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At least 19 recordsLinked to original sources
PubMedDate not supplied

Non-fatal injury hospitalizations among Alaska natives, 1994--1999: results from the Alaska Trauma Registry.

The Alaska Trauma Registry collects data on injuries resulting in hospitalization or transfer to a higher level of care from every hospital in the state. We analyzed non-fatal injuries to Alaska Native and White residents from 1994--1999. Statewide, the five most common causes of injuries to Alaska Natives were falls, suicide attempts, off-road vehicles, motor vehicles, and assaults. These accounted for two-thirds of all injuries; falls accounted for 26.3% of all injuries. For total injuries and for each cause, injury rates were significantly higher for Alaska Natives than Alaska Whites. The greatest discrepancies were for suicide attempts with firearms (Rate Ratio=12.7) and assault by striking (Rate Ratio=8.9). Alcohol was noted on the record of 37.5% of Alaska Native injuries and 15.5% of Alaska White injuries. Alcohol was involved in 60.8% of intentional injuries involving Alaska Natives and 27.1% for Alaska Whites.

Alaska↗
PubMed2005

Special Projects of National Significance and the Alaska Tribal Health System: an overview of the development of a best practice model for HIV/AIDS care and treatment in Alaska.

This article presents a discussion about the increased risk of the spread of HIV among Alaska Natives resulting from high-risk co-occurring conditions and social and cultural customs that create barriers to HIV/AIDS prevention education. Additionally, an overview of the unique structure of the Alaska Tribal Health System and how the Health Resources Service Administration's (HRSA) American Indian Alaska Native Special Projects of National Significance Initiatives (AI/AN SPNS) have been a critical component in creating the foundation for the development of a best practice model for HIV/AIDS care and treatment in Alaska is provided. This article is not a comparative analysis of the Indian Health Care System. Rather, it provides a discussion about tribal federalism, the Alaska Tribal Health System (ATHS), and the influence the AI/AN SPNS initiatives have had on the development of HIV/AIDS care and treatment in Alaska. In order to explain how the AI/AN SPNS initiatives have influenced the development of HIV/AIDS care and treatment in Alaska, it is also necessary to understand the evolution of the ATHS and how this system is unique compared to other tribal, private, and public health care systems throughout the United States.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Proceedings of the Alaska-Russia Native Peoples Health and Social Issues Conference. May 1992, Alaska.

An Alaska-Russia Native People's Health and Social Issues Conference, sponsored by the Alaska Department of Health and Social Services, the Alaska Native Foundation, the University of Anchorage Institute for Circumpolar Health Studies, the International Scientific Center "ARTIKA" (Magadan, Russia), the Associations of Native People of Chukotka and Kolyma, and the Magadan Native Association, was held in Wasilla, Alaska in May, 1992. The conference brought together Native people, primarily health and social services workers, to discuss differences and similarities in issues and approaches, and to lay the foundation for future collaboration. The primary participants came mostly from rural villages and small regional cities, and represented Native Health Corporations, Native Associations, and villages. Additional participants came from the University of Alaska, the Alaska Department of Health and Social Services, the Indian Health Service, the Magadan Health Department, the Inuit Circumpolar Conference, and the International Union for Circumpolar Health. A Total of 39 people participated, including: eight Russian Natives (Chukchi, Even, and Siberian Yup'ik); three non-Native Russians; 18 Alaska Natives (Aleut, Athabaskan, Inupiat, Siberian Yup'ik, Yup'ik); nine non-Native Alaskans; one Canadian. The issues discussed in individual and panel presentations, and in small groups, included history, demography, settlement patterns, the cash and subsistence economies, mental and physical health (epidemiology, etiology, treatment and prevention), education, governance, culture and language. As the conference participants came to know each other better, the discussions became increasingly open, and, particularly around shared feelings of cultural oppression and loss, emotional.(ABSTRACT TRUNCATED AT 250 WORDS)

Alaska↗
PubMed1990

Limited efficacy of a Haemophilus influenzae type b conjugate vaccine in Alaska Native infants. The Alaska H. influenzae Vaccine Study Group.

