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PubMed2005

Dietary intakes vary with age among Eskimo adults of Northwest Alaska in the GOCADAN study, 2000-2003.

Dietary factors influence the development of cardiovascular disease (CVD). The diet of Alaskan Eskimos differs from that of other populations. We surveyed Eskimo adults in Northwest Alaska to document their usual dietary intakes, differences based on gender and age, and sources of selected nutrients, and to generate appropriate dietary advice to reduce CVD. Interviewers surveyed 850 men and women 17-92 y old, using a quantitative food-frequency instrument. We observed many significant (chi(2) analysis P < 0.05) differences in nutrient intakes among 3 age-groups. Energy intake from carbohydrate was negatively related to participant age-group (P < or = 0.01). Energy intake from all fats (P < 0.001) and polyunsaturated fat (P < or = 0.01) was positively related to age-group among both men and women in contrast to other studies in which age differences were either not observed or decreased with age. Native foods were major sources of monounsaturated and polyunsaturated fats, including 56% of (n-3) fatty acids primarily from seal oil and salmon. However, Native foods contributed significantly less to the diets of young adults than to those of elders, especially among women. Store-bought foods were the main sources of energy, carbohydrate, fat, saturated fat, and fiber for all adults. Based on their nutrient density and potential to inhibit CVD, continued consumption of traditional foods is recommended. Variations in intake by age may portend changing eating patterns that will influence CVD as participants age. These data will contribute to understanding dietary risk factors for cardiovascular disease in this population.

Adolescent↗
PubMedDate not supplied

Bridging between two standards for collecting information on race and ethnicity: an application to Census 2000 and vital rates.

OBJECTIVES: The 2000 Census, which provides denominators used in calculating vital statistics and other rates, allowed multiple-race responses. Many other data systems that provide numerators used in calculating rates collect only single-race data. Bridging is needed to make the numerators and denominators comparable. This report describes and evaluates the method used by the National Center for Health Statistics to bridge multiple-race responses obtained from Census 2000 to single-race categories, creating single-race population estimates that are available to the public. METHODS: The authors fitted logistic regression models to multiple-race data from the National Health Interview Survey (NHIS) for 1997-2000. These fitted models, and two bridging methods previously suggested by the Office of Management and Budget, were applied to the public-use Census Modified Race Data Summary file to create single-race population estimates for the U.S. The authors also compared death rates for single-race groups calculated using these three approaches. RESULTS: Parameter estimates differed between the NHIS models for the multiple-race groups. For example, as the percentage of multiple-race respondents in a county increased, the likelihood of stating black as a primary race increased among black/white respondents but decreased among American Indian or Alaska Native/black respondents. The inclusion of county-level contextual variables in the regression models as well as the underlying demographic differences across states led to variation in allocation percentages; for example, the allocation of black/white respondents to single-race white ranged from nearly zero to more than 50% across states. Death rates calculated using bridging via the NHIS models were similar to those calculated using other methods, except for the American Indian/Alaska Native group, which included a large proportion of multiple-race reporters. CONCLUSION: Many data systems do not currently allow multiple-race reporting. When such data systems are used with Census counts to produce race-specific rates, bridging methods that incorporate geographic and demographic factors may lead to better rates than methods that do not consider such factors.

Adolescent↗
PubMed1998

mtDNA diversity in Chukchi and Siberian Eskimos: implications for the genetic history of Ancient Beringia and the peopling of the New World.

The mtDNAs of 145 individuals representing the aboriginal populations of Chukotka-the Chukchi and Siberian Eskimos-were subjected to RFLP analysis and control-region sequencing. This analysis showed that the core of the genetic makeup of the Chukchi and Siberian Eskimos consisted of three (A, C, and D) of the four primary mtDNA haplotype groups (haplogroups) (A-D) observed in Native Americans, with haplogroup A being the most prevalent in both Chukotkan populations. Two unique haplotypes belonging to haplogroup G (formerly called "other" mtDNAs) were also observed in a few Chukchi, and these have apparently been acquired through gene flow from adjacent Kamchatka, where haplogroup G is prevalent in the Koryak and Itel'men. In addition, a 16111C-->T transition appears to delineate an "American" enclave of haplogroup A mtDNAs in northeastern Siberia, whereas the 16192C-->T transition demarcates a "northern Pacific Rim" cluster within this haplogroup. Furthermore, the sequence-divergence estimates for haplogroups A, C, and D of Siberian and Native American populations indicate that the earliest inhabitants of Beringia possessed a limited number of founding mtDNA haplotypes and that the first humans expanded into the New World approximately 34,000 years before present (YBP). Subsequent migration 16,000-13,000 YBP apparently brought a restricted number of haplogroup B haplotypes to the Americas. For millennia, Beringia may have been the repository of the respective founding sequences that selectively penetrated into northern North America from western Alaska.

