IJCH - COVID-19 in the Arctic: special issue.

The Circumpolar region, comprising the Arctic territories encircling the North Pole, is home to diverse Indigenous cultures facing unique socio-economic challenges. Indigenous communities such as the Inuit, Sámi, Athabaskan, Gwitchin, and Russian Arctic groups exhibit rich traditions and adaptive practices tied to their environments. Environmental diversity, from icy tundra to boreal forests, influences livelihoods and biodiversity, while significant socio-economic disparities persist, impacting access to healthcare, education, and economic opportunities. Against this backdrop, the global COVID-19 pandemic accentuated the intersection of environment, culture, and health in remote Arctic regions, presenting distinct challenges and opportunities. Initiated by a collaborative research project led by Fulbright Arctic Initiative Alumni, this special issue of the International Journal of Circumpolar Health explores the impacts of COVID-19 on Arctic Indigenous and rural communities. Building on previous work and recommendations, the issue features community case studies, highlighting community experiences and collaborative approaches to understand and address the pandemic's effects. The authors highlight both positive and negative societal outcomes, presenting community-driven models and evidence-based practices to inform pan-Arctic collaboration and decision-making in public health emergencies. Through sharing these insights, the special issue aims to privilege local and Indigenous knowledge systems, elevates community responses to complex and multifaceted challenges, and contributes to the evidence base on global pandemic response.

Linking climate and infectious disease trends in the Northern/Arctic Region.

Recognition of climate-sensitive infectious diseases is crucial for mitigating health threats from climate change. Recent studies have reasoned about potential climate sensitivity of diseases in the Northern/Arctic Region, where climate change is particularly pronounced. By linking disease and climate data for this region, we here comprehensively quantify empirical climate-disease relationships. Results show significant relationships of borreliosis, leptospirosis, tick-borne encephalitis (TBE), Puumala virus infection, cryptosporidiosis, and Q fever with climate variables related to temperature and freshwater conditions. These data-driven results are consistent with previous reasoning-based propositions of climate-sensitive infections as increasing threats for humans, with notable exceptions for TBE and leptospirosis. For the latter, the data imply decrease with increasing temperature and precipitation experienced in, and projected for, the Northern/Arctic Region. This study provides significant data-based underpinning for simplified empirical assessments of the risks of several infectious diseases under future climate change.

Ecology of Arctic rabies: 60 years of disease surveillance in the warming climate of northern Canada.

Rabies occurs throughout the Arctic, representing an ongoing public health concern for residents of northern communities. The Arctic fox (Vulpes lagopus) is the main reservoir of the Arctic rabies virus variant, yet little is known about the epidemiology of Arctic rabies, such as the ecological mechanisms driving where and when epizootics in fox populations occur. In this study, we provide the first portrait of the spatio-temporal spread of rabies across northern Canada. We also explore the impact of seasonal and multiannual dynamics in Arctic fox populations and climatic factors on rabies transmission dynamics. We analysed data on rabies cases collected through passive surveillance systems in the Yukon, Northwest Territories, Nunavut, Nunavik and Labrador from 1953 to 2014. In addition, we analysed a large and unique database of trapped foxes tested for rabies in the Northwest Territories and Nunavut from 1974 to 1984 as part of active surveillance studies. Rabies cases occurred in all Arctic regions of Canada and were relatively synchronous among foxes and dogs (Canis familiaris). This study highlights the spread of Arctic rabies virus variant across northern Canada, with contrasting rabies dynamics between different yet connected areas. Population fluctuations of Arctic fox populations could drive rabies transmission dynamics in a complex way across northern Canada. Furthermore, this study suggests different impacts of climate and sea ice cover on the onset of rabies epizootics in northern Canada. These results lay the groundwork for the development of epidemiological models to better predict the spatio-temporal dynamics of rabies occurrence in both wild and domestic carnivores, leading to better estimates of human exposure and transmission risk.

Biogeography and ecology of Ostracoda in the U.S. northern Bering, Chukchi, and Beaufort Seas.