BACKGROUND: The prevention of invasive Haemophilus influenzae type b disease requires a vaccine that is effective when administered during the first six months of life. The infants of Alaska Natives are at particularly high risk of invasive H. influenzae type b disease. METHODS: To evaluate the protective efficacy of a H. influenzae type b polysaccharide-diphtheria toxoid conjugate vaccine (polyribosylribitol phosphate-diphtheria toxoid [PRP-D]), we enrolled 2102 Alaska Native infants in a randomized, double-blind, placebo-controlled trial in which either the vaccine or a saline placebo was administered at approximately two, four, and six months of age. RESULTS: After 3969 subject-years of follow-up and 32 episodes of H. influenzae type b disease, the overall incidence of invasive disease was not reduced significantly in the vaccinated subjects (6.0 cases per 1000 patient-years), as compared with the placebo controls (9.6) or with other Alaska Native infants (6.0). After one, two, or three doses there was no significant protective efficacy with the vaccine; after three doses the efficacy was only 35 percent (95 percent confidence interval, -57 to 73). The lack of efficacy was not related to the age at onset of disease, age at immunization, type of disease, degree of Alaska Native heritage, time after immunization, or year of the study. Levels of H. influenzae type b anticapsular antibody in recipients of the vaccine became significantly higher than levels in those who received placebo only after the second and third doses. Even after the third dose, only 48 percent of the vaccinated infants had antibody levels of more than 0.1 microgram per milliliter (geometric mean titer, 0.18). Antibody responses did not vary with the level of maternally acquired antibody, degree of Alaska Native ancestry, or age at time of the first or second immunizations, but they increased with increasing age at time of the third dose (P less than 0.001). CONCLUSIONS: We found no evidence that the PRP-D vaccine provides significant protection, at least for Alaska Native infants, against invasive diseases caused by H. influenzae type b. The ineffectiveness of the vaccine paralleled its limited immunogenicity.

Age Factors↗
PubMedDate not supplied

Tobacco use during pregnancy among Alaska Natives in western Alaska.

OBJECTIVE: To determine tobacco use rates during pregnancy among Alaska Natives residing on the Yukon-Kuskokwim (Y-K) Delta of western Alaska. Alaska Natives residing in this region use Iqmik, a unique form of smokeless tobacco (ST). STUDY DESIGN: Retrospective cohort study. The medical records of the most recent consecutive 100 Alaska Native women delivering within the Y-K Health Corporation system in 2001 were abstracted for information on tobacco use during this pregnancy and basic demographics. RESULTS: Of the 100 women, 24 did not use tobacco, 55 used ST only, 18 smoked cigarettes only, and 3 used both ST and smoked cigarettes during this pregnancy. Of the 58 who used ST, 22 used Iqmik only, 32 used commercial ST only, and 4 used both. The frequency of ST use increased significantly with age (p=0.007; OR=1.65 per 5-year increase in age, 95% CI 1.15 to 2.36), while the frequency of cigarette smoking tended to decrease with age (p=0.254; OR=0.79 per 5-year increase in age, 95% CI 0.53 to 1.18). CONCLUSION: A high proportion of Alaska Native women use tobacco during pregnancy. The rate of ST use (58%) among pregnant Alaska Native women is markedly higher than the prevalence of ST use (0.5%) among women in the general U.S. population.

Adolescent↗
PubMed1979

Sociocultural stress and the American native in Alaska: an analysis of changing patterns of psychiatric illness and alcohol abuse among Alaska natives.

This paper presents selected morbidity and mortality statistics to outline developing trends and the current status of psychiatric illness and alcohol abuse among the Aleut, Athabascan, Yupik, Inupiat, Tlingit, Haida and Tsimpshian people of Alaska. Analysis of the records of the Indian Health Service, the Community Mental Health Centers and the Alaska Psychiatric Institute, the providers of care for Alaska Natives, shows that the number of individuals treated as inpatients and outpatients for psychiatric illness and alcohol abuse has been rising steadily. Accidental injury and suicidal behavior are common. The treated prevalence rates for these diagnoses exceed recorded rates for other American Native and non-Native groups. For each category of violent death, suicide, homicide, accidents and alcohol, rates for Alaska Natives are higher than rates for Alaska non-Natives, American Indians and the U.S. (all races) and are rising. The data suggest a public health problem in which the primary elements are behavioral disturbance and violent death.

Adolescent↗
PubMed1999

Grant award to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska. Center for Substance Abuse Treatment (CSAT), Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), HHS. Availability of grant funds for the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska.

