios (ORs) were calculated to describe associations between respiratory health and household and air quality characteristics.ResultsHousehold-reported respiratory health data were collected for 561 children in 328 households. In 1 region, 33.6% of children aged <5 years had a recent history of pneumonia and/or bronchitis. Children with these conditions were 2 times more likely to live in a wood-heated home, but these findings were imprecise. Resident concern with mould was associated with elevated prevalence of respiratory infections in children (ORs 1.6–2.5), while reported wheezing was associated with 1 or more smokers living in the household. Reported asthma in 1 region (7.6%) was lower than national prevalence estimates.ConclusionsFindings suggest that there may be preventable exposures, including wood smoke and mould that affect childhood respiratory disease in these rural areas. Additional research is needed to quantify particulate matter 2.5 microns in aerodynamic diameter or less and mould exposures in these communities, and to objectively evaluate childhood respiratory health.

Behavioral Health Aides in Rural Alaska: Their Experience in Caring for Alaska Native Cancer Survivors

The Alaska Native Tribal Health Consortium conducted a statewide survey of rural community behavioral health aides (BHAs) within the tribal health system to assess their need for psychological and emotional support training for their work with cancer survivors. An electronic survey was distributed to all 114 rural BHAs in Alaska. They were asked about cancer survivors living in their community, whether they had been called to provide counseling to those survivors and about their comfort level in addressing cancer-related emotional issues and concerns experience by the patients and their families. Sixty-one (54%) BHAs responded, 62% knew of cancer survivors in their community, and 88% of whom agreed that it is their job to provide support to those cancer survivors. Of the 47% of BHAs who had provided counseling to cancer survivors, 63% noted a lack of adequate training about how to provide that counseling. Dealing with "emotional concerns" was reported as the most difficult issue. Almost all (98%) reported that they would likely participate in training to improve counseling skills. Most BHAs in rural Alaska know of a cancer survivor in their community and may be called on to provide mental health services, but few report adequate training in how to provide these services. Given the remote locations in which many BHAs work and the lack of local resources to guide them, more education is needed about how to support cancer survivors. This study provides information to help guide development of content of that education.

Self-Reliance beyond Neoliberalism: Rethinking Autonomy at the Edges of Empire

Across scholarly and popular accounts, self-reliance is often interpreted as either the embodiment of individual entrepreneurialism, as celebrated by neoliberal designs, or the basis for communitarian localism, increasingly imagined as central to environmental and social sustainability. In both cases, self-reliance is framed as an antidote to the failures of larger state institutions or market economies. This paper offers a different framework for understanding self-reliance by linking insights drawn from agrarian studies to current debates on alternative economies. Through an examination of the social worlds of semisubsistence producers in peripheral zones in the Global North, we show how everyday forms of self-reliance are mutually constituted with states and markets, particularly through interactions with labor institutions and hybrid property regimes linking individual and collective interests. We draw on empirical data from two ethnographic case studies connected by a shared colonial history and continuing local mythologies of frontier self-sufficiency: salmon fisheries in rural Alaska in the US, and agrofood economies in socialist and postsocialist Lithuania. In each site we find that although local expressions of self-reliance diverge in critical respects from neoliberal visions, these forms of everyday autonomy are nevertheless enlisted to promote market liberalization, ultimately threatening the very conditions that have long sustained semisubsistence producers' self-reliance in the first place.

Seabirds as a subsistence and cultural resource in two remote Alaskan communities

Small rural Alaskan communities face many challenges surrounding rapid social and ecological change. The role of local subsistence resources may change over time because of changes in social perception, economic need, and cultural patterns of use. We look at the Bering Sea’s Pribilof Islands, comprising two very small communities, and investigate the relationship between the local residents and seabirds as a natural resource. Seabirds may strengthen ties to older ways of life and have potential for future economic opportunities, or modernization may direct interest away from seabirds as a cultural and economic resource. We conducted a survey and interviews of residents of the two Pribilof Island communities, St. Paul and St. George, to assess opinions toward seabirds and harvest levels. Seabirds were generally regarded as important both to individuals and the wider community. However, current levels of subsistence harvest are low, and few people continue to actively harvest or visit seabird colonies. Respondents expressed desire for greater knowledge about seabirds and also concerns about the current economy of the islands and a lack of future development prospects. Despite the challenging economic conditions, the villages retain a strong sense of community and place value on their environment and on seabirds. Surveys indicated an interest in developing eco-tourism based around local resources, including seabirds, as a way to improve the economy.

