Transcript Anchorage in Alaska

Communicable Diseases
Alan J. Parkinson, Deputy Director
Arctic Investigations Program, Centers for
Disease Control & Prevention, USA
Arctic Investigations Program
Mission
• Prevention of
morbidity &
mortality in Arctic
and sub-Arctic
populations
• Focus on indigenous
peoples
• Focus on infectious
diseases
The US Arctic (Alaska)
Total Population 614,180
Alaska Native
/American Indian 120,494
22 tribal health organizations
176 health aid clinics
24 health centers
7 regional hospitals
1 tertiary care hospital
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246 tribal governments
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Anchorage 266,155 of which
36,148 are Alaska Native
Challenges to Health &
Wellness-Alaska Natives
• Health impacts of:
– Environmental contaminants
• Impact on the traditional food supply
– Rapid economic change and
modernization-“the modern
diseases”
•
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Obesity
Diabetes
Cancer
Suicides
Cardiovascular diseases
– Climate change
Challenges to Health &
Wellness-Alaska Natives
• Health Disparities
– Life expectancy 64.9 years vs 76.7
years for US
– Unintentional injury mortality 3.3 times
US rate
– Suicide 4.2 times rate for US all races
– Cancer mortality is 1.5 times US all
races
– Infant mortality 8.7/1000 vs 7.2/1000
for US
– Higher rates of some infectious
diseases:
Challenges to Health &
Wellness-Alaska
• Health Disparities-Infectious Diseases
– Invasive bacterial diseases
(pneumonia; meningitis)
– Tuberculosis
– Influenza and other respiratory
viruses
– Infections resistant to antimicrobials
– Food borne diseases
– Parasitic diseases
– Some sexually transmitted infections
HIV-Alaska
• Rates of HIV and AIDS diagnosed
in Alaska in Alaska residents
Alaska are lower than are found
in the rest of the US.
– HIV 5.1 vs 20.7/100,000
– AIDS 1.9 vs 14.1/100,000
HIV affected people in all racial and
ethnic groups. (1982-2005)
HIV affected
Alaska Population
Tuberculosis-Alaska
Incidence compared to General US Population
Cases/100,000
20
15
10
5
0
Year
Tuberculosis-Alaska
Age of persons with TB: Alaska and the US
Tuberculosis-Alaska
Racial Demographics
Tuberculosis-Alaska
Incidence by Region
Northern
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Anchorage
Mat-Su SE
Gulf Coast
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Infectious Disease ChallengesAlaska
• Geography
– Sparse population, large area, few roads
– Climate
• Poverty
– Household crowding
– Lack of adequate sanitation services
• High prevalence of some infectious
diseases
– Invasive Bacterial Diseases, Respiratory
Diseases, TB, STI’s
• Public Health Capacity
– Staffing remote sites, training
Opportunities
• Well established public health infrastructures
– disease surveillance, prevention programs
• Linkage with national public health/research
organizations
– International Union for Circumpolar Health
• Arctic Cooperation
– Arctic Council
• AMAP
• SDWG
– Existing Multi National Cooperatives in infectious
disease control
• US/Canada
• Nordic/Russian Federation
• EU networks (EARSS, ENTERNET EU Surveillance)
• WHO
• ECDC
• NDPHS
International Circumpolar
Surveillance of Infectious Diseases
International Circumpolar Surveillance
Arctic Council
Sustainable Development Working Group
Steering Committee
Working Groups
Surveillance
Invasive Bacterial Disease (US lead)
Tuberculosis (Canada lead)
Birth Defects (Canada lead)
Others?
Climate Sensitive Infectious Disease
Injuries
Research
Viral Hepatitis (Denmark)
Helicobacter pylori (US lead)
Other ?
STI’s
International Circumpolar
Surveillance
• Is an integrated, collaborative, network of
hospital, public health, and reference
laboratories throughout the Arctic
• Collects standardize laboratory and
epidemiological data
• Monitors priority disease rates & trends
• Identifies risk factors for disease
• Identifies and evaluate potential intervention
strategies
– Vaccines
– Risk factor reduction
• Monitors effectiveness of the intervention for
sustained prevention & control.
Thank you!
Contact Information:
Alan J. Parkinson, Ph.D
Deputy Director
Arctic Investigations Program, Centers for
Disease Control & Prevention,
Anchorage, Alaska, USA
907 729 3407
[email protected]
Characteristics of HIV with and
without AIDS cases 1982-2007
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Total Cases 1206
974 (81%) male
700 (58%) white
Median age 34 (range 1-75years)
Exposure Category MSM
849 (70%) had Dx AIDS
417 (35% died
727 had first Dx in Alaska