Ostracoda (bivalved Crustacea) comprise a significant part of the benthic meiofauna in the Pacific-Arctic region, including more than 50 species, many with identifiable ecological tolerances. These species hold potential as useful indicators of past and future ecosystem changes. In this study, we examined benthic ostracodes from nearly 300 surface sediment samples, >34,000 specimens, from three regions-the northern Bering, Chukchi and Beaufort Seas-to establish species' ecology and distribution. Samples were collected during various sampling programs from 1970 through 2018 on the continental shelves at 20 to ~100m water depth. Ordination analyses using species' relative frequencies identified six species, Normanicythere leioderma, Sarsicytheridea bradii, Paracyprideis pseudopunctillata, Semicytherura complanata, Schizocythere ikeyai, and Munseyella mananensis, as having diagnostic habitat ranges in bottom water temperatures, salinities, sediment substrates and/or food sources. Species relative abundances and distributions can be used to infer past bottom environmental conditions in sediment archives for paleo-reconstructions and to characterize potential changes in Pacific-Arctic ecosystems in future sampling studies. Statistical analyses further showed ostracode assemblages grouped by the summer water masses influencing the area. Offshore-to-nearshore transects of samples across different water masses showed that complex water mass characteristics, such as bottom temperature, productivity, as well as sediment texture, influenced the relative frequencies of ostracode species over small spatial scales. On the larger biogeographic scale, synoptic ordination analyses showed dominant species-N. leioderma (Bering Sea), P. pseudopunctillata (offshore Chukchi and Beaufort Seas), and S. bradii (all regions)-remained fairly constant over recent decades. However, during 2013-2018, northern Pacific species M. mananensis and S. ikeyai increased in abundance by small but significant proportions in the Chukchi Sea region compared to earlier years. It is yet unclear if these assemblage changes signify a meiofaunal response to changing water mass properties and if this trend will continue in the future. Our new ecological data on ostracode species and biogeography suggest these hypotheses can be tested with future benthic monitoring efforts.

Mercury and neurochemical biomarkers in multiple brain regions of five Arctic marine mammals.

Mercury is a neurotoxic chemical that represents one of the greatest pollution threats to Arctic ecosystem health. Evaluating the direct neurotoxic effects of mercury in free ranging wildlife is challenging, necessitating the use of neurochemical biomarkers to assess potential sub-clinical neurological changes. The objective of this study was to characterize the distribution and speciation of mercury, as well as exposure-associated changes in neurochemistry, across multiple brain regions (n = 10) and marine mammal species (n = 5) that each occupy a trophic niche in the Arctic ecosystem. We found consistent species differences in mean brain and brain region-specific concentrations of total mercury (THg) and methyl mercury (MeHg), with higher concentrations in toothed whales (narwhal, pilot whales and harbour porpoise) compared to fur-bearing mammals (polar bear and ringed seal). Mean THg (µg/g dw) in decreasing rank order was: pilot whale (11.9) > narwhal (7.7) > harbour porpoise (3.6) > polar bear (0.6) > ringed seal (0.2). The higher THg concentrations in toothed whales was associated with a marked reduction in the percentage of MeHg (<40 %) compared to polar bears (>70 %) that had lower brain THg concentrations. This pattern in mercury concentration and speciation corresponded broadly to an overall higher number of mercury-associated neurochemical biomarker correlations in toothed whales. Of the 226 correlations between mercury and neurochemical biomarkers across brain regions, we found 60 (27 %) meaningful relationships (r>0.60 or p < 0.10). We add to the growing weight of evidence that wildlife accumulate mercury in their brains and demonstrate that there is variance in accumulation across species as well as across distinct brain regions, and that some of these exposures may be associated with sub-clinical changes in neurochemistry.

Herd immunity drives the epidemic fadeout of avian cholera in Arctic-nesting seabirds.

Avian cholera, caused by the bacterium Pasteurella multocida, is a common and important infectious disease of wild birds in North America. Between 2005 and 2012, avian cholera caused annual mortality of widely varying magnitudes in Northern common eiders (Somateria mollissima borealis) breeding at the largest colony in the Canadian Arctic, Mitivik Island, Nunavut. Although herd immunity, in which a large proportion of the population acquires immunity to the disease, has been suggested to play a role in epidemic fadeout, immunological studies exploring this hypothesis have been missing. We investigated the role of three potential drivers of fadeout of avian cholera in eiders, including immunity, prevalence of infection, and colony size. Each potential driver was examined in relation to the annual real-time reproductive number (Rt) of P. multocida, previously calculated for eiders at Mitivik Island. Each year, colony size was estimated and eiders were closely monitored, and evaluated for infection and serological status. We demonstrate that acquired immunity approximated using antibody titers to P. multocida in both sexes was likely a key driver for the epidemic fadeout. This study exemplifies the importance of herd immunity in influencing the dynamics and fadeout of epidemics in a wildlife population.