Alaska↗
PubMed1984

Advances in the dental search for Native American origins.

The Sinodont dental morphology pattern of NE Asia is today more complex and was so by 20,000 years ago, than the simplified Sundadonty of SE Asia-Oceania, and the very simplified pattern that evolved greater than 20,000 B.P. All Native Americans are Sinodonts. Intra--and inter-hemispheric statistical analyses of 28 dental traits in greater than 6000 N & S American and greater than 1100 NE Asian crania reveal three temporally stable American sub-patterns, suggesting prior evolution in Sino-Siberia. The hypothesized biocultural associations and migration episodes are: (1) "Upper Cave" Sinodonts with the generalized Chinese Microlithic Tradition reach the Arctic steppe via the Lena basin to become Paleo--and most later Indians. (2) Smaller-game-hunting Siberian Diuktaians cross to Alaska at forest-forming terminal land bridge times to become Paleo-Arctic and subsequent Na-Dene-speaking NW forest Indians. (3) Lower Amur basin-N Japan blade-makingfolk evolve a coastal culture on the way to the land bridge's SE terminus at Anangula-Umnak where the oldest skeletons of the dentally distinctive but variable Aleut-Eskimos have been found.

Americas↗
PubMed1990

Smokeless tobacco: a product for the new generation of tobacco users. Dipping and chewing in the Northwest Territories, Canada, and its global relevance.

The use of smokeless tobacco appears to be a socially acceptable behavior among certain ethnic and cultural groups in developing and developed countries. Some native groups in the Northwest Territories have traditionally used smokeless tobacco. With the visits of the merchant supply ships to the Northwest Territories in the early 1950's, a wider commercial variety of smokeless tobacco began to be used. Of great concern is the generation of Canadian children and adolescents who start this habit and become addicted to smokeless tobacco during their primary and secondary school years. Smokeless tobacco is reemerging as a popular form of tobacco among children and adolescents in Canada, the United States (including Alaska), Scandinavia and Britain. Chemical analysis of samples of smokeless tobacco from six countries has revealed that moist snuff obtained in 1985, from Gjoa Haven, Northwest Territories (imported from the United States) had the highest levels of cancer causing tobacco-specific nitrosamines (TSNA) of 228,400 and 240,100 parts per billion. If these levels were found in any other consumer product today, it would be banned from the marketplace. Because of their known carcinogenicity, the United States Department of Agriculture and Federal Food and Drug Administration have set up strict tolerance levels for human exposure to these chemicals and they prohibit the sale of beer, bacon or baby bottle nipples that contain levels greater than 10 parts per billion. TSNA concentrations in snuff exceed the levels of nitrosamines in other consumer products by over one hundredfold. During snuff dipping or chewing tobacco, the nitrosation process continues within the mouth.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2002

Effect of racial/ethnic misclassification of American Indians and Alaskan Natives on Washington State death certificates, 1989-1997.

OBJECTIVES: This study examined effects of racial/ethnic misclassification of American Indians and Alaskan Natives on Washington State death certificates. METHODS: Probabilistic record linkage were used to match the 1989-1997 state death files to the Northwest Tribal Registry. RESULTS: We identified matches for 2819 decedents, including 414 (14.7%) who had been misclassified as non-American Indians and Alaskan Natives on the death certificates. The likelihood of being correctly classified increased 3-fold for each higher level of American Indian and Alaskan Native ancestry (odds ratio = 2.88; 95% confidence interval [CI] = 2.51, 3.30) and decreased by 6.9% per calendar year (95% CI = 2.0, 11.5). CONCLUSIONS: Systematic biases on death certificates in Washington State persist. Methods to reduce misclassification can improve data quality and enhance efforts to measure and reduce racial/ethnic health disparities.

Alaska↗
PubMed1998

Gonorrhea among drug users: an Alaskan versus a national sample.

