Health Transitions in Arctic Populations

Health Transitions in Arctic Populations

T. Kue Young
Peter Bjerregaard
Copyright Date: 2008
Pages: 496
https://www.jstor.org/stable/10.3138/j.ctt2ttwj1
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  • Book Info
    Health Transitions in Arctic Populations
    Book Description:

    Health Transitions in Arctic Populationsoffers both an examination of key health issues in the north and a vision for the future of Arctic inhabitants.

    eISBN: 978-1-4426-8819-3
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-viii)
  3. List of Tables
    (pp. ix-xii)
  4. List of Figures
    (pp. xiii-xvi)
  5. List of Maps
    (pp. xvii-xviii)
  6. Preface
    (pp. xix-2)
  7. 1 Introduction
    (pp. 3-20)
    KUE YOUNG and PETER BJERREGAARD

    This is a book about the health of the diverse populations who inhabit the circumpolar regions in the northern hemisphere. It describes and explains their changing patterns of health, how these came about, and what can be done to improve the health of these populations. We utilize the concept of ‘health transitions’ and apply it to the circumpolar world. We correlate changes in health status with major environmental, social, economic, and political changes in the regions. We seek commonalities in the experience of Arctic populations, while recognizing their immense diversity.

    A circumpolar approach to identifying common issues and developing solutions...

  8. PART ONE: REGIONS
    • 2 Greenland
      (pp. 23-38)
      PETER BJERREGAARD and THOMAS STENSGAARD

      Although Greenland – or Kalaallit Nunaat in Greenlandic – is the world’s largest island, only a narrow coastal strip is inhabited (map 4). The population in 2006 was 57,000, of which almost 90 per cent were Inuit. This Inuit majority is by far the largest of any indigenous people in any jurisdiction of the circumpolar region. Greenland has, since 1979, had its own Home Rule government with extensive powers, and negotiations for self-determination are in progress. However, half of the national income still consists of subsidies from Denmark, the former colonial master.¹

      The Inuit of Greenland refer to themselves collectively...

    • 3 Northern Canada
      (pp. 39-52)
      KUE YOUNG

      As stated in the introduction, northern Canada is defined in this book administratively to include Yukon, the Northwest Territories, and Nunavut. These three territories, which are sometimes referred to as the Territorial North by Canadian geographers, share the latitude 60° N as their southern land border (map 5). The region, with its 4 million square kilometres, constitutes some 40 per cent of Canada’s land mass and is among the world’s most sparsely populated areas. (See chapter 7 for information on the Inuit living in the northern parts of Quebec [Nunavik region] and in Labrador.)

      Northern Canada is a frontier (or...

    • 4 Alaska
      (pp. 53-70)
      JAMES BERNER

      Alaska is the only state in the United States containing lands that are considered arctic. As discussed in the introduction, the entire state falls within the purview of this book (map 6). Alaska is the largest but least populated state in the United States, with an area of 1.52 million square kilometres, about one-fifth the total area of all the forty-eight contiguous states combined (usually referred to as the ‘lower-48’), and two and a half times the size of Texas.

      Successive portions of the earth’s crustal plates that migrated to the north-western edge of the North American plate now form...

    • 5 Arctic Russia
      (pp. 71-102)
      ANDREW KOZLOV and DMITRY LISITSYN

      The Russian North (Sever) stretches across the Eurasian landmass (see map 8). The Ural Mountains, which extend north-south for some 2,000 kilometres, are regarded as the dividing line between Asia and Europe. ‘Siberia’ (Sibir), as a geographical term, is generally used to refer to all of Russia east of the Urals and sometimes in a more restricted sense, excluding the Far East. In this chapter, the focus is on those parts of Russia located to the north of 60° N.¹

      The European North of Russia extends from the Kola Peninsula and Kareliya in the west, across the Vychegda Lowland and...

    • 6 Northern Fennoscandia
      (pp. 103-116)
      SVEN HASSLER, PER SJÖLANDER and URBAN JANLERT

      As a geographic term, ‘Scandinavia’ has different meanings and usages. In its broadest sense, it encompasses all the Nordic countries and their dependent territories. More narrowly, it refers to only Denmark, Norway, Sweden, and Finland, or only the three contiguous countries of Norway, Sweden, and Finland. Sometimes Finland is excluded; when Finland is included, the term ‘Fennoscandia’ is often used. For the purpose of this book, Scandinavia will be used interchangeably with Fennoscandia to refer to Norway, Sweden, and Finland collectively (map 9).

      We define northern Scandinavia, which does not exist as a single political-administrative unit, as comprising the six...