This notice is to inform the public that CSAT and CMHS are making available approximately $5,000,000 for an award in FY 1999 to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska to support development, implementation, and evaluation of a comprehensive, seamless system of care for persons with co-occurring substance abuse (including alcohol and other drugs) and mental health disorders in Anchorage, Alaska, and its environs. CSAT and CMHS will make this award if the application is recommended for approval by the Initial Review Group and the CSAT and CMHS National Advisory Councils. This is not a formal request for applications; assistance will be provided only to the Alaska Division of Mental Health and Developmental Disabilities. Eligibility for this program is limited to the State of Alaska, as specified in Congressional report language, in recognition of primacy of its responsibility for, and interest in, providing for the needs of its citizens, and because the success of the program will depend upon the authority and ability to broadly coordinate the variety of resources essential for full program success. The State has committed itself to moving certain mental health services from their extant institutional bases to community bases, and, simultaneously, changing from parallel systems of service delivery--for substance abuse and mental health problems--to an approach designed to deliver services seamlessly to persons with comorbidity. Alaska needs a high level of systemic competence in delivering these services due, in great part, to its climate (resulting in deaths of homeless comorbid persons), and to the requirements of its proposed systems changes. The proposed project presents a unique opportunity for SAMHSA and its Centers to learn, first hand, how the transition from parallel systems to a seamless system of care can be accomplished in a small city in a rural/frontier State, and at what costs. The project promises to yield learnings on the factors and circumstances that facilitate and/or retard systemic change in complex treatment systems. This "Anchorage Comorbidity Services" project is also part of SAMHSA's commitment to improving services, and relates directly to the resolution unanimously adopted by its National Advisory Council earlier this year. Funding from CSAT and CMHS will support some services to persons with co-occurring disorders; continuing planning, review, management, and infrastructure development for the effort; and a tripartite evaluation of the project, including process, outcome, and impact evaluations. This is a unique opportunity to evaluate significant change in a State system of care for persons with co-occurring disorders.

Alaska↗
PubMed2005

Diabetes mellitus and impaired fasting glucose in Alaska Eskimos: the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study.

AIMS/HYPOTHESIS: We aimed to: (1) define the prevalence of type 2 diabetes and IFG in Eskimos in Norton Sound, Alaska; (2) determine correlates of prevalent diabetes in this population; and (3) compare the prevalence of diabetes in the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) Study with other samples of Eskimos, Inuit, American Indians and US blacks, whites and Mexican Americans. METHODS: The GOCADAN Study enrolled 1,214 participants >or=18 years who were members of extended pedigrees from the Norton Sound region of Alaska. Diagnosed type 2 diabetes was based on reported use of insulin or hypoglycaemic medications and a medication inventory. Fasting glucose measurements were obtained to ascertain IFG status and undiagnosed diabetes according to American Diabetes Association (ADA) criteria. OGTTs were performed to ascertain diabetes according to the World Health Organization (WHO) definition. We used logistic regression analysis to model factors that were significantly associated with odds of prevalent ADA diabetes. RESULTS: The prevalences of ADA diabetes and IFG were 3.8% (5.0% of women; 2.2% of men) and 15.6% (13.9% of women; 17.7% of men), respectively. In the subset of 787 participants who took the OGTT, the prevalences of ADA and WHO diabetes were 5.1 and 6.9%, respectively. The adjusted odds of ADA diabetes was 2.8 times higher in participants meeting Adult Treatment Panel III criteria for abdominal obesity than in those who did not. The statistically significant sex-related difference in diabetes prevalence did not persist in multivariable analyses. CONCLUSIONS/INTERPRETATION: Alaska Eskimos have a low prevalence of type 2 diabetes. The high prevalence of IFG indicates that diabetes may become increasingly problematic in this population. Abdominal obesity in women may help explain why diabetes prevalence differs according to sex.

Adult↗
PubMed2006

Alaska sentinel surveillance for antimicrobial resistance in Helicobacter pylori isolates from Alaska native persons, 1999-2003.

BACKGROUND: Previous studies in Alaska have demonstrated elevated proportions of antimicrobial resistance among Helicobacter pylori isolates. MATERIALS AND METHODS: We analyzed H. pylori data from the Centers for Disease Control and Prevention (CDC)'s sentinel surveillance in Alaska from July 1999 to June 2003 to determine the proportion of culture-positive biopsies from Alaska Native persons undergoing routine upper-endoscopy, and the susceptibility of H. pylori isolates to metronidazole [minimum inhibitory concentration (MIC) of > 8 g metronidazole/mL), clarithromycin (MIC > or = 1), tetracycline (MIC > or = 2) and amoxicillin (MIC > or = 1)] using agar dilution. RESULTS: Nine-hundred sixty-four biopsy specimens were obtained from 687 participants; 352 (51%) patients tested culture positive. Mean age of both culture-positive and culture-negative patients was 51 years. Metronidazole resistance was demonstrated in isolates from 155 (44%) persons, clarithromycin resistance from 108 (31%) persons, amoxicillin resistance from 8 (2%) persons, and 0 for tetracycline resistance. Metronidazole and clarithromycin resistance varied by geographic region. Female patients were more likely than male subjects to show metronidazole resistance (p < .01) and clarithromycin resistance (p = .05). CONCLUSIONS: Resistance to metronidazole and clarithromycin is more common among H. pylori isolates from Alaska Native persons when compared with those from elsewhere in the USA.

