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BACKGROUND: COVID-19 has profoundly affected sleep, although little research has focused on high-risk populations for poor sleep health, including American Indian/ Alaska Native (AI/AN) adolescents. METHODS: This is the first longitudinal study to examine changes in sleep with surveys completed before the pandemic and during the early months of COVID-19 in a sample of urban AI/AN adolescents (N=118; mean age= 14 years at baseline; 63% female). We use a mixed-methods approach to explore how COVID-19 affected urban AI/AN adolescents’ sleep, daily routines, and interactions with family and culture. Quantitative analysis examined whether pandemic-related sleep changes were significant and potential moderators of COVID-19’s effect on sleep, including family and community cohesion and engagement in traditional practices. RESULTS: Findings demonstrate changes in sleep, including increases in sleep duration, delays in bedtimes and waketimes, and increases in sleep-wake disturbances (p’s

Purpose Estimates of diabetic eye disease in American Indian and Alaska Natives (AI/AN) vary over time, region, and methods. This article reports recent prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME) in AI/AN served by the Indian Health Services' (IHS) teleophthalmology program, as identified using ultrawide field imaging (UWFI). Methods This was a retrospective analysis of 2016-2019 clinical data (n = 53,900). UWF images were acquired by certified imagers using a validated protocol, and graded by licensed, certified optometrists supervised by an ophthalmologist. Graders evaluated the extent/severity of retinal lesions in comparison to standard photographs. DR lesions predominantly in any peripheral field were considered "predominantly peripheral lesions" (PPL). The analyses calculated prevalence of any DR, any DME, DR and DME severity, sight-threatening disease, and PPL. Results Patients averaged 56 years of age with a 68 mmol/mol A1c and 55% had had diabetes for 5+ years. Prevalence of any DR, any DME, and sight-threatening disease was 28.6%, 3.0%, and 3.0%. In patients with mild nonproliferative DR, PPL was seen in 25.3%. PPL suggested a more severe level of DR in 8.7% of patients. DR increased with age. DME decreased with age. Males and patients in the Nashville IHS area had more diabetic eye disease. Conclusion AI/AN have a high burden of diabetes and its complications. The IHS is resource-constrained, making accurate disease estimates necessary for resource allocation and budget justifications to Congress. These data update the estimates of diabetic eye disease in Indian Country and suggest that UWFI identifies early DR.

Background: California has the largest American Indian and Alaska Native (AIAN) population in the United States and faces several commercial tobacco related disparities. This study assessed current interest, readiness, and knowledge regarding commercial tobacco control policies in California Tribal communities.Objectives: A community readiness assessment was conducted in California Tribal communities to understand commercial tobacco policies that included: Tobacco 21 (California State, and now federal, law restricting commercial tobacco sales to age 21 and over), tobacco tax, smoke-free worksites on Tribal lands, smoke-free households, and smoke-free indoor and outdoor areas in multi-unit housing.Methods: Twelve Tribal communities participated in focus groups and interviews between 2016-2019. Content analysis was utilized to code and data were analyzed using ATLAS.ti software.Results: A total of 165 community members participated (65% female), with most expressing support for unwritten, community-based "small p" policies, (e.g., placing signage to create a smoke-free perimeter). However, there was little to no support for "big P" policies (e.g., written ordinances on smoke-free casinos, smoke-free housing). Support for tobacco product taxation varied. The importance of Tribal sovereignty and the need for tobacco prevention and cessation programs for youth were two additional topics that emerged.Conclusions: Participants supported Tribal policies and wished for outsiders to respect Tribal sovereignty in this regard. Communities are currently working to raise awareness about the dangers associated with commercial tobacco use and would benefit from the responsiveness of future funders to these requests.