  9. PART TWO: PEOPLES
    • 7 Inuit
      (pp. 119-133)
      PETER BJERREGAARD and KUE YOUNG

      The wordInuitis the plural ofinuk, which means a person. The term is today used to denote a number of closely related population groups inhabiting the circumpolar region. These groups are known under a variety of self-designated names, including Kalaallit (in Greenland), Inuit and Inuvialuit (in Canada), Inupiat and Yupik (in Alaska), and Yuit (in Siberia). The older term ‘Eskimo’ is generally perceived to be derogatory in Canada, while in Greenland it refers to historical populations, and in Alaska it continues to be acceptable. In this book, we will use the term Inuit, which is also the term...

    • 8 Dene
      (pp. 134-147)
      KUE YOUNG

      Dene (or Den’a or Dine, depending on the language) is a self-designation term, meaning ‘the people.’ This group is usually referred to by anthropologists as Athabascan (or Athapaskan or Athabaskan) Indians, a linguistic classification. Dene is now the term preferred by some indigenous organizations, especially in Canada – for example, the Dene Nation, which represents various First Nations in the Northwest Territories. The homeland of the Dene is referred to as Denendeh. For the purpose of this book, Dene will be used to refer to all Athabascan-speaking people in northern Canada and Alaska.¹

      The Dene have a wide distribution throughout...

    • 9 Sami
      (pp. 148-170)
      SVEN HASSLER, SIV KVERNMO and ANDREW KOZLOV

      The Sami are the indigenous people of Scandinavia. ‘Sami’ is the name used in self-designation, by and large replacing the term ‘Lapp,’ which is of Finnish origin and now regarded as derogatory. In older studies and in official documents until the 1980s, ‘Lapp’ was most often used.¹

      The Sami homeland, Sápmi, today stretches over the northern regions of four countries – Norway, Sweden, Finland, and Russia (fig. 9.1). It extends from the fjords along the North Atlantic coast of Norway in the west to the Kola Peninsula of Russia in the east. It encompasses a wide variety of terrains, including...

    • Colour plates
      (pp. None)
  10. PART THREE: DETERMINANTS
    • 10 Environment and Living Conditions
      (pp. 173-191)
      PETER BJERREGAARD, JAMES BERNER and JON ØYVIND ODLAND

      As a health determinant, ‘environment’ is usually conceived of separately from ‘biology’ and encompasses all that is external to the human body. It is often further divided into the ‘physical and social,’ spreading out in expanding concentric circles that represent the home, the workplace, the community, and ultimately the entire planet. The influence of the environment on health has long been recognized, from Hippocrates’ bookAirs, Waters, and Placesto the 1992 WHO Commission on Health and Environment and the 2007 report of the Intergovernmental Panel on Climate Change. The distinction between physical and social environment is arbitrary, as there...

    • 11 Diet, Nutrition, and Physical Activity
      (pp. 192-204)
      PETER BJERREGAARD and MARIT JØRGENSEN

      Considerable lifestyle changes have occurred over the past decades among indigenous peoples in the circumpolar region. Parallel to this has been a change in disease patterns, with an increase, for example, in cardiovascular disease and diabetes (see chapter 16). Among the main causes of such adverse transitions are alterations to the diet and levels of habitual physical activity, as the population shifts from their traditional hunting and fishing economy to more Westernized living conditions.

      For many indigenous peoples in the Arctic, the traditional diet is not only a way of obtaining the necessary nutrients but it is also a social...

    • 12 Smoking, Alcohol, and Substance Use
      (pp. 205-228)
      ANNA RITA SPEIN

      Many personal behaviours or lifestyles are associated with the development of a variety of diseases and health conditions. Smoking and alcohol use are among the most important of such lifestyle determinants of health. As forms of addiction, they can be considered ‘diseases’ in their own right and not just risk factors for other diseases. The modification of such behaviours has become the mainstay of public health programs in most jurisdictions. In this chapter, the patterns, determinants, and consequences of smoking, alcohol, and substance use in the circumpolar region are discussed, with particular focus on the Sami in Scandinavia and other...

    • 13 Genetic Susceptibility
      (pp. 229-244)
      ROBERT HEGELE and REBECCA POLLEX

      It has been known for centuries that children tend to look like their parents, that certain diseases run in families, and that there is an intangible inherent factor that dictates present and future health. In the present scientific age, with our ability to read DNA sequences and manipulate the human genome in vitro, we have shifted from largely observational studies, such as the work carried out by Mendel with his pea plants, to direct investigations into the precise molecular basis of many human traits and disorders. It is now clearly understood that genetics can play the lead role in disease,...

    • 14 Cold Exposure, Adaptation, and Performance
      (pp. 245-262)
      TIINA MÄKINEN and MIKA RYTKÖNEN

      Circumpolar residents are exposed to cold during their occupational activities, while commuting to work, and/or during their leisure time. Circumpolar environmental conditions are characterized by marked fluctuations in temperature and sunlight, with long, cold, and dark winters and short, cool, bright summers. In these northern areas, winter is the longest season. For example, in Finland, the number of days when the mean daily temperature drops below 0°C range between 90 and 220. Most often, the coldest days occur in January and February, and temperatures as low as –50°C have been recorded in Fennoscandia (map 10). The cold conditions in winter...