The study described here investigates the replicability of gender-specific risk profiles for gonorrhea based on an Alaskan sample compared to a U.S. national sample of drug users at risk for HIV infection. The Alaska sample (interviewed at a field station in Anchorage, Alaska; N=1,049) and the national sample (interviewed at 18 sites other than Alaska; N=17,619) consisted of cocaine smokers and injection drug users not in drug treatment. A history of gonorrhea infection was self-reported and coded as ever or never. The Anchorage and national risk profile for men included the following factors: (a) history of intranasal or parenteral cocaine use, (b) being black versus nonblack, (c) being older, (d) income from illegal activity, and (e) history of amphetamine use. The Anchorage and national risk profiles for women included the following factors: (a) trading sex for money, (b) being Native American versus non-Native American, and (c) trading sex for drugs. The Anchorage model for women included perceived homelessness as a factor, but it was not retained in the national model. The extent of the replicability of these models illustrates the generalizability of Alaskan findings to other U.S. drug-using populations. The authors also discuss the implications of these findings for disease prevention.

Comorbidity↗
PubMedDate not supplied

Preventing amputations from diabetes mellitus: the Indian Health Service experience.

With the heavy burden of diabetes mellitus among American Indians and Alaskan Natives, lower-extremity amputation (LEA) has become a common complication. Rates of diabetes-related LEA are 2-3 times those observed in other diabetic populations. During the past 12 years, the Indian Health Service (IHS) has made LEA prevention a public health priority. From 1988 to 1992 screening criteria based on simple examinations were developed and validated in primary care Settings. Prevention efforts have focused on targeting high-risk individuals for self-care foot education, provision of protective footwear, and routine podiatry care. Follow-up studies in Alaska and northern Minnesota saw 25-50% reductions in LEA rates associated with these interventions. In settings where these efforts were augmented with system changes, such as team coordination, patient-tracking systems, comprehensive footcare practice guidelines, flowsheets, and outreach programmes, LEA incidence was reduced by 50-75%. Efforts are currently underway to disseminate system-based approaches for comprehensive diabetic footcare and to expand the availability of foot care resources to tribal communities served by the IHS.

Alaska↗
PubMed1982

Epidemiology of testicular cancer in the Pacific Basin.

Although a rare tumor, testicular cancer shows substantial international variation in incidence. In whites, the peak incidence occurs at 25-30 years of age, with a second increase in old age. Blacks have much lower rates than do whites. The rate of increase in the incidence and mortality of this cancer has been consistent but low during the past 40 years. Risk factors identified in epidemiology studies of testicular cancer include cryptorchidism (best documented), inguinal hernia, testicular injury, wearing of tight-fitting underclothing, obesity, maternal use of exogenous estrogens during pregnancy, higher social class, and professional occupations. Epidemiological evidence provides two etiologic hypotheses: a relative hormone imbalance, particularly an excess of estrogen, and a failure of normal thermal regulation of the testis. In the Pacific Basin region, notable variation in incidence rates is also seen. High-risk populations include whites, Polynesians (in Hawaii and New Zealand), and Native Alaskans. Low-risk groups include Filipinos (in Hawaii and Manila), Japanese (in Hawaii and Japan), Indians, and Malays. Most of this variation occurs in the younger ages (0-54 yr). Several areas for potentially fruitful research on this cancer in the Pacific region are given.

Adolescent↗
PubMed2006

Relationship between IgE and specific aeroallergen sensitivity in Alaskan native children.

BACKGROUND: The relationship between atopic disease and serum IgE levels varies among populations and geographic regions. The close association of atopy with IgE may not occur in subarctic populations as it does in developed countries in temperate climates. OBJECTIVE: To evaluate the relationship between total and specific IgE concentrations and clinical atopy in 5- to 8-year-old Alaskan native children. METHODS: Medical record reviews, interviews, physical examinations, serum IgE measurements, and radioallergosorbent testing (RAST) were performed. RESULTS: The IgE geometric mean was 122.1 IU/mL. Fifty-eight percent of patients had IgE levels greater than 70 IU/mL, and 17% had levels greater than 1,000 IU/mL; 14% had RAST values greater than 0.35 kU/L. Both IgE levels greater than 70 IU/mL and greater than 1,000 IU/mL were associated with RAST values greater than 0.35 IU/L (P = .004) and early wheezing (P = .005) but not with current wheezing, asthma, eczema, or a history of allergies. A RAST value greater than 3.51 kU/L was associated with eczema (P = .04) but not with allergies or wheezing. Children with current wheezing were more likely to have allergies (P = .03) but not eczema, an IgE level greater than 70 IU/mL, or a positive RAST value. Children hospitalized with respiratory syncytial virus (RSV) were not more likely than controls to have current wheezing. CONCLUSIONS: Elevated serum IgE concentrations, including levels greater than 1,000 IU/mL, are common among Alaskan native children; positive RAST reactions to aeroallergens are not. The IgE levels do not relate to wheezing, eczema, a history of allergies, or past hospitalization for RSV infection but likely reflect infections other than RSV and environmental factors in subarctic indigenous populations.