Underserved populations are at increased risk for obesity and related cardiovascular disease, type 2 diabetes, and other chronic diseases. Lack of access to healthy foods, sedentary behaviour, and other social environmental factors contribute to disease risk. Yup'ik Alaska Native communities are experiencing lifestyle changes that are likely to affect their cardiometabolic risks. BarreraCastro's Cultural Adaptation Framework was used to adapt an evidence-based intervention (EBI) originally designed for Latino communities for use in Yup'ik communities. Focus groups and key informant interviews were held in two Yup'ik communities. Major themes included causes of obesity, barriers and facilitators to healthy foods and physical activity, and intervention ideas. The adaptation process was guided by a Community Planning Group of Yup'ik women and included information gathering, preliminary adaptation design, preliminary adaptation tests, and adaptation refinement. Two of the adapted educational modules were pilot tested. Involving community members as co-researchers in cultural adaptation is vital for an EBI to be effective in another population. Small group gatherings led by local lay health workers are culturally appropriate and may be an effective health promotion model in Yup'ik communities. Social environmental factors affecting healthy food availability and physical activity need further exploration.

The opioid crisis in the United States has received national attention and critical resources in the past decade. However, what has been overlooked is the effect the opioid crisis may be having on a three-decade suicide crisis among American Indian and Alaska Native (AIAN) communities that already have too few resources to address behavioral and mental health issues. This paper describes recent epidemiological trends associated with both opioid overdose and suicide at a national level for AIANs and the rest of the United States. We used data reported by the Centers for Disease Control and Prevention to report historical trends of opioid overdose and suicide for AIAN and non-AIAN populations. We found alarming and potentially correlated trends of opioid use and suicidality among AIAN populations. We highlight both current and future research that will be essential to understanding and addressing the unique intersection between opioid and suicide risk and protective factors to inform dual prevention and intervention efforts among AIAN populations with potential relevance to public health response among other at-risk populations.

Drawing from the rejection-identification model, acculturation, and acceptance threat literatures, we examined how Indigenous and mainstream identification influence the effect of discrimination on acculturative and physical stress. A community sample of 126 Indigenous Alaskans reported discrimination, identification with Indigenous Alaskans and mainstream Americans, and acculturative and physical stress. As perceptions of personal discrimination increased, so did Indigenous identification and reports of acculturative and physical stress. Contrary to the rejection-identification hypothesis, Indigenous identification did not reduce the effect of discrimination on stress. Instead, following personal discrimination, Indigenous and mainstream identification interacted to predict acculturative stress. As Indigenous identification increased, so did acculturative stress - particularly among those who strongly identified with mainstream culture. These associations were not present for group-based discrimination. Thus, experiencing personal rejection from mainstream society may be particularly stressful for Indigenous people who strongly identify with their ethnic group, placing them at higher risk for mental and physical illness.

In the initial stage of Russian colonization of Alaska, very few Natives were involved in carrying out maritime service on Russian ships, as they lacked some of the required qualifications and skil...

This study aimed to evaluate the effectiveness of an educational intervention at improving Oral Health Professionals (OHP's) knowledge of HPV and comfortability to discuss vaccination with their American Indian and Alaskan Native patients. OHP's attended an educational lecture covering HPV vaccination. Participants completed four validated questionnaires that encompassed a sociodemographic survey, a pre-lecture questionnaire (pre-Q), a post-lecture questionnaire (post-Q), and a follow-up questionnaire (follow-Q). The McNemar test was used to assess the significance of marginal probabilities in the responses between the pre-Q and post-Q and the Chi-square test to assess responses between the post-Q and follow-Q. A total of 122 OHP's completed the sociodemographic survey, pre-Q, and post-Q. Among these, 29 OHP's completed the eight-week follow-Q. The majority of all the participants were White/Caucasian (41%), 31 to 60years of age (72%), females (64%), and held a graduate/professional degree (52%). Analysis of the pre-Q responses showed that only 6.8% of OHP's discuss the connection between HPV and oropharyngeal cancer with patients and a lack of information on the topic was the major barrier reported. After the educational intervention (post-Q), 86.5% of OHP's reported they were more likely to recommend the HPV vaccine and 69.8% felt more comfortable administering it. Comparison between the pre-Q and the post-Q showed a significant improvement in overall HPV knowledge. Similarly, a comparison between the post-Q and the follow-Q showed retained knowledge overtime. Our study suggests that the educational intervention was effective at improving OHP's knowledge of HPV and enhancing their comfortability and preparedness to discuss the vaccination with their patients.

