Social and Physical Determinants of Circumpolar Health: A Meta-analysis

David Driscoll, Ph.D., M.P.H., M.A. and Bruce Dotterrer, M.S.

Investigations in the growing field of population health research can highlight key social and physical determinants of health disparities and provide metrics for process and outcome evaluation of programs to mitigate those disparities. The ICHS conducted a meta-analysis of secondary literature assessing associations between specific health determinants and outcomes in Alaska and other circumpolar populations and organized these studies by research methodology. Research articles were screened for inclusion if they were reported in English, no earlier than 1999, by a peer-reviewed journal, and represented original and region-specific research. Over 3,000 articles were reviewed and 52 studies were identified as providing rigorous assessments of specific social or physical determinants of Arctic population health.

Seven distinct health determinants were identified in the review: addiction, social isolation, environmental exposures, diet/nutrition, global climate change, access to clean water and access to quality health care. Addiction was related to every leading cause of death in Alaska (except for Alzheimer's disease) during the last 10 years. Other determinants such as environmental exposures -- associated with four of the top five leading causes of death -- and diet/nutrition were also frequently represented in the review. The downstream effects of these determinants, preventable health outcomes such as respiratory diseases and suicide, comprised more than half (52 percent) of the outcomes identified in the review.

The results of the meta-analysis indicate that a need exists for population health promotion interventions in addiction, diet/nutrition, and environmental exposures.

Download a PDF of the presentation Driscoll gave at the 27th Annual Alaska Health Summit Dec. 7, 2009.

The Institute for Circumpolar Health Studies was created by the Alaska State Legislature in 1988 (AS 14.40.088) to develop new solutions to health problems in Alaska and the North. The Institute provides support and coordination for health research, information and training. Working closely with faculty throughout the University of Alaska system, ICHS provides technical assistance and support to increase the capacity within the state to address the health needs of all Alaskans. ICHS also encourages student involvement through academic course work, internships, and research assistantships.

Rosemary Shinohara of the Anchorage Daily News wrote a story about this study which was published March 14. Read it here.