Alaska↗
PubMed1991

Nasopharyngeal carcinoma: epidemiology and dietary factors.

Nasopharyngeal carcinoma (NPC) is a disease with a remarkable racial and geographical distribution. It is very rare (incidence of less than 1 per 100,000 person-years) in most parts of the world, and in only a handful of populations does this low-risk profile deviate; these groups include people in southern China, Eskimos and other natives of the Arctic region, natives of south-east Asia, and the mainly Arab populations of North Africa and Kuwait. Convincing evidence implicates dietary factors as the primary cause of NPC among Chinese. A series of case-control studies conducted in various Chinese populations with distinct risks of NPC, ranging from the very high-risk Cantonese populations to the relatively low-risk northern Chinese, have suggested that ingestion of salted fish and other kinds of preserved foods constitutes the most important cause of NPC among these people. Preliminary data on Malays in south-east Asia, Eskimos in Alaska and Arabs of North Africa also suggests that ingestion of preserved foods by these population groups may be responsible for their raised incidence of NPC.

Animals↗
PubMed1990

Diet and nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a disease with a remarkable racial and geographical distribution. It is very rare (incidence of less than 1 per 100,000 person-years) in most parts of the world and only a handful of populations are known to deviate from this low-risk profile, which include people of southern China. Eskimos and other natives of the Arctic region, natives of southeast Asia, and mainly Arab populations of north Africa and Kuwait. There is now convincing evidence implicating dietary factors as the primary cause of NPC among Chinese. A series of case-control studies conducted in various Chinese populations with distinct risks of NPC, ranging from the very high-risk Cantonese to the relatively low-risk Northern Chinese, have suggested that ingestion of salted fish and other kinds of preserved foods by the Chinese constitutes the most important cause of NPC development among these people. Preliminary data on Malays in southeast Asia, Eskimos in Alaska, and Arabs of north Africa also suggest that ingestion of preserved foods by these population groups may be responsible for their raised incidence of NPC.

Animals↗
PubMed2001

A reconsideration of the origins of the type 2 diabetes epidemic among Native Americans and the implications for intervention policy.

Type 2 diabetes has reached epidemic proportions in many Native American communities in North America. The overwhelming majority of physicians, biomedical researchers, and medical ecologists continue to explain the astoundingly high prevalence rates of diabetes among Native Americans and other high prevalence populations in terms of yet-to-be-identified genetic factors. Recent experimental and epidemiological research, however, has brought to light an etiological alternative to the genetic-predisposition model. This body of research suggests that type 2 diabetes may result initially from fetal malnutrition and, in subsequent generations, be propagated via perturbations in the intrauterine environment. Native American populations at greatest risk for diabetes today are the ones most likely to have endured severe nutritional stress in their recent histories, thus experiencing the conditions that are most conducive to the diabetic developmental sequence. If further substantiated, the implications of the fetal-origin model of diabetes for diabetes intervention programs are profound.

Adult↗
PubMed1990

Diet and nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a disease with a remarkable racial and geographical distribution. It is very rare (incidence of less than 1 per 100,000 person-years) in most parts of the world and only a handful of populations are known to deviate from this low-risk profile, which include people of southern China, Eskimos and other natives of the Arctic region, natives of southeast Asia, and the mainly Arab populations of north Africa and Kuwait. There is now convincing evidence implicating dietary factors as the primary cause of NPC among Chinese. A series of case-control studies conducted in various Chinese populations with distinct risks of NPC, ranging from the very high-risk Cantonese to the relatively low-risk Northern Chinese, have suggested that ingestion of salted fish and other kinds of preserved foods by the Chinese constitutes the most important cause of NPC development among these people. Preliminary data on Malays in southeast Asia, Eskimos in Alaska, and Arabs of north Africa also suggest that ingestion of preserved foods by these population groups may be responsible for their raised incidence of NPC. Regardless of race and geography, the commonest form of nasopharyngeal cancers are those that arise from the epithelial cells lining the nasopharynx. These carcinomas (commonly referred to as NPCs) constitute 75-95% of nasopharyngeal cancers in low-risk populations and virtually all nasopharyngeal cancers in high-risk populations (Ho, 1971; Sugano et al, 1978; Levine and Connelly, 1985).