The prevalence of self-reported hypertension is higher among Alaska Native and American Indian (ANAI) individuals than in the majority USA population. Although hypertension is the primary modifiable risk factor for cardiovascular disease and stroke, it can be difficult to manage successfully. The objective of this study was to explore patients' and providers' perspectives about hypertension, hypertension management strategies, and patient-provider communication strategies within a tribally-owned and operated health system in Alaska. We conducted four focus groups that included 16 ANAI patients and five primary care providers. Patient participants tended to consider hypertension a transient state, in contrast with providers' understanding of hypertension as a chronic condition. Differences were noted in participants' perceptions regarding providers' counselling and education efforts, with providers feeling that current strategies are effective and patients desiring a more personalised discussion about hypertension. Patients expressed preferences for behaviour change approaches compared with pharmacotherapy; providers often resorted to medication as a first step towards controlling blood pressure. Our findings suggest areas of potentially promising future research with respect to patient-provider communication and treatment of hypertension.

The purpose of this study was to explore (a) current utilization rates of university mental health services among American Indian/Alaskan Native/Native Hawaiian (AI/AN/NH) student veterans and (b) predictors of mental health service utilization among AI/AN student veterans.

Background: Suicide is the second leading cause of death for Native youth aged 15-24. Similarly, Native youth have a suicide rate 1.5 times higher than the general population and are at higher risk for depression and substance use. A persistent need remains for culturally specific mental health interventions for American Indian youth.Methods: In response to the push for research-supported interventions, evidence mapping has emerged as systematic, rigorous, and replicable analysis of evidence. The overall goal of this study is to utilize evidence mapping for mental health interventions for American Indian youth.Results: A total of 9 interventions were mapped as research-supported interventions for American Indian mental health. The interventions fell into one or more of four main categories: school-based services, cultural adaptations, culture as treatment, and community involvement.Discussion: Results of this study demonstrate the strength of culturally specific mental health interventions for American Indian youth. Future research should seek to evaluate promising practices for American Indian youth in order to increase available research-supported interventions. Additionally, future endeavors should seek to combine both Indigenous and Western approaches to practice with a particular focus on holistic wellness.

This study reviews student's perspectives of an American Indian and Alaska Native Indian Studies center in a Master of Social Work degree (MSW) program from the Brown School at Washington University in St. Louis. The article describes the Kathryn M. Buder Center for American Indian Studies many contributions over the years and how it continues to grow in innovative ways. This article begins by considering the social, economic, and historical circumstances that make Native-focused training in social work critical to the future of Indian Country. The article then discusses the founding of the center, the curriculum, program offerings and the effectiveness of the center's services. Additionally, results of the evidence indicates that financial assistance and support programs are strong factors in recruitment, student motivation to pursue a degree, and persistence to completion of a Master of Social Work credential. Lastly, the paper offers recommendations for recruiting, retaining and graduating American Indian and Alaska Native graduate students.

Introduction: Many barriers exist for American Indian/Alaska Native (AI/AN) students pursuing advanced degrees. The Brown School at Washington University in St. Louis has a higher than aver...

We provide a literature review concerning healthcare access for Native Americans in rural areas. We group previous research around three themes; barriers in rural America; barriers within the Indian Health Services system (including provider recruitment and retention); and the scale of services offered. Considering a wide range of access measures, a general failure exists in providing Native Americans with services comparable to those received by other Americans There are repeated findings of disparities in specific resources available, such as staff and infrastructure. Improvement appears possible through increased funding, and by giving greater management control to each tribe.

Objectives: American Indians and Alaska Natives (AI/AN) have a unique healthcare system uniquely interwoven with the Affordable Care Act (ACA). The aim of this study is to document changes in healt...

Objective: How social support (SS) affects the odds of suicide attempt among American Indian/Alaska Native (AI/AN) youth in New Mexico and is modified by school location and metropolitan status. Me...