[Traditional nutrition and demography in the Arctic zone of Western Siberia].

High requirements for macro- and micronutrients of the organism of a pregnant woman living in the Far North are associated with the influence of extreme factors of high latitudes, and the needs of the mother and the growing fetus. Only the products of the unique food culture of the Arctic people - the Nenets, make it possible to meet the emerging needs. The aim of the work was to study the impact of traditional nutrition on the reproductive health of Nenets women living in the Arctic zone of Western Siberia. Material and methods. 619 indigenous inhabitants (Nenets) of the Yamal, Nadym and Taz districts of the Yamal-Nenets Autonomous Okrug at the age of 18-65 years were examined. The influence of the type of nutrition (traditional or imported products) on reproductive health indicators (the number of pregnancies, the number of children, the number of spontaneous abortions, frequency of gestosis, threats of termination of pregnancy, operative deliveries) for the period 2013-2018 was studied by analyzing official statistics and by questioning of the female population in own research. Results. The consumption of traditional products (venison, local fishery products, at least 3 times a week) by Nenets women was more often accompanied by a normal physiological course of pregnancy and childbirth (75.2 versus 64.2%, χ2=8.7; p=0.003). It led to a 1.5-fold decrease in the frequency of complications during pregnancy (gestosis, the threat of abortion) (χ2=5.8; p=0.01) and a 20% decrease in the frequency of delivery by cesarean section (χ2=16.6; p<0.001). As a result, a family whose diet was dominated by traditional products had a statistically significantly larger number of children (per child). Conclusion. The preservation of the consumption of reindeer and river fishery products by indigenous women will contribute to the sufficient intake of macro- and micronutrients, that will make it possible to gestate and give birth to a healthier generation of the Nenets society.

Spatiotemporal dynamics of the COVID-19 pandemic in the arctic: early data and emerging trends.

Since February 2020 the COVID-19 pandemic has been unfolding in the Arctic, placing many communities at risk due to remoteness, limited healthcare options, underlying health issues and other compounding factors. Preliminary analysis of available COVID-19 data in the Arctic at the regional (subnational) level suggests that COVID-19 infections and mortality were highly variable, but generally remained below respective national levels. Based on the trends and magnitude of the pandemic through July, we classify Arctic regions into four groups: Iceland, Faroe Islands, Northern Norway, and Northern Finland with elevated early incidence rates, but where strict quarantines and other measures promptly curtailed the pandemic; Northern Sweden and Alaska, where the initial wave of infections persisted amid weak (Sweden) or variable (Alaska) quarantine measures; Northern Russia characterised by the late start and subsequent steep growth of COVID-19 cases and fatalities and multiple outbreaks; and Northern Canada and Greenland with no significant proliferation of the pandemic. Despite limitations in available data, further efforts to track and analyse the pandemic at the pan-Arctic, regional and local scales are crucial. This includes understanding of the COVID-19 patterns, mortality and morbidity, the relationships with public-health conditions, socioeconomic characteristics, policies, and experiences of the Indigenous Peoples. Data used in this paper are available at https://arctic.uni.edu/arctic-covid-19.

Food Sovereignty of the Indigenous Peoples in the Arctic Zone of Western Siberia: Response to COVID-19 Pandemic.

