FAIRBANKS — In parts of the U.S., a person would be hard pressed to find a grocery store, said Ellen Lopez, a researcher at the Center for Alaska Native Health Research.
Fresh meat, vegetables, fruit, dairy and grains — essentials foods for healthy living — can’t be found for block after block.
“It’s called a food desert,” said Lopez, who is also an assistant professor of psychology at the University of Alaska Fairbanks.
It’s also called a health disparity, she points out. A health disparity is social or economic barrier to good health faced by a certain group of people, and not faced by the majority, according to the Centers for Disease Control. Health disparities are unfair, unjust and avoidable, as well as a matter between life and death, according to a report by the World Health Organization.
The inability to access healthy food is a health disparity for some Alaska Native people, but there are other barriers to good health. Alaska Native people have a high prevalence of cancer and suicide that are also health disparities.
The reasons for this are many and complex, but those who study the issue would say it is mainly because of a change in culture, and its impact on Native people’s lifestyle and their ability to care for themselves and their families.
A person can work hard and overcome health problems, but sheer determination isn’t the ultimate solution, Lopez said. For instance, people can and do eat well and exercise, but because of genetics and environmental factors, they may still develop cancer. To build interventions and foster healthy changes, medical and other scientists need to understand the underlying issues that affect health.
“For me if you’re not studying the root causes of health disparities, or if you focus on health without trying to understand why a group of people may be more at risk for certain health issues, then it’s easy to blame people — and that’s wrong,” Lopez said.
A health disparity can be as simple as a person not being fluent in English, said Monica Skewes, an assistant professor of psychology and behavioral health researcher at CANHR. A language barrier can prevent a person from understanding physician or pharmacist instructions, she said.
“These things really matter,” Skewes said. Most times, health disparities have to do with poverty and social disadvantages, which adds a layer of stress, she said.
Stress affects health, too. This can lead to unhealthy coping behaviors, such as smoking or drinking, she said. Both can cause chemical changes in the brain, making quitting either a difficult task.
“People do these behaviors because it meets a need,” Skewes said. “We have to have empathy and compassion to understand health disparities.”
It also helps to understand what may help a person to stay healthy, despite being at risk, said Bert Boyer, CANHR’s director. CANHR studies show that Alaska Native people who practice a traditional lifestyle appear to be happier and healthier. The Yupiit of Southwestern Alaska who have healthy blood lipids also eat a lot of marine animals, loaded in polyunsaturated fatty acids, he said.
If further studies strongly link those connections, the next step is to construct interventions that have a better chance of working, he said.
The way CANHR does research is different from the past. For CANHR scientists and participants, research means learning from each other. CANHR scientists listen to what Alaska Native people have to say, just has CANHR researchers must explain their work in a way that can be understood, he said.
“It’s our ethical responsibility,” Boyer said.
Lopez hopes her research in cancer survivorship with Alaska Native people might help prevent cancer or help people live a good life if they do get it.
Cancer wasn’t common among Alaska Native people 60 years ago, but now is the No. 1 cause of death. Some Alaska Native people have poor survival rates, as well, and are another health disparity. Understanding the history of what happened to cause these rates is part of the job, she said.
“It takes a long time to overcome inequality,” she said. Doing helpful research with, and not on, Alaska Native people is the key to better understanding the root causes of health disparities. The answers will only come from working together.
Diana Campbell is CANHR’s communication specialist and is a tribal member of the Native Village of Venetie. CANHR is part of UAF’s Institute of Arctic Biology. More information can be found on the web at http://canhr.uaf.edu, www.nimhd.nih.gov or www.who.int/en.