Because use of sexual health services among American Indian/Alaska Native women is understudied we: (1) examined disparities in use of sexual health services between American Indian/Alaska Native and non-Hispanic white women and (2) identified factors associated with service use among American Indian/Alaska Native women. We used data from the National Survey of Family Growth regarding the use of sexual health services collected between 2006 and 2010 from women aged 15-44 years who self-identified as American Indian/Alaska Native (n = 819) and white (n = 6,196). Weighted logistic regression models estimated the likelihood of reporting the use of sexual health services by race and factors associated with use in the American Indian/Alaska Native sample. Compared to whites, American Indian/Alaska Native women were less likely to use birth control services and more likely to use services for sexually transmitted diseases and HIV. Among American Indian/Alaska Natives, younger women were more likely to use birth control services, and women who had a higher number of sexual partners were more likely to use services for sexually transmitted diseases and HIV. Our results provide a national baseline against which to assess disparities and changes in the use of sexual health services among American Indian/Alaska Native women over time.

Although alcohol misuse is a priority for health care systems serving Alaska Native and American Indian (ANAI) people, stakeholders’ perceptions of misuse are understudied. Patients (n = 34), provi...

Objectives: HIV and sexually transmitted diseases (STDs) are serious health conditions among American Indian and Alaska Native (AIAN) populations, especially youth. However, few sexual risk reducti...

Though there is evidence linking the history of colonialism and oppression of Indigenous people to the high rates of rape and child sexual abuse experienced by this population today, it is less understood how colonial processes, past and present, condition the decision to disclose or report victimization. Drawing on a survivorship storytelling study of rural Alaska Native survivors of child sexual abuse, this paper underscores the importance of centering colonialism in understanding the culture of silence surrounding sexual victimization among Indigenous people. Results show that reasons for non-disclosure are quite embedded within larger social, historical and political themes of colonialism, oppression, and marginalization. Implications for policy and praxes are discussed, as well as a broader mandate of social change to remove barriers to disclosure.

Substance abuse is especially undesirable among pregnant or parenting women (PPW). As such, there is a need to examine the factors impacting positive treatment outcomes, particularly among American Indian/Alaska Native (AI/AN) PPW, as they are seeking substance abuse treatment at rates considerably higher than the national average. This study aimed to identify the social and cultural mechanisms that support their recovery. Qualitative analyses were used to identify mechanisms used by AI and non-AI PPW in their recovery. Several differences between AI and non-AI PPW emerged. AI participants mentioned their families more often as the reason why they wanted to become or stay sober. In addition to familial support, AI participants relied on a variety of other sources for assistance in their recovery. Many of the women had difficulty defining specific aspects of their culture, especially in relation to their recovery. However, for AI PPW, many aspects of AI culture were identified as they described their recovery, suggesting the often subtle ways culture can impact everyday life. Our findings indicated that women utilized cultural supports in different ways; therefore, it is necessary to help them define their culture in ways that are meaningful in their recovery.

Research is an important tool in addressing myriad American Indian and Alaska Native (AIAN) health disparities; however, tensions exist between common empirical measurement approaches that facilitate cross-cultural comparisons and measurement specificity that may be more valid locally and/or culturally appropriate. The tremendous diversity of AIAN communities, small population sizes of distinct AIAN cultural groups, and varying cultural contexts and worldviews should influence measurement decisions in health research. We provide a framework for guiding measurement in collaboration with AIAN communities using examples from substance abuse research for illustration. Our goal is to build upon ongoing efforts to advance measurement validity for AIAN research by engaging community-researcher partnerships and critical thinking in the selection, adaptation, creation, and implementation of measures.

