Michael Hanifen: Covid reveals broader health disparities that put Alaskans at risk

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Dr. MICHAEL HANIFEN

Despite the promising recent news that those who want the vaccine can get one, Alaska has been seeing a troubling trend. There has been a considerable surge of new cases of the virus in Interior Alaska, leaving healthcare workers concerned for public health more widely in the area.   

Unfortunately, this news reflects a broader trend of health disparities that have torn through Alaska for years. With such a large rural population, many people across our state lack consistent, reliable access to high-quality healthcare, putting many in danger of having serious health problems with nowhere to turn.

In rural areas with less reliable access to internet services, even telehealth isn’t always a viable option. A report released last year by the Centers for Disease Control and Prevention found that one in five American Indians or Alaska Natives were in “fair or poor health,” considerably more than the 12.1 percent average for U.S. adults more broadly.    

Furthermore, data from the Indian Health Service, which is operated by the U.S. Department of Health and Human Services, reveals American Indians and Alaska Natives have a life expectancy of 5.5 years lower than the average for the U.S. population. They also have higher rates of various health conditions including heart disease, diabetes, liver disease, and more.    

Add in the pandemic, and the problems only grow. According to a CDC report issued last summer, American Indians and Alaska Natives had an incidence of confirmed Covid-19 cases 3.5 times higher than other Americans. These communities were also at higher risk for serious health problems due to the coronavirus pandemic, amplifying the broader inconsistencies at work that must be addressed.   

Finally, reining in these health concerns will be a daunting task that requires action from more than just state or federal governments. Thankfully, many companies and nonprofits are stepping up to tackle the issues of both rural health among Native American Indian and Alaska Native populations.    

For example, the Department of Veterans Affairs recently partnered with Veterans of Foreign Wars, the American Legion, and Philips North America to create a program called Accessing Telehealth through Local Area Stations (ATLAS). This program helps to bring telehealth options directly to veterans – many of whom live in rural parts of Alaska and other states – directly at their closest VFW or American Legion posts. That way, they don’t have to worry about being unable to use home telehealth options and can avoid extensive travel.   

In another public-private partnership that saw a high level of success, the IHS partnered with Philips and eHealth Initiative to create a series of webinars on Native Americans’ health during the pandemic. Now, Philips is also partnering with the Health Equity, Action & Leadership Initiative, which provides fellows who spend two years working and learning from hospitals in Native American communities.   

The inconsistencies that pervade the American healthcare system will not be dispatched overnight, and the success of efforts to bring them to an end will depend on support from local and federal lawmakers.

Our lawmakers should be doing what they can to expand public-private partnerships like those that (ATLAS)  is spearheading. Given that these issues affect Alaskans poignantly and uniquely, I encourage Senators Lisa Murkowski and Dan Sullivan and Congressman Don Young to help support both public and private projects to create and sustain a more equitable consistent health system for all Alaskans. 

Dr. Michael Hanifen is owner and president of North Star Chiropractic Wellness Center, LLC. 

11 COMMENTS

  1. I do not see anything discussed here that rises to the largest health care problems in AK. The biggest problem is that government pays for so much of the health care here (so consumers don’t care about the cost) that many specific therapies cost 70 to 100 percent more than in Seattle. That drives costs up for businesses and for government, and it’s indefensible. The biggest problem in rural Alaska is that the tribal roles are closed based upon race (racism, really) so rural people who are not 1/32 by blood or part of a recognized tribe are screwed. It’s Medicaid or punt for rural non-Natives. Another problem is the lackluster medical performance compared with Virginia Mason, Swedish and other alternatives. You cannot have breakfast in the Virginia Mason restaurant without running into many Alaskans. There are solutions to these problems. Health care payers need to allow and encourage that patients go to Seattle and Portland. Our delegation to Congress need to demand that the tribal roles be open to Alaskans who have been here for generations. Many SE Filipinos have successfully converted to being recognized as Native, for instance. And governments and nonprofits need to publish data that reveals health outcome disparities between Alaska providers and the Lower 48. I know this will work (or at least the industry thinks it will) because I have observed that if a state official champions one or more of these improvements the Alaska health care industry hires her/him at triple the state salary. Finally, take a look at what the Alaska health care industry spends on lobbying in Juneau.

  2. Dr Hanifen, you state the stats well, but you are not asking the “Why?” question. You need to dig deeper. For starters: Why is there such a high suicide rate in the Bush? Why is the murder rate so high? The disappeared? Domestic violence? Alcoholism? My village has a health aide, and the care is quite good. But a medevac flight is an hour and a half away. The problem is not “disparities”, but simply distance. More programs won’t solve them.

  3. The following statement made by Dr. Hanifen is false. “There has been a considerable surge of new cases of the virus in Interior Alaska,”.

    Recommendations for new programs based on false claims are sketchy. I’m not against public & private initiatives to provide rural health services, and the ATLAS program is one way the VA might be streamlining services, but new expenditures by the government must not be based on hyped false data just to snag federal covid money. Long term programs must be funded by sustainable well thought out partnerships. A quick review of various public and private program reveals some successes but other failures.

    It is also doubtful that temporary physicians will be able to integrate well enough into the rural communities to affect the percentage of vaccine hesitancy. Tribal organizations and village leaders are best suited for that effort.

    Cases are lower in interior Alaska and Fairbanks. The highest case rates and alerts are in western Alaska and southeast, with intermediate levels in the Arctic. The vaccine distribution was successful in all of these rural areas.

    Fairbanks and the interior are at low alert levels. Please review the data hub by DHSS.

  4. Plenty of dollars going for native health in Alaska. If they don’t have it maybe it’s cause they don’t want it!!

  5. Why would anyone want to partner with an entity that is 40 trillion dollars in debt? That should give you a hint at how well they do things. Unless it involves stealing your money.

  6. So roughly how much more in taxpayers’ earnings should be thrown at expanding what are already terribly expensive and in some cases race-based government programs to ensure the equal outcomes you’re mewling for, Dr. Hanifen?

    And given your profession, would you care to weigh in with how might you stand to personally benefit from government reaching further into the pockets and purses of the productive?

  7. Vaccine,” a substance used to stimulate the production of antibodies and provide immunity against one or several diseases.” Is this what the Covid-19 shot is? I am informed that it doesn’t do any of the above and is actually a “treatment”, so why call it a vaccine? Why not call it what it is, an “Experimental Treatment”. BTW, vaccines go through stringent clinical trials that can last up to 10 years before they are released into the public realm. Yet here we see something rushed into prescription to stop a disease that kills less than .5% of those that contact Covid-19? People are being pressured to take an experimental shot that has to date killed over 5000 people in the U.S. alone, much less world wide. Despite what the Chiropractor author of this article says some of us do not see the efficacy of taking an Experimental Treatment masquerading as a “vaccine”. So much for government helping provide healthcare for Alaskans. You would be better off calling up the Shaman and breaking out the Bear Gall and Devils Club.

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