Animals↗
PubMed1998

Traditional healing and allopathic medicine: issues at the interface.

There is increasing interest in Native traditional healers and the possibility of their working in some form of relationship with the allopathic medical system. It represents a resurgence of effort in an area of great potential benefit to the Native community, but is rife with issues that could destroy the effort at any number of stages in the process. Issues related to professional and institutional responsibility, the power of medicalization, physical and philosophical interactions of the systems of healing, measures of effectiveness, issues of reimbursement, and many more must be dealt with in an intentional and thorough manner if the process is to be successful.

Alaska↗
PubMed1990

Effectiveness of Haemophilus influenzae type b vaccines.

PURPOSE: To determine the clinical effectiveness of Haemophilus influenzae type b (Hib) vaccines. STUDY IDENTIFICATION AND SELECTION: Computerized searches of MEDLINE, EMBASE and SCISEARCH databases were performed, and the reference list of each retrieved article was reviewed. Two prospective clinical trials of Hib polyribosyl ribitol phosphate conjugated with diphtheria toxoid (PRP-D) were identified. In addition, one cohort study of the PRP-D vaccine, two trials of the PRP vaccine, five case-control studies of the PRP vaccine and 10 randomized controlled trials of the immunogenicity of the PRP-D vaccine were identified. DATA EXTRACTION: Study quality was assessed and descriptive information concerning the study populations, the interventions and the outcome measurements was extracted. RESULTS: The difference in the effectiveness of the PRP-D vaccine between the prospective trials, in which a three-dose schedule had been used beginning at 2 to 3 months of age, was clinically important (37% v. 83%) but not statistically significant. The PRP vaccine, which induces lower antibody responses than the PRP-D vaccine does, was clinically effective only in a subgroup of one prospective trial; 90% effectiveness was reported among children 18 to 60 months of age. CONCLUSIONS: Hib vaccine appears to be less effective in high-risk populations. None the less, because of the large variation in baseline risk, the number of children who would have to be vaccinated to prevent one case of invasive Hib disease is substantially less for high-risk than for low-risk populations. The vaccination of children at high risk, such as native children, with the PRP-D vaccine using a four-dose schedule (at 2, 4, 6 and 14 months of age) seems warranted. The currently available evidence does not strongly support a policy of universal vaccination with either a one-dose or a four-dose schedule.

Alaska↗
PubMed1975

Cancer mortality among Alaskan natives, 1960-69.

During 1960-69, 321 reported deaths among Alaskan natives (Eskimos, Indians, and Aleuts) were attributed to cancer. This number is not significantly different from the cancer mortality of U.S. Caucasians during this period, but is significantly higher than that of U.S. Indians. The mortality of Alaskan natives from cancers of the nasopharynx, esophagus, kidneys, and salivary glands was significantly increased. Among Alaskan Caucasians, only nasopharyngeal cancer was in excess in both sexes. Deficits in mortality among Alaskan Caucasians for cancers of other sites may be attributable, at least in part, to selection factors associated with the migration of healthy workers into the State.

Adult↗
PubMedDate not supplied

Report of the mental health team 1991 Alaska/Magadan medical expedition and exchange.

This report provides a brief overview of the July, 1991 mental health team visit to the Magadan and Chukotka regions. A previous trip to the region was made by a mental health team in the summer of 1990. The sites covered were Anadyr, Magadan, Yagodnoye and Sinegorye. There are several follow-up activities and projects currently underway, such as a Fetal Alcohol Syndrome project, alcohol treatment comparisons, and Native Elder exchanges. The Soviet economy has had a marked effect in the type of treatments available in hospitals and clinics for all the types of physical and mental health problems. Because of the openness and cooperation of the Soviet medical personnel, much data and information has been gathered and will be used to determine the areas to be addressed for joint study and application.

Alaska↗