Objectives: This study captured factors integral to healthy ageing in central Alaska. To date, conceptual models fail to meaningfully address how healthy ageing is impacted by location and context, particularly in remote or sparsely populated areas. The way “healthy”, or “successful”, ageing is defined in an extreme environment, and how that contrasts with global definitions of healthy ageing, has yet to be examined. Method: Residents of central Alaska aged 60 and older completed background demographics and several measures of personality and well-being and then engaged in a guided discussion. Results: Themes identified as important to healthy ageing were attitude/perspective, socialisation, sense of community, purpose and staying active, and independence. Challenges endorsed included service gaps, transportation, seasonality, cost of living, and isolation. Discussion: The current data parallels previous investigations of healthy ageing and provides a new understanding of the importance of resilience factors for those living in central Alaska.

American Indian and Alaska Native sexual minority (two-spirit) women are vulnerable to substance misuse and mental health challenges due to multiple minority oppressed status and exposure to stress and trauma. Yet, these women find pathways toward healing and wellness. We conducted a qualitative data analysis of interviews derived from a national health study and gained an understanding of 11 two-spirit women’s resilience and recovery patterns. Emergent from the data, a braided resiliency framework was developed which elucidates multi-layered abilities, processes, and resources involved in their resiliency. We recommend that resilience-promoting strategies be incorporated into substance misuse and mental health interventions.

Today, AIAN Elders are more actively engaged in their families and communities, encouraging the development of intergenerational programs, language and cultural revitalization, being stewards in research conducted in their communities, as well passing on their knowledge and experiences on how to live as healthy Native people. Elders have traditionally been quiet and observant of their environment, but the current and future cohorts of Elders are advocates, leaders, and culture bearers for their families and communities and they are now in positions of leadership. Western society acknowledges the value of traditional knowledge and AIAN Elders are viewed as exemplars of healthy aging and their lessons and experiences can be attributed to our own lives. This commentary highlights the paradigm shift in how society views older adults, specifically AIAN Elders and their role in health and wellbeing.

American Indian youth have the highest suicide rates in the United States; however, many do not use services and access barriers exist. This study was a cross-sectional evaluation of 6 gatekeeper trainings conducted on 1 reservation with N = 84 individuals. Analyses examined participant characteristics, impact on training objectives, and satisfaction. The majority of participants were American Indian and female (89.3%). Significant increases in knowledge (p

American Indians and Alaskan Natives (AI/AN) are a highly diverse group in terms of culture and language, but share a history of oppression and attempted extermination that has left many with a legacy of poverty and poor health. Cultural and biological survival are important issues for many AI/AN groups.Using US criteria, AI/AN groups are more likely to be poor. The US National Center for Health Statistics reports that US AI/ANs have higher mortality and morbidity rates than the US population. While all groups racially defined by the US National Center for Health Statistics have been experiencing a decline in fertility since 1983, AI/ANs seem to be suffering a substantially greater and earlier decline in fertility. Given the importance of fertility in the survival of AI/AN communities, it is important to identify the source of this decline.A recent study of one AI/AN group living along the St. Lawrence River found that obesity and exposure to a particular group of polychlorinated biphenyls were the factors most highly associated with indicators of impaired fertility. Economic factors are often cited as reasons for fertility declines, however in this situation these other factors may have either primary or contributing roles.If the associations with obesity and toxicant exposure are confirmed, intervening on these factors might be important steps in stemming continued declines in fertility.

The aim of the study was to investigate whether there were differences in acceptance rates for VR services among African Americans, White Americans, Native American or Alaskan Natives, and Asian or Pacific Islanders with disabilities in the USA?The study was based on a population 599 444 customers who sought VR or Bureau of Visual Service Agency services in the USA from 1 October, 1997, through 30 September, 1998. The subsample of customers with no missing values on the variables under investigation included African Americans (n = 13 287), White Americans (n = 38 048), Native American or Alaskan Natives (n = 599), and Asian or Pacific Islanders (n = 596). The chi-square test of homogeneity of proportions was the test statistic. The final random subsample included African Americans (n = 300), White Americans (n = 300) Native American or Alaskan Natives (n = 300), and Asian or Pacific Islanders (n = 300) was drawn from the population of VR customers in the USA.The study supports the hypothesis that African Americans were more likely to be found ineligible for VR services, while Asian or Pacific Islanders were more likely to be accepted for VR services.While discovering that African Americans are more likely to be rejected for VR services was not surprising, discovering that Asians or Pacific Islanders are more likely to be accepted for VR services than African Americans was unexpected, given that past VR acceptance research adduced that White Americans, not Asian or Pacific Islanders, are more likely to be accepted for VR services when compared to African Americans with disabilities. While a preponderance of VR research indicates that White Americans are more likely to be accepted for VR services than African Americans, it was also unexpected that White Americans were not statistically significant when education, type of major disability, disability severity, and SES were controlled.

