Diving below the surface: A framework for arctic health research to support thriving communities

Abstract

Aims: Historically, health research in the Arctic has focused on documenting ill-health using a narrow set of deficit-oriented epidemiologic indicators (i.e., prevalence of disease and mortality rates). While useful, this type of research does not adequately capture the breadth and complexities of community health and well-being, and fails to highlight solutions. A community’s context, strengths, and continued expressions of well-being need to guide inquiries, inform processes, and contextualize recommendations. In this paper, we present a conceptual framework developed to address the aforementioned concerns and inform community-led health and social research in the Arctic. Methods: The proposed framework is informed by our collective collaborations with circumpolar communities, and syntheses of individual and group research undertaken throughout the Circumpolar North. Our framework encourages investigation into the contextual factors that promote circumpolar communities to thrive. Results: Our framework centers on the visual imagery of an iceberg. There is a need to dive deeper than superficial indicators of health to examine individual, family, social, cultural, historical, linguistic, and environmental contexts that support communities in the Circumpolar North to thrive. A participatory community-based approach in conjunction with ongoing epidemiologic research is necessary in order to effectively support health and wellness. Conclusions: The iceberg framework is a way to conceptualize circumpolar health research and encourage investigators to both monitor epidemiologic indicators and also dive below the surface using participatory methodology to investigate contextual factors that support thriving communities.

A research framework for the United Nations Decade of Healthy Ageing (2021–2030)

“…However, despite the Decade Action calling on communities to foster the abilities of older people, there has been little exploration of the capacity of communities to do this, Wellbeing could provide a way to evaluate the sufficiency of community material resources (e.g., infrastructure and local economy) and relationships (e.g., sense of coherence and participation) (DeVerteuil et al 2020 ; Ryser et al 2021 ) as well as community narratives (e.g., as flourishing or left behind) (Li and Zehr 2020 ; Wiseman and Brasher 2008 ). Mapping diversities across these wellbeing domains could help us better understand the extent to which older people with the greatest need for age-friendly interventions do not always reside in places with the capacity to implement them (Cueva et al 2021 ; Winterton 2016 ).…”

From Resilient to Thriving: Policy Recommendations to Support Health and Well-being in the Arctic

“…While this work is valuable, there is much that lies below the surface of indicators such as mortality, incidence, and prevalence rates of specific diseases. To support thriving communities in the circumpolar North, the academic community needs to delve deeper to investigate strengths-based factors that promote a culture of health (Cueva et al, 2021).…”

“…Research on Arctic communities' contexts, strengths, and continued expressions of well-being has received insufficient attention. Consequently, the fellows developed and published a conceptual framework to encourage investigation into the contextual factors that support circumpolar communities to thrive (Cueva et al, 2021).…”

Time trends and geographical clusters in suicide among Greenland Inuit

“…Arctic research is developing a more holistic strength-based approach to suicide prevention focusing on community strengths and protective factors fostering thriving communities (32,33,(37)(38)(39). Prevention should be culturally relevant, community-based, and include individual, family, social, historical, cultural, and environmental factors that constitute the base of the 'iceberg' of which suicide would gure as part of the visible tip above water (40). In Greenland, land-based and intergenerational interventions for mental health among youth are being conducted and monitored.…”