Arja Rautio

Social determinants of health (SDHs) and the impact of colonization can make Canadian Arctic Indigenous communities susceptible to infectious diseases, including the coronavirus disease 2019 (COVID-19). This scoping review followed the PRISMA guidelines for scoping reviews and studied what is known about selected pandemics (COVID-19, tuberculosis, and H1N1 influenza) and SDHs (healthcare accessibility, food insecurity, mental health, cultural continuity, housing, community infrastructure, and socioeconomic status (SES)) for Canadian Arctic Indigenous communities. Original studies published in English and French up to October 2024 were located in databases (PubMed, Medline, and CINAHL), AlterNative: An International Journal of Indigenous Peoples, and through reference tracking. We included 118 studies: 6 relating to COVID-19, 5 to influenza, 5 to TB, 27 to food insecurity, 26 to healthcare access, 22 to mental health, 9 to SES, 8 to housing, 7 to cultural continuity, and 3 to community infrastructure. SDHs affecting Indigenous individuals include food insecurity, limited healthcare access, mental health challenges, low SES, suboptimal housing, and limited cultural continuity. These findings are relevant to other Arctic regions. It is crucial to understand how SDHs impact the health of Arctic communities and to utilize this information to inform policy and practice decisions for pandemic prevention, management, and treatment. Many SDHs pose challenges for preventing and managing infectious diseases.

There is growing awareness and recognition of the importance of the One Health paradigm to address existing environmental threats and recognise emerging ones at an early stage among Arctic residents, public health agencies, and wildlife resource managers. The One Health approach, emphasising the interconnectedness of human, animal, and ecosystem health, plays a pivotal role in addressing these multifaceted issues. Warming climate and permafrost thaw may influence both contaminant exposure and the spread of zoonotic infectious diseases and have impacts on water and food security. Migration from rural regions to larger communities and urban centres along with increased tourism may be accompanied by changes in exposure to contaminants and zoonotic diseases. Universities have developed educational programmes and research projects on One Health in the Arctic, and under the Arctic Council there is running a project of One Arctic, One Health. These arctivities have produced interdisciplinary information and practical solutions for local communities, decision-makers, and in scientific forums. There is a need for epidemiological zoonotic/human disease models, as well as new approaches to integrate existing and future surveillance data to climatic and environmental data. This requires not only regional and international collaboration but also multi-agency and transdisciplinary research.

This paper presents the results of a multidisciplinary study with the aim of assessing the potential combined risk from consuming locally harvested food products in the Euro-Arctic region of Norway, Finland, and Russia. The three important contaminant groups—radioactive substances, heavy metals, and persistent organic pollutants (POPs)—were measured in food samples such as berries, mushrooms, fish, birds, reindeer, and moose; they were sampled in 2013–2015. To assess the combined pollution levels and investigate the trends, similarities, and variations between different contaminant groups, subsequent multivariate statistical analysis was performed. The results showed that, in general, the levels of radioactive substances, toxic elements, and POPs were below the permitted EU maximum content in food products. However, statistical analysis revealed some correlations, similarities, and peculiarities between the accumulation of different contaminants in various species, which allowed for a better understanding of the mechanisms of accumulation and interaction between different contaminant groups. It also gave a better insight into the possible added risks and helped pinpoint species that could serve as reference markers for the accumulation of different contaminants in food. Mushrooms, fish, and reindeer were found to be important markers in the combined risk assessments for the contents of metals and radioactive substances. Further research, as well as the development of methodologies for combined assessments, are recommended.

One Health, a multidisciplinary approach to public health, which integrates human, animal, and environmental studies, is prudent for circumpolar Arctic health research. The objective of our bibliometric review was to identify and compare research in select infectious diseases in Arctic wildlife species with importance to human health indexed in English language databases (PubMed, Scopus) and the Russian database eLibrary.ru. Included articles (in English and Russian languages) needed to meet the following criteria: (1) data comes from the Arctic, (2) articles report original research or surveillance reports, (3) articles were published between 1990 and 2018, and (4) research relates to naturally occurring infections. Of the included articles (total n = 352), most were from Russia (n = 131, 37%), Norway (n = 58, 16%), Canada (n = 39, 11%), and Alaska (n = 39, 11%). Frequently reported infectious agents among selected mammals were Trichinella spp. (n = 39), Brucella spp. (n = 25), rabies virus (n = 11), Echinococcus spp. (n = 10), and Francisella tularensis (n = 9). There were 25 articles on anthrax in eLibrary.ru, while there were none in the other two databases. We identified future directions where opportunities for further research, collaboration, systematic reviews, or monitoring programs are possible and needed.