Adult↗
PubMed2005

Springtime macronutrient intake of Alaska natives of the Bering Straits Region: the Alaska Siberia Project.

OBJECTIVES: The diet of Alaska Natives is a complicated mix of native and imported foods. Dietary intake, which may have changed considerably in the past several decades, has important implications for risk of chronic disease. The objective of this study was to add to the knowledge of dietary intake of Alaska Natives of the Bering Straits Region by describing the macronutrient intake of adults. STUDY DESIGN: Observational study of dietary intake. METHODS: A 24-hour dietary recall was administered among all consenting, non-pregnant residents of four villages, aged 25 years, or more. RESULTS: Data are presented for 209 men and 225 women, who represent 48% of eligible participants. Dietary intake was higher in proportion of energy from protein and lower in proportion of carbohydrate than non-Hispanic white Americans overall. Higher energy and protein intakes were reported for men. Comparisons were also made among Alaskan ethnic groups and previous Alaskan surveys. CONCLUSION: This study of diet among Alaska Natives demonstrates consistency with other recent work. Differences in diet from earlier 20th century observations, such as higher carbohydrate and lower protein intake, are consistent with documented acculturation in Alaska and other circumpolar regions.

Adult↗
PubMed1996

Substance use, mental health, and health in Alaska: emphasis on Alaska Native peoples.

It has always been a problem in Alaska to obtain a compilation of accurate and current data with regard to mental health, health, and substance abuse. This paper was designed to pull together different sources of data to present a comprehensive perspective on the substance use, mental health, and health problems facing Alaskans today. The article summarizes the most current substance abuse, mental health, and health data available for the State of Alaska from public, academic, and institutional sources. It emphasizes data relevant to Alaska Native groups, calling for improved efforts in the future to collect data according to ethnicity and gender. The data presented identify a number of significant substance use and mental health problems that are prevalent in Alaska, providing geographic and ethnic data wherever available.

Adolescent↗
PubMed2000

Alcohol control and injury death in Alaska native communities: wet, damp and dry under Alaska's local option law.

OBJECTIVE: This article tests whether different forms of community-level alcohol control significantly affect injury deaths in a population with extremely high injury mortality. METHOD: The 1981 Alaska local option law provides a natural experiment for studying how implementation of community level controls may be associated with changes in injury deaths, most of which are alcohol-related, among Alaska Natives living in small communities. The study compares population and community-specific death rates under different levels of alcohol control for the 97 communities that passed restrictions between 1980 and 1993 with the death rates in the same communities during periods when no restrictions were in place. RESULTS: Injury death rates were generally lower during periods when alcohol sales, importation or possession were restricted than when no restrictions were in place (wet). More restrictive controls (dry) significantly reduced homicides; less restrictive control options (damp) reduced suicides. Accident and homicide death rates fell, on average, by 74 and 66 per 100,000, respectively, for the 89 communities that banned sale and importation or possession. A control group of 61 small communities that did not change control status under the law showed no significant changes over time in accident or homicide death rates. CONCLUSIONS: The changes in accidental and homicide death rates are statistically significant, although these reduced rates remain 2.5 to 7 times national death rates. The isolated nature of Alaskan villages may explain why alcohol control has more effect in Alaska than has been found in studies of Native Americans living in other states.

Accidents↗
PubMed2002

Botulism among Alaska natives in the Bristol Bay area of southwest Alaska: a survey of knowledge, attitudes, and practices related to fermented foods known to cause botulism.

OBJECTIVES: Botulism cases due to traditional Alaska Native fermented foods occur periodically in Southwest Alaska. In this population, we conducted a survey on knowledge, attitudes, and practices related to botulism and fermented foods. METHODS: We interviewed 140 adults randomly chosen from nine villages. Data collected included fermented food consumption frequency; knowledge about the cause and symptoms of botulism; and fermented food preparation methods. RESULTS: Most respondents (81%) had eaten Alaska Native fermented foods at least once. Over 70% identified botulism as a foodborne illness, and over 87% believed eating certain Native fermented foods could cause botulism. One-third of fermented food preparers used plastic containers for fermentation. To prevent botulism, 45% vwould consider boiling fermented foods, and 65% would not eat foods fermented in plastic or glass containers. CONCLUSIONS: Despite high awareness of botulism in this population, one-third of fermented food preparers use plastic containers, a practice which may increase the risk of botulism. Misconceptions and acceptable prevention messages about botulism, such as using traditional nonplastic fermentation methods, were identified and included in an educational video.

