title: The polar bear in the room: diseases of poverty in the Arctic.
abstract: In the face of global warming, budgetary austerity and impoverished Arctic residents, the nations of the circumpolar region are presented with a number of difficult choices regarding the provision of health care to the far-flung and isolated regions of their northernmost provinces. Complicating that picture is the reality of neglected tropical diseases in areas far from their perceived normal equatorial range as well as endemic food-borne diseases, including protozoan and helminth parasites, respiratory and gastrointestinal diseases and vaccine-preventable illnesses. This paper discusses the problems of caring for the health and well-being of indigenous populations suffering from extreme poverty, isolation and discrimination in the circumpolar region. After presenting difficulties as supported by the extant literature, the paper continues by suggesting solutions that include novel telenursing applications, targeted distance-educational programs and local community-based health care assistant (HCA) vocational training. These programs will provide cost-effective care that increases life-spans, improves quality of life and provides opportunities to distressed populations in isolated rural communities of the Far North. The toolkit presented in the paper is intended to spur discussion on community health programs that could be adopted to provide proper and humane care for marginalized Arctic populations in an extreme and rapidly changing environment.
authors.affiliation: University of Alaska, Anchorage, USA. cwaldennelson@gmail.com
authors.forename: Chris
authors.initials: C
authors.lastname: Nelson
mesh_terms: D001110:Arctic Regions / Q000453:epidemiology; D003695:Delivery of Health Care / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006303:Health Services, Indigenous / Q000458:organization & administration; D006304:Health Status; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data*; D017216:Telemedicine
keywords: Arctic; circumpolar; disease; poverty