As descendants of the indigenous peoples of the United States, American Indians and Alaska Natives (AI/ANs) have experienced a resurgence in population and prospects since the beginning of the twentieth century. Today, tribally affiliated individuals number over two million, distributed across 565 federally recognized tribal communities and countless metropolitan and nonreservation rural areas. Although relatively little evidence is available, the existing data suggest that AI/AN adults and youth suffer a disproportionate burden of mental health problems compared with other Americans. Specifically, clear disparities have emerged for AI/AN substance abuse, posttraumatic stress, violence, and suicide. The rapid expansion of mental health services to AI/AN communities has, however, frequently preceded careful consideration of a variety of questions about critical components of such care, such as the service delivery structure itself, clinical treatment processes, and preventive and rehabilitative program evaluation. As a consequence, the mental health needs of these communities have easily outpaced and overwhelmed the federally funded agency designed to serve these populations, with the Indian Health Service remaining chronically understaffed and underfunded such that elimination of AI/AN mental health disparities is only a distant dream. Although research published during the past decade has substantially improved knowledge about AI/AN mental health problems, far fewer investigations have explored treatment efficacy and outcomes among these culturally diverse peoples. In addition to routine calls for greater clinical and research resources, however, AI/AN community members themselves are increasingly advocating for culturally alternative approaches and opportunities to address their mental health needs on their own terms.

/pdf/american-indian-and-alaska-native-mental-health-diverse-22aoqti9ej.pdf

American Indian and Alaska Native Mental Health: Diverse Perspectives on Enduring Disparities

Over the past decade research examining the human dimensions of climatic change in the Arctic has expanded significantly and has become the dominant framework through which the relations between northern peoples and climatic change are understood by scholars, policy makers, political leaders, and the media. This paper critically examines the assumptions, exclusions, and orientations that characterize this broad literature, and suggests revising and expanding the terms upon which it is carried out. It focuses in particular on the exclusion of colonialism from the study of human vulnerability and adaptation to climatic change, the framing of Indigenous peoples and communities in terms of the local and the traditional, and the ways in which efforts to improve the lives of northern Indigenous peoples risk perpetuating colonial relations. The paper argues that these exclusions and orientations lead scholars to systematically overlook the immense importance of resource extraction and shipping as human dimensions of climatic change in the Canadian Arctic, and it examines the implications of such oversights.

Securing Indigenous politics: A critique of the vulnerability and adaptation approach to the human dimensions of climate change in the Canadian Arctic

Problem/Condition: Suicidal thoughts and behaviors are important public health concerns in the United States. In 2008, a total of 36,035 persons died as a result of suicide, and approximately 666,000 persons visited hospital emergency departments for nonfatal, self-inflicted injuries. State-level data on suicide-related issues are needed to help establish program priorities and to evaluate the effectiveness of suicide prevention strategies. Public health surveillance with timely and consistent exchange of data between data collectors and prevention program implementers allows prevention program practitioners to implement effective prevention and control activities. Reporting Period: January 1, 2008-December 31, 2009. Description of System: The National Survey on Drug Use and Health (NSDUH) is a national- and state-level survey of a representative sample of the civilian, noninstitutionalized U.S. population aged ≥12 years. NSDUH collects data on health-risks related to the use of illicit drugs, alcohol, and tobacco; initiation of substance use; substance use disorders and treatment; health care; and mental health. This report summarizes data on responses to questions concerning suicidal thoughts and behaviors contained in the mental health section among sampled persons aged ≥18 years in all 50 states and the District of Columbia. This report analyzes data on the prevalence of suicidal thoughts, planning, and attempts by age, sex, race/ethnicity, and state from 92,264 respondents in the 2008 and 2009 NSDUH. Results: Prevalence estimates of suicidal thoughts and behaviors varied by sociodemographic factors, region, and state. During 2008-2009, an estimated 8.3 million (annual average) adults aged ≥18 years in the United States (3.7% of the adult U.S. population) reported having suicidal thoughts in the past year. The prevalence of having suicidal thoughts ranged from 2.1% in Georgia to 6.8% in Utah. An estimated 2.2 million (annual average) adults in the United States (1.0% of the adult U.S. population) reported having made suicide plans in the past year. The prevalence of reports of suicide planning ranged from 0.1% in Georgia to 2.8% in Rhode Island. An estimated 1 million (annual average) adults in the United States (0.5% of the U.S. adult population) reported making a suicide attempt in the past year. The prevalence of reports of suicide attempts ranged from 0.1% in Delaware and Georgia to 1.5% in Rhode Island. The prevalence of suicidal thoughts, suicide planning, and suicide attempts was significantly higher among young adults aged 18-29 years than it was among adults aged ≥30 years. The prevalence of suicidal thoughts was significantly higher among females than it was among males, but there was no statistically significant difference for suicide planning or suicide attempts. Interpretation: The findings in this report indicate that substantial variations exist at the regional and state level in the prevalence of adults who had suicidal thoughts, made plans to attempt suicide, and attempted suicide in the past year. Geographic differences in prevalence might be attributable to selective migration, sociodemographic composition of the population, or the local social environment (e.g., social relationship indicators such as divorce rates or resources for access to health care). These findings emphasize the importance of continued surveillance to collect locally relevant data on which to base prevention and control activities. Public Health Action: A better understanding of the patterns of the precursors to suicide is crucial to planning and evaluating a broad spectrum of suicide prevention efforts. These results can be used by state health departments and federal agencies to measure progress toward achieving national and state health objectives (e.g., those outlined in the National Strategy for Suicide Prevention). Continued surveillance is needed to design, implement, and evaluate public health policies and programs that can lead to a reduction in morbidity and mortality related to suicide-related thoughts and behaviors. Possible strategies to implement could include universal strategies (e.g., public education campaigns that focus on improving recognition of suicide risk) and indicated strategies (e.g., cognitive-behavioral therapy) that address the needs of persons exhibiting certain risk factors (e.g., persons who have made suicide attempts). Language: en