Adolescent↗
PubMed2001

Dietary intake among Alaska native women resident of Anchorage, Alaska.

OBJECTIVE: We summarized data from a study of Alaska Native women living in predominantly urban communities to assess the quality of their dietary intakes and compare to current US dietary recommendations. STUDY DESIGN: Descriptive cross sectional study of seventy-four Alaska Native women living in and around Anchorage, Alaska. Each completed up to four 24-h diet recalls during one year. Participants were enrolled in 1996 and 1997. Blood samples were analyzed for hematocrit, vitamin A, vitamin C, vitamin E and folate. RESULTS: Results were compared with current US dietary guide lines for food groups and nutrients. Mean intake of these women fell below recommendations for all food groups except the Meat and Beans Group. Mean intakes of sweets, sodium and energy from fat and saturated fat exceeded recommendations. Red blood cell folate levels were low in 32% of the women. Only one-quarter of the women reported eating Native foods. CONCLUSIONS: The survey shows room for improvement in diet to include reduced intakes of saturated fat, and increased intakes of folate, calcium, and dietary fiber by increasing consumption of fruits and vegetables, whole grain breads and cereals, non-fat milk products, and Native foods.

Adolescent↗
PubMedDate not supplied

Oral health of young Alaska Native children and their caregivers in Southwestern Alaska.

OBJECTIVE: We sought to determine the prevalence of caries and associated risk factors in young Native children and their caregivers in two communities in rural Alaska. METHODS: A random sample of Alaska Native children between 12-36 months and a subset of their caregivers from two Southwestern Alaska communities were examined for dental decay. Caregivers completed a 43-item questionnaire about oral hygiene, dietary and other practices. RESULTS: Of the 65 children examined, 59% had evidence of decay. Among the 41 primary caregivers examined, 98% had experienced dental decay with an average of 11.4 decayed, missing, and filled teeth. On linear regression analyses, factors significantly associated with more decay in the children included a child taking a juice-containing bottle to bed, eating candy 1 or more times per day, and higher caregiver oral S. mutans counts. CONCLUSIONS: Our results suggest that preventive efforts for children at high risk for dental decay should begin early in life, should emphasize decreasing candy and bedtime juice bottle use, and should consider the caregivers' oral health status in addition to the child's.

Adult↗
PubMed2004

Unheard Alaska: culturally anchored participatory action research on sobriety with Alaska Natives.

Alcohol research in Alaska Native communities has a contentious history. This project has attempted to address a critical need for research to guide alcohol abuse prevention and treatment with Alaska Natives using culturally anchored participatory action research. The process of grounding the research methodology in the culture and community is described, along with its contribution to community psychology's understanding of the importance of cultural factors. Tensions between indigenous values and ways of knowing, and Western research methodologies are delineated, along with how these tensions were resolved. Important issues that arose in doing culturally anchored participatory action research are described. These included the development of a community of inquiry, key methodological decisions, the empowerment of participants as coresearchers, and flexibility in research implementation.

Alaska↗
PubMedDate not supplied

Highly specific photoscreening at the Alaska State Fair. Valid Alaska Blind Child Discovery photography and interpretation.

During the Alaska State Fair, from 1999 through 2001, experienced MTI photoscreeners from the District 49-A Lions Club screened 1844 children as a part of the Alaska Blind Child Discovery. Physician interpretation produced the following recommendations: normal 93.8%, "normal +" 3.4%, "positive" 2.7% and inconclusive 0.2%. Extrapolating from 53 confirmatory follow-up exams estimates the specificity of this screening (true negatives/all normal follow-up exams) from 97% to 100%, with a positive predictive value (true positive/all positive screenings) greater than 90%. High specificity increases the cost-effectiveness of screening. We derived "ABCD-Specificity" equals true negatives/(exam negatives plus inconclusives). In 2002, an additional 655 children were screened yielding 22 "positive" (3.4%), 28 N+ (4.3%), 605 "normal" (92.4%) and no "inconclusive." This brings the total ABCD State Fair Effort to 2499 screened with 2.8% "positive," 3.6% N+, 93.4% "normal" and only 0.12% "inconclusive."

Alaska↗