Rising to the challenge of health in the far North

Northern communities face serious problems, but researchers and students can make a positive impact, says dean of public health.

(Edmonton) According to Kue Young, dean of the University of Alberta's School of Public Health and an expert on northern and Aboriginal health, for any health indicator you choose, circumpolar peoples are typically worse off than others.

Young has good reason to think so-from his research in Aboriginal communities in circumpolar regions, he has found that infectious diseases (such as tuberculosis) and injuries (including suicide) are particularly serious problems that northern communities face today.

"While infectious diseases have been going down in recent years, they haven't gone away completely, and their incidence is still consistently higher than in the south," says Young. And in recent years, circumpolar regions have seen increases in new health problems-such as obesity, diabetes and heart disease-that are related to lifestyle choices. Circumpolar people are those who live in regions surrounding the North Pole, including Alaska, the Yukon, the Northwest Territories, Nunavut, Greenland, northern Scandinavia and the Russian Arctic.

To begin tackling the health challenges facing circumpolar peoples and regions, Young says the social determinants of health need to be examined first.

"There is a lot of work that needs to be done on socio-economic development, such as employment and housing. Population growth in circumpolar regions is outstripping the gains being made, so they are always playing catch-up."

According to Young, there is room for innovation in areas of health-care technology, including transportation, telecommunications and human resources. With the remoteness of the population, per capita health-care expenditures in Canada's North are among the highest in the world.

For Young, an encouraging development is that interest in circumpolar health is growing. For example, the Canadian Institutes of Health Research recently put out a team grant call for research related to wellness, mental health and suicide prevention in circumpolar areas.

"This is the first call of its kind internationally," says Young. "It will be interesting to see what kind of best practices come from the knowledge synthesis and what information can be shared."

According to Young, the U of A's School of Public Health is poised to provide leadership in circumpolar health. He is currently working with associate professor Arto Ohinmaa on a five-year project to look at primary health care in the Northwest Territories. Other researchers in the school, such as Cindy Jardine and Tania Bubela, are also working extensively with circumpolar peoples. Still, Young says, more attention and work needs to be focused on these northern regions.

"There is plenty of opportunity for research and practice, and also for policy development. I am personally interested in exposing more of our students to northern health and related initiatives," he says. He envisions placing students in the master of public health program into short-term practicum positions in northern regions.

"Public health agencies in the North could benefit from having a student come on board, helping them with projects and data analysis," he says. "Students can learn about public health in a real-world situation. They'd be on the front lines, rather than gleaning knowledge from a textbook."

With a longer-term involvement in northern communities, Young sees opportunities for MSc and PhD students, as well.

"If you are well prepared in the sciences of public health you can go to the northern regions, learn from the people there, make adaptations, and apply your knowledge and skills," says Young. "At the school, we want to teach our students to do something well, and then they can take those skills anywhere in the world and have a positive impact."