Suicidal thoughts and behaviors among adults aged ≥18 years--United States, 2008-2009.

Tundra ecosystems are vulnerable to hydrocarbon development, in part because small-scale, low-intensity disturbances can affect vegetation, permafrost soils, and wildlife out of proportion to their spatial extent. Scaling up to include human residents, tightly integrated arctic social-ecological systems (SESs) are believed similarly susceptible to industrial impacts and climate change. In contrast to northern Alaska and Canada, most terrestrial and aquatic components of West Siberian oil and gas fields are seasonally exploited by migratory herders, hunters, fishers, and domesticated reindeer (Rangifer tarandus L.). Despite anthropogenic fragmentation and transformation of a large proportion of the environment, recent socioeconomic upheaval, and pronounced climate warming, we find the Yamal-Nenets SES highly resilient according to a few key measures. We detail the remarkable extent to which the system has successfully reorganized in response to recent shocks and evaluate the limits of the system's capacity to respond. Our analytical approach combines quantitative methods with participant observation to understand the overall effects of rapid land use and climate change at the level of the entire Yamal system, detect thresholds crossed using surrogates, and identify potential traps. Institutional constraints and drivers were as important as the documented ecological changes. Particularly crucial to success is the unfettered movement of people and animals in space and time, which allows them to alternately avoid or exploit a wide range of natural and anthropogenic habitats. However, expansion of infrastructure, concomitant terrestrial and freshwater ecosystem degradation, climate change, and a massive influx of workers underway present a looming threat to future resilience.

/pdf/high-resilience-in-the-yamal-nenets-social-ecological-system-1ppffdkd5f.pdf

High resilience in the Yamal-Nenets social–ecological system, West Siberian Arctic, Russia

As part of the National Action Alliance for Suicide Prevention’s American Indian and Alaska Native (AI/AN) Task Force, a multidisciplinary group of AI/AN suicide research experts convened to outline pressing issues related to this subfield of suicidology. Suicide disproportionately affects Indigenous peoples, and remote Indigenous communities can offer vital and unique insights with relevance to other rural and marginalized groups. Outcomes from this meeting include identifying the central challenges impeding progress in this subfield and a description of promising research directions to yield practical results. These proposed directions expand the alliance’s prioritized research agenda and offer pathways to advance the field of suicide research in Indigenous communities and beyond.

Advancing Suicide Prevention research with rural American Indian and Alaska Native populations

The social determinants of elevated rates of suicide among Inuit youth

Education in the Canadian arctic : What difference has the nunavut government made?

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The social determinants of elevated rates of suicide among Inuit youth

Education in the Canadian arctic : What difference has the nunavut government made?