Suicide and alcohol-related disorders in the U.S. Arctic: boosting research to address a primary determinant of health disparities

Abstract

Objectives To review the existing epidemiological literature on suicide and alcohol related disorders and their social determinants in the U.S. Arctic, as it relates to U.S. government research and evaluation efforts, and to offer recommendations to boost research capacity in the U.S. Arctic and collaborations across the circumpolar arctic as part of global health initiatives. Study design: Synthetic literature review. Methods Published literature, federal and state reports on suicide and alcohol-related disorders, federal databases on research and program evaluation in the U.S Arctic were reviewed, with a focus on epidemiological trends over the past 50 years. Results Suicide and alcohol-related disorders play a significant role in health disparities t in the U.S. Arctic, with evidence of a disturbing prevalence trend over the past 50 years. Important variations exist in suicide rates across different regions of Alaska with different majority populations of Alaska Native cultural groups, and in selected key instances, within these regions, with immense implications for guiding effective prevention efforts. Consequences of alcohol abuse are severe and particularly significant in their impact upon Alaska Native people. Health related conditions associated with alcohol abuse are among leading causes of mortality. Conclusions Recommendations to boost research capacity in behavioural health in the U.S. Arctic are offered; specifically on strategies and methods of inquiry and analysis, distinctions between populations and communities in rural circumpolar contexts, future epidemiological and implementation research.

Indigenizing CBPR: Evaluation of a Community‐Based and Participatory Research Process Implementation of theElluam Tungiinun(Towards Wellness) Program in Alaska

“…The quote that opens this paper comes from an Elder who is a member of a Yup’ik Alaska Native community that engaged with university researchers to plan, develop and deliver an intervention to reduce the prevailing disparities in suicide and substance abuse devastating this region of Alaska (Allen et al 2011; Hagan and Provost 2009). The Elder was interviewed as part of an evaluation, reported here, describing process outcomes from the implementation of a community based participatory research (CBPR) approach to intervention development that took place over a three-year period in the indigenous community context of a remote, Yup’ik community in southwest Alaska.…”

Mapping resilience pathways of Indigenous youth in five circumpolar communities

“…Kirmayer, Boothroyd, & Hodgins, 1998; Kvernmo & Heyerdahl, 2003; O'Neil, 1986), as well as literature specific to Eveny in Siberia (Bogoyavlensky, 1997; Pika, 1993, 1999; Prokhorov, 1987; Rethman, 2001; Vitebsky, 2000, 2002, 2006), Sámi in Norway (Silviken, Haldorsen & Kvernmo, 2006; Spein, 2008), Inuit in Canada (Damas, 2002; Kral et al, 2009; Kral, 2012; Murry & Brody, 1999; O'Neil, 1986; Rigby, MacDonald, & Otak, 2000; Tester & McNicoll, 2004), and Inupiaq and Yup’ik in Alaska (Wexler, 2006; 2009; Wexler, Hill, Bertone-Johnson & Fenaughty, 2008; Wexler, Silveira, & Bertone-Johnson, In press; Alaska Injury Prevention Center, Critical Illness and Trauma Foundation Inc., & American Society for Suicidology, 2007; J. Allen, Levintoya, & Mohatt, 2011; Hendin, Maltsberger, Lipschitz, Haas, & Kyle, 2001; Perkins, Sanddal, Howell, Sanddal, & Berman, 2009).…”

“…Allen, Levintoya, & Mohatt, 2011; Hendin, Maltsberger, Lipschitz, Haas, & Kyle, 2001; Perkins, Sanddal, Howell, Sanddal, & Berman, 2009). This literature also includes several reviews of substance abuse, violence, and suicide in the Arctic (Allen, Levintoya, et al, 2011; Berry, 1985; Bjerregaard, 2001; Chandler & Proulx, 2006; Condon, 1990; Kettl & Bixler, 1991; Kirmayer, Fletcher, & Boothroyd, 1998; Kirmayer, Brass, & Tait, 2000; Kvernmo & Heyerdahl, 2003; Larsen 1992; Lynge, 1985; Oosten & Remie, 1999; Sanson-Fisher, Campbell, Perkins, Blunden, & Davis, 2006). …”

Relationship of Social Network to Protective Factors in Suicide and Alcohol Use Disorder Intervention for Rural Yup’ik Alaska Native Youth

“…Suicide and alcohol use disorders are significant health disparities experienced by Alaska Native people, with youth, and male youth in particular, at significantly higher risk for death by suicide and alcohol related problems, in contrast to their age cohort in the U.S. general population (Allen, Levintova, & Mohatt, 2011). Rural Yup’ik Alaska Native communities in southwest Alaska have been severely impacted by suicide and alcohol, and in response, several of the communities in this region have created a multilevel cultural intervention for their youth that draws extensively from Yup’ik traditional practices and cultural worldview, drawing from community strengths and local expertise (Rasmus, Charles, & Mohatt, 2014).…”