Impact of fuel costs on high-latitude subsistence activities

Most rural residents in Arctic communities rely on motorized transportation to hunt, fish, trap, and gather subsistence resources. Although these technologies have created advantages, one significant disadvantage is that peoples' ability to meet their nutritional and cultural needs now depends on consistent opportunities for wage employment and availability of affordable fuel. Recent qualitative research suggested that rising fuel prices have disrupted subsistence lifestyles in the Arctic. Our objectives were to collaborate with subsistence users in rural Alaskan communities to quantify how rising fuel costs have impacted subsistence activities and explore ways local residents may adapt to the trajectory of change. We conducted interviews with 178 subsistence harvesters in 8 communities. During the last 10 years, 81% of the harvesters reduced the distance they traveled for subsistence and 89% reduced the number of subsistence trips they took because of gasoline costs. During the last 10 years, the median distance traveled to perform subsistence decreased by 60%, and the median annual number of trips taken to perform subsistence decreased by 75%. The change in subsistence activity was similar across and within communities. Eighty-five percent of the people interviewed reported that they were making sacrifices with serious consequences, such as putting off paying monthly bills, to buy gasoline for subsistence activities. To adapt to high gasoline prices, most participants said that they are using more efficient modes of transportation (69%), followed by more sharing of gasoline costs with family and friends (37%), and conducting more multipurpose subsistence trips (20%). With subsistence practices being critical to food security and cultural identity in the Arctic, our results suggest that unaffordable fuel has threatened social resilience. Because global markets drive gasoline prices, we suggest that future research focus on the effectiveness of adaptation options that build resilience into subsistence systems.

Measuring perceptions of climate change in northern Alaska: pairing ethnography with cultural consensus analysis

Given current and projected warming trends in the Arctic and the important role played by subsistence hunting and fishing in the life of northern rural communities, it is increasingly important to document local observations of climate change and its impacts on livelihood practices. We describe ethnographic research exploring local observations of climate changes and related impacts on subsistence fisheries in three Inupiat communities in northwest Alaska and six Athabascan communities in the Yukon River drainage. We found consistent agreement among perceptions concerning a broad range of environmental changes affecting subsistence practices in these communities. These observations of environmental changes are not experienced in isolation but within the context of accompanying social changes that are continually reshaping rural Alaskan communities and subsistence economies. In this paper we reflect on our research approach combining multiple methods of inquiry. Participant observation and semidirected interviews provided the conceptual framework for broadening our focus from climate and environmental change to community residents’ understanding of climate change in the context of their holistic human-environment worldview. Cultural consensus analysis allowed us to assess the extent to which perceptions of change are shared among hunters and fishers within and between villages and regions and to identify those phenomena occurring or experienced at smaller scales. Reflecting on this multimethods approach, we highlight important questions that have emerged about how we understand, synthesize, and represent local knowledge, especially as it is used in regulatory or management arenas.

Changing Daily Wind Speeds on Alaska’s North Slope: Implications for Rural Hunting Opportunities

Because of their reliance on the harvest of fish and game, Alaskan rural communities have experienced a variety of impacts from climate change, the effects of which are amplified at high latitudes. We collaborated with hunters from the coastal community of Wainwright, Alaska, to document their observations of environmental change (e.g., sea ice, wind, temperature) and the implications of those changes for opportunities to hunt bowhead whale (Balaena mysticetus) during spring and caribou (Rangifer tarandus) during summer. We integrated hunter observations on wind with statistical analysis of daily wind speed data collected in the nearby community of Barrow, Alaska, between 1971 and 2010 to characterize changes in the number of days with suitable hunting conditions. Hunters in Wainwright currently observe fewer days than in previous decades with wind conditions suitable for safely hunting bowhead whales and caribou. The statistical analysis of wind speed data supported these conclusions and suggested that the annual windows of opportunity for hunting each species have decreased by up to seven days since 1971. This study demonstrates the potential power of collaboration between local communities and researchers to characterize the societal impacts of climate change. Continued collaborative research with residents of rural northern Alaskan communities could produce knowledge and develop tools to help rural Alaskans adapt to novel social-ecological conditions.

Risk Factors for Pneumococcal Colonization of the Nasopharynx in Alaska Native Adults and Children.