This article presents the challenges facing reindeer herding as being both a profitable business and part of the traditional culture of the nomadic Indigenous peoples in the Arctic zone of Western Siberia which addresses substantial needs of the local population. Reindeer herding products are used as traditional nutrition, and as effective preventive means and remedies for adapting to the cold and geomagnetic activity in the High North. Export trends of traditional reindeer products have decreased local Indigenous peoples' access to venison and had a negative impact on their health. Due to the COVID-19 pandemic, it is especially urgent for the Indigenous peoples to have sufficient access to traditional food and be involved in policy decision-making to maintain this traditional business. We aim to analyze the dependencies of Indigenous peoples on the reindeer produce-exporting "food value chain" and explore how (1) the independence of reindeer herders could be increased in these export chains and (2) how provision of their products to local communities could be secured. The study takes a multidisciplinary approach based on policy and socioeconomic analyses with input from medical research. Primary sources include data collected from interviews and surveys of Indigenous peoples during expeditions to the Nyda settlement, the Nydinskaya tundra, the Tazovsky settlement, the Tazovskaya tundra, the Nakhodka tundra, the Gyda and Gydansky settlements, the Yavai-Salinskaya tundra, the Seyakha settlement, the Seyakhinskaya and Tambeyskaya tundras located along the southern coast of the Ob Bay, the northeast coast of the Yamal Peninsula, the Tazovsky and Gydansky Peninsulas, and the Shuryshkarsky district. Data were collected during the summers and winters of 2014-2020.

Risk of hepatitis B when migrating from low to high endemic areas.

Prevalence of hepatitis B virus (HBV) infections varies markedly with geography and is endemic in the Arctic. Travel and migration have increased markedly while the influence of migration to high endemic areas remains unknown. We surveyed subjects migrating from an area with a low prevalence of chronic HBV infection (Denmark, 0.01%) to an endemic HBV area (West- and East Greenland, 3% and 29%) in order to describe the prevalence of HBV exposure among migrants. We included 198 Caucasian Danes that had migrated to Greenland and repeated the cross-sectional investigation after 10 years. We performed thorough serological testing for HBV. None had ongoing HBV infection. Migrants to East Greenland were more frequently exposed to HBV than those in West Greenland (34.3% vs 10.3%; p < 0.01). This difference was reduced at 10-year follow-up (8.1% vs 5.7%; ns) and the overall number of participants with past HBV infection decreased over the 10-year period from 19.4% to 6.9% (p = 0.02). In conclusion, migration from very low prevalence to endemic HBV areas associated with a markedly increased risk of exposure to HBV. Lack of vaccination among migrants from Denmark to Greenland was frequent and it poses a continuing risk. All who migrate from low to high endemic HBV areas should be vaccinated. ABBREVIATIONS: HBV: Hepatitis B virus; HBV-DNA: Hepatitis B virus deoxyribonucleic acid; HBsAg: Hepatitis B surface antigen; Anti-HBs: Antibodies against hepatitis B surface antigen; Anti-HBc: Antibodies against hepatitis B core antigen; BMI: Body mass index.

Disparities amidst plenty: a health portrait of Indigenous peoples in circumpolar regions.

This paper describes the extent and variation in health disparities between Indigenous and non-Indigenous people within Alaska, Greenland and the northern regions of Canada, Russia and the Nordic countries. We accessed official health statistics and reviewed research studies. We selected a few indicators of health status, health determinants and health care to demonstrate the health disparities that exist. For a large number of health indicators Indigenous people fare worse than non-Indigenous people in the same region or nationally, with the exception of the Sami in the Nordic countries whose health profiles are similar to their non-Sami neighbours. That we were unable to produce a uniform set of indicators applicable to all regions is indicative of the large knowledge gaps that exist. The need for ongoing health monitoring for Indigenous people is most acute for the Sami and Russia, less so for Canada, and least for Alaska, where health data specific to Alaska Natives are generally available. It is difficult to produce an overarching explanatory model for health disparities that is applicable to all regions. We need to seek explanation in the broader political, cultural and societal contexts within which Indigenous people live in their respective regions.

Alcohol in Greenland 1950-2018: consumption, drinking patterns, and consequences.

Alcohol is the single most important public health challenge in Greenland. We provide an overview of alcohol consumption, drinking patterns, and consequences of excessive use of alcohol in Greenland since 1950 through a synthesis of published results and analyses of population-based interview surveys. The import of alcohol fluctuated over the last 70 years with a peak in the 1980s at 22 litres 100% alcohol per person per year. In 1950 and 2015, the import of alcohol was similar at 8 litres. Several explanations have been put forward to explain the changes including restrictions, increased tax, demographic changes, treatment of alcohol disorders, and public health interventions. The proportion of abstainers increased from 1993 to 2018 while the proportion of participants with regular consumption decreased. About half of the population reported binge drinking at least monthly. Compared with Denmark, there were more abstainers and binge drinkers in Greenland, and fewer had a regular consumption. Although genetics may play a role for drinking patterns, social and cultural conditions are more important. Exposure to domestic alcohol problems and sexual abuse in childhood parallel the recorded import of alcohol and is a likely cause of transgenerational consequences such as youth suicides and alcohol problems.