Over 4 million American Indians and Alaskan Natives live in communities that receive health care primarily from the federal Indian Health Service or tribal health programs. Palliative care has only recently been formally addressed for these communities. An Indian Health Service program introduced the topic and several programs are ongoing. Needs for and barriers to palliative care in native peoples' communities are discussed and several successful programs at various stages of development and implementation are described.

This paper identifies and describes major themes in contemporary Alaska Native law. A selected and annotated bibliography is included to facilitate additional research.

We compared rates of unintentional injury (UI) deaths (total and by injury category) among Alaska Native (AN) people to rates of U.S. White (USW) and Alaska White (AKW) populations during 2006–2015. The mortality data for AN and AKW populations were obtained from Alaska Bureau of Vital Statistics and USW mortality data were obtained from WISQARS, the Center for Disease Control and Prevention online injury data program. AN and AKW rates were age-adjusted to the U.S. 2000 Standard Population and rate ratios (RR) were calculated. AN people had higher age-adjusted total UI mortality than the USW (RR = 2.6) and AKW (RR = 2.3) populations. Poisoning was the leading cause of UI death among AN people (35.9 per 100,000), more than twice that of USW (RR = 2.9) and AKW (RR = 2.5). Even greater disparities were found between AN people and USW for: natural environment (RR = 20.7), transport-other land (RR = 12.4), and drowning/submersion (RR = 9.1). Rates of AN UI were markedly higher than rates for either USW or AKW. Identifying all the ways in which alcohol/drugs contribute to UI deaths would aid in prevention efforts. All transportation deaths should be integrated into one fatality rate to provide more consistent comparisons between groups.

© 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Objective: Foetuses and neonates of women who use tobacco are exposed to nicotine and tobacco-derived carcinogens. We determined the relationship between urine biomarkers of tobacco toxicant exposure postpartum and in the neonates of Alaska Native (AN) women, comparing smokers and smokeless tobacco (ST) users, including iqmik, a homemade ST product. Methods: AN women, including 36 smokers, 9 commercial ST and 16 iqmik users their neonates participated. Urine from the woman at the time of delivery and her neonate’s first urine were analysed for cotinine, the major metabolite of nicotine, and 4-(methylnitrosamino)-1-(3) pyridyl-1-butanol (NNAL), a tobacco-specific carcinogen biomarker. Results: Maternal urine cotinine and neonatal urine cotinine were strongly correlated in all tobacco use groups (r from 0.83 to 0.9, p

Helicobacter pylori infection is common among Alaska native (AN) people, however scant gastric histopathologic data is available for this population. This study aimed to characterise gastric histopathology and H. pylori infection among AN people. We enrolled AN adults undergoing upper endoscopy. Gastric biopsy samples were evaluated for pathologic changes, the presence of H. pylori, and the presence of cag pathogenicity island-positive bacteria. Of 432 persons; two persons were diagnosed with gastric adenocarcinoma, two with MALT lymphoma, 40 (10%) with ulcers, and 51 (12%) with intestinal metaplasia. Fifty-five per cent of H. pylori-positive persons had cag pathogenicity island positive bacteria. The gastric antrum had the highest prevalence of acute and chronic moderate–severe gastritis. H. pylori-positive persons were 16 and four times more likely to have moderate–severe acute gastritis and chronic gastritis (p

Substance use and misuse among racial/ethnic subgroups remains a much understudied area. This article summarizes recent data from national surveys (SAMHSA) recording prevalence and treatment rates for major ethnic/racial subgroups. The authors point to a concern about the higher prevalence and treatment rates of alcohol among older American Indians and Alaskan Natives, but warn that more precise estimates must be obtained. They also address the finding that older African Americans have higher prevalence and rates of treatment admissions for certain illicit drugs such as cocaine. They highlight the unique concerns for older African Americans as the largest minority group within the U. S. Finally, a research agenda for the twenty-first century is suggested which will stress emphasis on continued, careful analysis of the life course of substance use among racial/ethnic subgroups.