Alaska Native children have high invasive pneumococcal disease (IPD) rates, and lack of in-home running water has been shown to have a significant association with infection. Pneumococcal conjugate vaccines reduced IPD; however, this population saw substantial replacement disease and colonization with nonvaccine serotypes. We evaluated risk factors for nasopharyngeal pneumococcal colonization in Alaska Native adults and children. We conducted annual surveys from 2008 through 2011 of residents of all ages in 8 rural Alaskan villages. Interviews were conducted, medical charts were reviewed, and nasopharyngeal swabs were cultured for Streptococcus pneumoniae. Multivariate logistic regression models were developed for 3 age groups (under 10 years, 10-17 years, and 18 years and older) to determine risk factors for colonization. We obtained 12 535 nasopharyngeal swabs from 4980 participants. Our population lived in severely crowded conditions, and 48% of households lacked in-home running water. In children <10 years, colonization was associated with lack of in-home running water, household crowding, and more children in the home. Pneumococcal vaccination status was not associated with colonization. In older children and adults, increased number of persons in the household was associated with pneumococcal colonization. Higher colonization prevalence may partially explain increased IPD rates seen in those lacking in-home water services. Improving availability of sanitation services and reducing household crowding may reduce the burden of IPD in this population.

The Importance of Optimism in Maintaining Healthy Aging in Rural Alaska

Many Alaska Native Elders attended government-run boarding schools as children, were forbidden to speak their native language, and were forced to abandon their traditional subsistence lifestyle, yet they maintained an optimistic outlook on life and continued to age well. The Explanatory Model Interview Protocol was adapted to interview a purposive sample of Alaska Native Elders (n = 26) and grounded theory was used to develop a model of successful aging for Alaska Native Elders in Bristol Bay, Alaska. The theme of optimism was significant in the findings and was also found in each of the elements of successful aging, which were spirituality, emotional well-being, community engagement, and physical health. These four elements served as the foundation of the Model of Successful Aging. The Elders believed they were able to age successfully because they continued to be optimistic despite the challenges they faced (and are currently facing) in their communities.

Dial in: Fostering the use of telebehavioral health services in frontier Alaska.

Telehealth programs continue to develop rapidly in the United States, with video teleconferencing leading the way in rural areas. Unfortunately, organizational factors can limit the use of these innovative services. Researchers explored key factors that foster initial or renewed interest, continued extensive use, and adaptations to barriers in implementing Telebehavioral Health Services in rural Alaska. A total of 18 key informant interviews were conducted with direct care staff, administrative staff, and information technology professionals. Summative interview narratives were thematically coded by hand. Results indicate that direct care and administrative staff were found to be interested in the following benefits of telehealth services: increased care, decreased patient travel, decreased organizational costs, and meeting a perceived patient preference. The fulfillment of these interests, coordination, adequate staffing, accessibility of equipment, and clinician competency all contributed to the use of telehealth services. Numerous adaptations to barriers were found involving coordination, personal oversight, acceptance of limitations, education, staffing, billing for services, consultation, modifying referrals patterns, and creating treatment alternatives. Information technology professionals identified communication and assistance, testing connections, resolving initial issues, maintenance, and vision and control as vital factors. Findings may aid programs in dealing with pragmatic issues to maintain organizational readiness.

P3.393 Iknowmine.org - a Comprehensive Wellness Website For Alaska Native Youth

BackgroundAlaska has some of the highest rates of Chlamydia and gonorrhoea in the United States. The Centers for Disease Control and Prevention (CDC) ranked Alaska #1 for Chlamydia and #3...

O22.5 Providing Discrete and Reliable STD Testing in Alaska Via a Web-Based At-Home Service

BackgroundAlaska has one of the highest rates of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in the United States. Alaska Native people, women and youth (ages 15–29) are disproportionately affected....

Black bear baiting in Alaska and in Alaska's National Park Service lands, 1992–2010

We assessed American black bear (Ursus americanus) harvest trends, generally, and black bear harvest over bait, specifically, in Alaska from 1992 to 2010 at 3 spatial scales: statewide, on drainages adjacent to and including National Park Service (NPS) units, and on NPS lands. Statewide, black bear reported harvest increased by an average of 93 bears/year, and harvest over bait increased by an average of 21 bears/year over this period. Harvest over bait increased by 4.3% (SE = 4.3) annually, and harvest by other methods increased by 3.9%/year (SE = 3.1). The proportion of females harvested over bait was 30.9% compared to 26.4% by other methods. Harvest increased around Lake Clark National Park and Preserve, while other units and adjacent lands had stable or decreasing harvest rates. Few bears were harvested using bait on NPS units (≤37 bears; <2 bears/year) with ≤34 (91.9%) of these bears harvested in Wrangell St. Elias National Park and Preserve. Only 3 bears were harvested over bait by rural Alaska residents from NPS lands from 1992 to 2010. Thus, little to no population-level effects arose from the practice of bear baiting on NPS lands. Rather, the complexity surrounding the practice of bear baiting is centered on the management goals of minimizing food-conditioning of bears, fostering public safety, preventing defense of life and property killing of individual bears, and maintaining natural processes and behaviors. We recommend application of the formal field of conservation ethics and argument analysis as one path forward in assessing policy on bear baiting on Alaskan NPS units and recommend that the issue of harvesting bears over bait on NPS lands not be falsely characterized as a conservation or population management issue.