The impact of a national caries strategy in Greenland 10 years after implementation. A failure or a success?

Aims 1) to describe the dental health goals and the single financial goal defined in 2008 with a new national caries strategy in Greenland (CSG) and the progress made during the subsequent 10-year period; 2) to describe the CSG initiatives; and 3) to report caries outcome data for 3-year-old children as well as 9-year-old children in 2012 and 2018; for 6-year-old children as well as 12-year-old children in 2015 and 2018 and for 15-year-old children in 2018, and to compare the data with the baseline data from 2008. Only 6 of the 20 dental health goals were close to being or were achieved over the 10-year period. The total cost of running PDHS-G increased by 4% from 2008 to 2018. The CSG strategy focused on predetermined visits/examinations, risk-related recalls, oral health promotion and predetermined fluoride and sealing policies. The percentage of children with a defs/DMFS = 0 increased by 8-18%, and the mean defs/DMFS decreased by 40-60% between 2008 and 2018 in all five age groups involved. To conclude, the goals defined in 2008 were generally not achieved (failure), but the caries status improved significantly from 2008 to 2018 in all age groups (success).

Recruitment best practices of a cardiovascular risk reduction randomised control trial in rural Alaska Native communities.

Though not native to Alaska, tobacco use is common among Alaska Native people in the Norton Sound region, an area consisting of 16 communities with population size 107 to 3,695. We summarise best practices in recruiting Alaska Native adults who smoke for a randomised controlled tobacco treatment trial. Participants were Alaska Native, 19 years and older, smoking daily, with hypertension and/or high cholesterol, residing in the Norton Sound region of Alaska. Study staff travelled to the remote communities to recruit, typically staying 5 days. Screening and enrolment success was examined by day, season, and staffing level. From June 2015 - December 2018, the study team made 122 trips, screening 1089 individuals and enrolling 314 participants. In the field, days 2-3 (51%) were best for screening, while days 3-4 (53%) had the greatest enrolment. Community size correlated with enrolment (r = 0.83, p <.001). Recruitment was optimised in spring and with multiple staff in the field. Despite challenges (e.g., harsh weather, poor internet connectivity), with active outreach (e.g. tabling in busy areas, attending community events, utilising mixed media, collaborating with clinic staff), the project reached its recruitment goal. Study findings can inform community-based tobacco treatment research trials in remote areas. ABBREVIATIONS: CVD: Cardiovascular disease; VTC: Video teleconferencing; ANMC: Alaska Native Medical Centre; HEALTHH: Healing and Empowering Alaskan Lives Towards Healthy Hearts; NSHC: Norton Sound Health Corporation; RERB: Research Ethics Review Board.

Persistent pain associated with socioeconomic and personal factors in a Sami and Non-Sami population in Norway: an analysis of SAMINOR 2 survey data.

In international studies, higher prevalence of persistent pain has been reported in indigenous populations compared to majority populations. The present study aimed to determine the prevalence of persistent pain within a Sami and a non-Sami population in northern Norway, with adjustment for the confounding factors of age, sex, marital status, education, income, mental health, smoking status and ethnic background. Using SAMINOR 2 survey data including Sami and non-Sami populations, we analysed 5,546 responses, from individuals aged 40-79 years, to questions concerning persistent pain (≥ 3 months). In total, 2,426 (43.7%) participants reported persistent pain with differences between Sami women and non-Sami women (44.1% versus 51.1%, respectively), but none between Sami men and non-Sami men (38.7% versus 38.2%, respectively). Elderly Sami women were less likely to report persistent pain than were elderly non-Sami women. In men, no ethnic differences in pain were observed according to age-group. Marital status, education levels, household income, psychological distress, and smoking status did not influence the association between ethnicity and pain. Pain severity and location did not differ between Sami and non-Sami participants. In this study, we found only minor ethnic differences in persistent pain. Similar living conditions and cultural features may explain these findings.

[Nutritional status of children in rural areas of the Komi Republic and Khanty-Mansi Autonomous Okrug - Yugra by anthropometric data].