SUMMARY A comprehensive model describing drug abuse behavior is presented which incorporates biological, social and psychological domains. Within the structure of this interactive model, specific drug related phenomena are discussed, including inhalant abuse, cultural factors (with an emphasis on Alaskan Natives) and post-traumatic stress disorder (PTSD). Future research needs are addressed with the presentation of several hypotheses derived from the model.

Summary Clinical considerations and comparisons are explored in direct relationship to the role of spirituality in recovery for gays, lesbians, and Native Americans with an emphasis on American Indians and Alaskan Natives. Considered are the development stages of identity, common prejudices experienced by these minority groups, the influence of Christianity and the role of the church and synagogue, alcohol incidence rates, and the historical context of ‘exile’ from homeland. Comparisons occur among these groups which could aid the worker in a greater understanding of this clientele, thus directly impacting the success of client/worker contact in the recovery and healing process.

Alaska, with its predominately youthful population and its "last frontier" ethic, provides an ideal setting to explore what role drugs may play in people's lifestyles, and to learn how such behavior is related to a society that is still attempting to define itself. The present research was undertaken to identify the prevalence of drug use among Alaskan youth, specifically focusing on gaining an understanding of prevalence levels among members of different ethnic groups. The findings from a study of students in grades 7 to 12 revealed that lifetime prevalence for experience with any chemical substances is extraordinarily high among all youth in these grades. The levels are much higher than that found in comparable ages youth in the lower-48 states. High prevalence levels are also noted for 4th and 6th graders. A study of the proportion of youth within each of the different ethnic groups revealed that drug involvement was very high for Alaskan Natives, Americna Indians, Hispanics, and students of mixed back...

This study presents a conceptual model for examining the social impacts of the Valdez oil spill on natural resource‐dependent communities. Data on social and subsistence disruption experienced by Alaskan natives are analyzed for two time periods: 1989 and 1990. The results reveal substantial uncertainty and disruption, with indications of changing patterns for long‐term social impacts. The study concludes with recommendations for restoration and recovery suggested from the results of our data analysis and the natural resource community model.

Alaska has the highest accidental death rate in the nation. A five-year study of Alaskan death certificates revealed that accidents accounted for 19% of all deaths and were the most important cause of death. Alaskan natives sustained an accidental death rate over 31/2 times the national rate, while Alaskan non-native rates were only moderately elevated above US mortality. Groups at greatest increased risk of accidental death in Alaska were males, natives, and native children In particular. Principal causes of acci" dental death among non-natives were aircraft and motor vehicle accidents and brownings, while drownings and fires were the most frequent sources of native accident mortality. Lowest accident rates in Alaska occurred in the urban regions of the state, with higher rates in the rural areas, largely attributable to drownings and fires.

(1967). Maze Performance and Personal, Social, and Economic Adjustment of Alaskan Natives. The Journal of Social Psychology: Vol. 73, No. 1, pp. 37-45.

Planners, developers, conservationists, and others have tended to view wetland habitats in Alaska as being "unused." In actuality, wetlands provide the foundation for many Alaska Native subsistence-based economies. Social, cultural, economic, and valuative components of Alaska Native societies are integrated within hunting, gathering, fishing, and trapping activities, providing for a dynamic adaptive system focused on the use of local resources in wetlands. This paper provides comparative examples statewide to demonstrate that rural wetlands in Alaska cannot be assumed to be unused. In fact, the uses of wetland habitats and resources by rural Alaskan Natives are subject to serious threat as a result of changing land status over the past few decades.