Building Partnerships in Community-Based Participatory Research

Community-based participatory research (CBPR) is an important framework for partnering with communities to reduce health disparities. Working in partnership with community incurs additional costs, some that can be represented in a budget summary page and others that are tied to the competing demands placed on community and academic partners. These cost considerations can inform development of community-academic partnerships. We calculated costs from a case study based on an ongoing CBPR project involving a Community Planning Group (CPG) of community co-researchers in rural Alaska and a bicultural liaison group who help bridge communication between CPG and academic co-researchers. Budget considerations specific to CBPR include travel and other communication-related costs, compensation for community partners, and food served at meetings. We also identified sources of competing demands for community and academic partners. Our findings can inform budget discussions in community-academic partnerships. Discussions of competing demands on community partners' time can help plan timelines for CBPR projects. Our findings may also inform discussions about tenure and promotion policies that may represent barriers to participation in CBPR for academic researchers.

Sources and perceptions of indoor and ambient air pollution in rural Alaska.

Even though Alaska is the largest state in the United States, much of the population resides in rural and underserved areas with documented disparities in respiratory health. This is especially true in the Yukon-Kuskokwim (southwest) and Ahtna (southcentral) Regions of Alaska. In working with community members, the goal of this study was to identify the air pollution issues (both indoors and outdoors) of concern within these two regions. Over a two-year period, 328 air quality surveys were disseminated within seven communities in rural Alaska. The surveys focused on understanding the demographics, home heating practices, indoor activities, community/outdoor activities, and air quality perceptions within each community. Results from these surveys showed that there is elevated potential for PM10/PM2.5 exposures in rural Alaska communities. Top indoor air quality concerns included mold, lack of ventilation or fresh air, and dust. Top outdoor air pollution concerns identified were open burning/smoke, road dust, and vehicle exhaust (e.g., snow machines, ATVs, etc.). These data can now be used to seek additional funding for interventions, implementing long-term, sustainable solutions to the identified problems. Further research is needed to assess exposures to PM10/PM2.5 and the associated impacts on respiratory health, particularly among susceptible populations such as young children.

Factors influencing success of wind-diesel hybrid systems in remote Alaska communities: Results of an informal survey

In 2008, the Alaska State Legislature created and funded the Renewable Energy Fund (REF) grant program. As a result of this significant increase in available funding, the number of wind-diesel hybrid power systems is growing dramatically in rural Alaska. Development, integration, and operation of complex wind technologies in remote, rural communities are challenging. With multiple communities in Alaska installing and operating these systems, it is important to understand the factors that influence successful completion, operation and long-term maintenance of projects. As of December 2013, over $340 million has been spent constructing wind projects in 30 communities. The majority of these systems was built since 2008 and utilized over $50 million in appropriations from the REF by the Alaska legislature. This report summarizes the findings of an informal survey conducted on the most important characteristics of a successful wind-diesel hybrid power project in small remote rural communities. The survey was done to help guide socioeconomic research in Alaska on community capacity to ensure sustainable projects.

Meeting Indigenous Subsistence Needs: The Case for Prey Switching in Rural Alaska

Identifying coping strategies that Alaskan subsistence hunters use while responding to adverse conditions provides insights into their capacity to sustain traditional livelihoods. Previous qualitative research has suggested that subsistence hunters switch prey to cope with fluctuations in the availability of subsistence resources. We developed and quantitatively tested a predictive framework assessing whether 19 rural Alaskan communities used this strategy. We found, between 1993 and 2004, these communities rarely substituted one resource for another. Our lack of evidence for prey switching may reflect other complicating factors such as greater availability of groceries and increased formal employment opportunities. These results highlight the need for improved data collection on harvests, hunter effort, and socioeconomic characteristics to inform comprehensive models. Our findings characterize subsistence hunting systems in rural Alaska, providing regulatory agencies with a greater understanding of the systems they manage. This may facilitate more flexible management that balances conservation concerns with rural livelihoods.