  11. PART FOUR: CONSEQUENCES
    • 15 Infectious Diseases
      (pp. 265-290)
      ANDERS KOCH, MICHAEL BRUCE and PREBEN HOMØE

      In the first part of the twentieth century and earlier, infectious diseases were major causes of death in Arctic communities, not only in terms of absolute numbers but also relative to other causes. Since then, infectious disease mortality rates have decreased markedly. In 1925 more than half of all deaths in Greenland were caused by acute infections and tuberculosis, compared with 5 per cent some seventy-five years later.¹

      In spite of this improvement, the overall burden of infectious diseases in the Arctic remains high, and higher than in southern populations. The present pattern of Arctic infectious diseases is characterized by...

    • 16 Cardiovascular Diseases, Diabetes, and Obesity
      (pp. 291-307)
      MARIT JØRGENSEN and KUE YOUNG

      In the circumpolar region, substantial lifestyle changes have occurred since the 1950s. Among indigenous peoples, the declining dependence on hunting and fishing, decrease in physical activity, and change from a traditional diet to a more Western diet have been observed. Such environmental factors, interacting with genetic susceptibility, have exerted a considerable influence on the prevalence and incidence of obesity, diabetes, cardiovascular diseases, and their risk factors.

      Obesity is the excess of body fat or adipose tissue. While body fat serves a variety of essential metabolic functions, its excess can predispose an individual to significant health problems, including diabetes, coronary heart...

    • 17 Cancer
      (pp. 308-333)
      JEPPE FRIBORG and SVEN HASSLER

      Cancer is a collective term for a group of diseases with different etiologies, clinical presentations, and pathological features, all sharing the uncontrolled growth and spread of abnormal (malignant) cells. Because it affects different body organs and tissues, cancer is generally classified according to anatomic site (i.e., where the ‘primary’ cancer originates, to be distinguished from ‘secondary’ sites where it may have spread or metastasized). However, within each site, there may well be several different histological types (such as squamous cell carcinoma, adenocarcinoma, etc). Cancer may be detected at different stages in its natural history, often a reflection on the quality...

    • 18 Injuries and Violence
      (pp. 334-358)
      KUE YOUNG and SVEN HASSLER

      In the decades since the 1940s, among the most serious health problems affecting northern peoples, particularly the indigenous population, are injuries sustained as a result of accidents and violence. This trend is reflected in excessive mortality, morbidity, health care utilization, residual disability, and social and economic costs. This chapter will not discuss suicide in detail, which is covered in the next chapter on mental health. However, data on suicide are included in some statistical tables covering all injuries. The main geographical focus is on northern Canada, supplemented by data and case studies from other circumpolar jurisdictions.

      The study of injury...

    • 19 Mental Health and Suicide
      (pp. 359-378)
      ANNE SILVIKEN and SIV KVERNMO

      Circumpolar peoples are subject to immense mental stress as their communities undergo profound social and cultural changes. Particularly for indigenous peoples, the second half of the twentieth century has been a period when the traditional life irrevocably gave way to Western lifestyles. Among the mental health/psychosocial health problems experienced by indigenous peoples, suicide is clearly the most significant, more so in some populations and regions than in others. This chapter will first discuss general mental health and well-being and then focus on suicide among the Sami and Inuit.

      Mental well-being can be evaluated by the presence or absence of common...

    • 20 Maternal and Child Health
      (pp. 379-402)
      JON ØYVIND ODLAND and LAURA ARBOUR

      Circumpolar maternal and child health is a very complex issue. Life conditions and socio-economic status vary considerably between countries, regions, and population groups. A good example is the area along the Norwegian-Russian border, where socio-economic differences have been among the highest in the world between neighbouring nations. Two important international programs have discussed life conditions for pregnant women and children in detail since the 1990s: the Arctic Monitoring and Assessment Programme (AMAP) under the Arctic Council, and the Analysis of Arctic Children and Youth Health Indicators project (AACYHI), an initiative of the Arctic Council’s Sustainable Development Working Group. In this...

  12. PART FIVE: STRATEGIES
    • 21 Improving the Health of Arctic Populations
      (pp. 405-418)
      PETER BJERREGAARD, KUE YOUNG and JAMES BERNER

      The previous chapters of the book have given an overview of the disease patterns of circumpolar peoples with an emphasis on the Inuit, Dene, and Sami and have outlined the main genetic, environmental, and behavioural causes of disease in these populations. Basically, three distinct patterns emerge: that of the Sami, who, in regard to health, are more or less indistinguishable from their non-Sami neighbours; that of the Inuit in North America and Greenland as well as the Dene in Canada and Alaska, who differ from the non-indigenous majority populations; and that of the ethnic minorities in Arctic Russia, who carry...

  13. References
    (pp. 419-478)
  14. Contributors
    (pp. 479-485)