Climate warming in Arctic Canada, e.g., permafrost thaw, comprehensively impacts biota and the environment, which then affects the lives of people. This study aimed to investigate which perceived environmental and adaptation factors relate to self-rated well-being, quality of life, satisfaction with life (sum variable = life balance), self-rated health, and feeling of empowerment to face the changes related to permafrost thaw. The study sample was collected from one community using a questionnaire (n = 53) and analyzed by cross-tabulation. Results indicated that most participants had at least good well-being, quality of life, satisfaction with life, and a medium level of health, and over 40% assessed being empowered to face the changes related to permafrost thaw. Problems and challenges associated with permafrost thaw, e.g., health, traditional lifeways, and infrastructure, were recognized; these had impacts on life balance, feeling of empowerment, and self-rated health. Traditional knowledge regarding adaptation to face changes was seen as important. More adaptation actions from the individual to global level seemed to be needed. This study provides an overview of the situation in one area, but more research, with a larger study sample, should be conducted to achieve a deeper understanding of climate-related impacts on life and holistic well-being.

Older people and their families were particularly affected during the COVID-19 pandemic in 2020, but not much is known about the context of the Arctic regions of Russia. In this study, we identified the changes in family care before and during the pandemic using a questionnaire for the informal caregivers of older people. We investigated how and to what extent the pandemic has affected the relationships between caregiver and older person, and how the mental and physical health of older people and caregivers were affected by self-isolation in the Arkhangelsk region of Russia. The pandemic has changed the contribution of care from various actors: the share of care by charities, churches, and other aid agencies increased, while that of municipal services decreased. Sixteen percent of female and forty percent of male caregivers informed the study that COVID-19-related restrictions led to deterioration in the health of older people cared for at home. Family caregivers’ own health worsened, especially mental health: 28% of caregivers reported aggravated stress during the COVID-19 pandemic and expressed various fears. Our data show that the main resources in overcoming the period of self-isolation have been telephone communication, personal contact, reading/music, friends, as well as the help of social services and maintaining a positive attitude.

Climate change is a global challenge which has direct and indirect health impacts on the lives of people and communities in the Arctic. The aim of our study was to evaluate the perception of permafrost thaw and health challenges and to determine which perceived environmental and adaptation factors relate to self-rated health and, more specifically, to feeling of empowerment when facing the changes and impacts of climate change and permafrost thawing. Questionnaire data (n = 100) were collected from one community located in Greenland, Disko Bay. Data were analyzed by cross-tabulation and the significances were tested either by Pearson’s χ² test, Fisher’s exact test or by the t-test, when applicable. Based on these analyses, logistic and linear regression analyses were used to evaluate the associations between demographic variables, challenges posed by permafrost thaw and self-rated health, and associations between feeling of empowerment and perceived environmental/adaptation factors. The results indicated that climate change was not assessed as being a direct risk for the health of local people or their feeling of empowerment. Nature seemed to play an important role for local people, and not being in the natural environment for recreational activities seemed to decrease feeling of empowerment (OR 0.42, p = 0.042, 95% CI 0.17–0.97). This paper provides new, multidisciplinary research information about the perception of health challenges, health, and feeling of empowerment among people living in an environment impacted by permafrost thaw and climate change.

Thawing permafrost creates risks to the environment, economy and culture in Arctic coastal communities. Identification of these risks and the inclusion of the societal context and the relevant stakeholder involvement is crucial in risk management and for future sustainability, yet the dual dimensions of risk and risk perception is often ignored in conceptual risk frameworks. In this paper we present a risk framework for Arctic coastal communities. Our framework builds on the notion of the dual dimensions of risk, as both physically and socially constructed, and it places risk perception and the coproduction of risk management with local stakeholders as central components into the model. Central to our framework is the importance of multidisciplinary collaboration. A conceptual model and processual framework with a description of successive steps is developed to facilitate the identification of risks of thawing permafrost in a collaboration between local communities and scientists. Our conceptual framework motivates coproduction of risk management with locals in the identification of these risks from permafrost thaw and the development of adaptation and mitigation strategies.