A characteristic feature of the "global obesity epidemic" in recent decades is the rapid spread of overweight among the rural population. However, there is a lack of objective data on how this process is unfolding in the northern and Arctic regions of the Russian Federation. The aim of the work was to analyze the prevalence of malnutrition and rates of overweight and obesity in children living in Khanty-Mansi Autonomous Okrug - Yugra (KhMAO) and the Komi Republic (KR). Material and methods. We conducted a study of the nutritional status of rural children in the northern regions of the Russian Federation in 2018-2019. The subjects of the study were children aged 3-17 years of KhMAO, ethnic Khanty, Mansi and of various non-indigenous descent in small remote settlements (n=302) and 956 children in the administrative center of the northern district, a town-type residency. We also examined 7-17-year-old children (n=628) in large settlements of the KR, over 90% of them were ethnic Komi. For each individual, body mass index values (BMI) were calculated. The nutritional status was assessed by comparing the individual BMI with the age and sex specific standards set by the Ministry of Health of the Russian Federation (2017). Results and discussion. 74.4% of children aged 3-6 in KhMAO, and 70% of the 7-17-year-old children of KR and KhMAO meet the standards for their age-sex groups; 6.1% of children aged 3-17 are underweight and 19.5% are overweight. Among the 7-17-year-olds, the ratio of the underweight and overweight (including obese) differs significantly in the settlement dwellers of the KR from that in the living in small settlements of KhMAO (p=0.004), as well as in the group of town residents of KhMAO (p=0.017). The children of the KR have slightly higher percentage of the overweight and obese (26.6 vs 25.7 and 24.8% in the town and settlements of KhMAO, respectively), but significantly lower percentage of those who are underweight (1.9 vs 5.0 and 6.8%). The proportion of obese schoolchildren in small remote settlements of KhMAO is higher than that in the large settlements of KhMAO and in large settlements of the KR (13.1, 7.7 and 9.2%, respectively). Conclusion. There were no differences found between ethnic groups, however the role of social and anthropological factors in the formation of the nutritional status differences between the indigenous and non-indigenous children in Western Siberia calls for further investigation.

Low seasonal variation in greater mouse-eared bat (Myotis myotis) blood parameters.

The greater mouse-eared bat (Myotis myotis) is a flagship species for the protection of hibernation and summer maternity roosts in the Western Palearctic region. A range of pathogenic agents is known to put pressure on populations, including the white-nose syndrome fungus, for which the species shows the highest prevalence and infection intensity of all European bat species. Here, we perform analysis of blood parameters characteristic for the species during its natural annual life cycle in order to establish reference values. Despite sexual dimorphism and some univariate differences, the overall multivariate pattern suggests low seasonal variation with homeostatic mechanisms effectively regulating haematology and blood biochemistry ranges. Overall, the species displayed a high haematocrit and haemoglobin content and high concentration of urea, while blood glucose levels in swarming and hibernating bats ranged from hypo- to normoglycaemic. Unlike blood pH, concentrations of electrolytes were wide ranging. To conclude, baseline data for blood physiology are a useful tool for providing suitable medical care in rescue centres, for studying population health in bats adapting to environmental change, and for understanding bat responses to stressors of conservation and/or zoonotic importance.

From rural to urban living - migration from Sami core areas to cities in Norway. Study design and sample characteristics.

The Indigenous Sami population have inhabited rural northern areas of Norway, Sweden, Finland and the Kola Peninsula in Russia for thousands of years. Today, many Sami live in cities. No large quantitative studies have investigated the health and life of urban Sami in Norway. As a basis for further research, this paper describes the background, methods, participation and sample characteristics of the survey From Rural to Urban Living, conducted in 2014. The unique sampling design is based on internal migration records. Those invited were everyone born 1950-1975 who had relocated from preselected rural Sami core areas to cities in Norway. Their children above the age of 18 were also invited. The paper is descriptive with some basic statistical tests. In total, 2058 (response rate 34%) first-generation and 1168 (response rate 19%) second-generation migrants responded. The response rate was lowest in the younger age groups and among men. One out of three reported Sami background. The education level was in general high. From Rural to Urban Living enables numerous research possibilities within health and social sciences, and may contribute to new insight into the health, culture and identity of the growing Sami population in urban areas of Norway.