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Health of Indigenous Circumpolar Populations

October 2013
Annual Review of Anthropology 42(1):69-87

DOI:10.1146/annurev-anthro-092412-155517

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Indigenous circumpolar populations have experienced profound transitions in lifeways over the past half-century as a result of economic development. Although there have been positive aspects of this social transformation, most circumpolar groups today have a triple burden of disease, with a modestly elevated infectious disease level, an elevated and increasing burden of chronic conditions such as obesity and cardiovascular disease, and high rates of mental health-related challenges. The health of contemporary circumpolar populations is not easily characterized because of dramatic regional differences that stem from socioeconomic disparities among nonindigenous groups, individual population histories, lifestyle factors, environmental pollution, and underlying biological variation. Overall health and well-being range from excellent among the Sami of Sweden and Norway to extremely poor among marginalized native populations in northern Russia. Circumpolar groups today are not only threatened by continued regional economic development and pollution, but also uniquely vulnerable to global climate change.

Map of the Arctic showing key countries, regions, or political units within countries (green text) and selected indigenous circumpolar populations (black text). Locations are approximate and do not accurately show population overlap or full geographic distribution. Modified from Arctic Ocean Relief Map by Uwe Dedering through Wikimedia Commons (original available from http://commons.wikimedia.org/wiki/File:Arctic_Ocean_relief_location_map.png).

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AN42CH05-Snodgrass ARI 18 September 2013 14:43

Health of Indigenous

Circumpolar Populations

J. Josh Snodgrass

Department of Anthropology, University of Oregon, Eugene, Oregon 97403;

email: jjosh@uoregon.edu

Annu. Rev. Anthropol. 2013. 42:69–87

First published online as a Review in Advance on

August 19, 2013

The Annual Review of Anthropology is online at

anthro.annualreviews.org

This article’s doi:

10.1146/annurev-anthro-092412-155517

2013 by Annual Reviews.

Keywords

Arctic, human biology, nutrition transition, biocultural, climate change

Abstract

Indigenous circumpolar populations have experienced profound transitions

in lifeways over the past half-century as a result of economic development.

Although there have been positive aspects of this social transformation, most

circumpolar groups today have a triple burden of disease, with a modestly el-

evated infectious disease level, an elevated and increasing burden of chronic

conditions such as obesity and cardiovascular disease, and high rates of men-

tal health–related challenges. The health of contemporary circumpolar pop-

ulations is not easily characterized because of dramatic regional differences

that stem from socioeconomic disparities among nonindigenous groups, in-

dividual population histories, lifestyle factors, environmental pollution, and

underlying biological variation. Overall health and well-being range from

excellent among the Sami of Sweden and Norway to extremely poor among

marginalized native populations in northern Russia. Circumpolar groups to-

day are not only threatened by continued regional economic development

and pollution, but also uniquely vulnerable to global climate change.

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Further

ANNUAL

REVIEWS

AN42CH05-Snodgrass ARI 18 September 2013 14:43

Persistent organic

pollutant (POP):

an organic compound

from industrial

processes [e.g.,

polychlorinated

biphenyls (PCBs)] that

resists degradation and

can have human health

effects

INTRODUCTION

The health of northern populations varies considerably, an unsurprising fact given the enor-

mity of the circumpolar region (17 million km2), its ﬁve major areas (Alaska, northern Canada,

Greenland, Scandinavia, and northern Russia), and a population of nearly 10 million residents

(Chatwood et al. 2012). This collective circumpolar population is characterized by its diversity

and includes an array of indigenous groups (several dozen representing seven language fami-

lies) and a considerable number of recent migrants to the region (Young & Bjerregaard 2008b).

Furthermore, circumpolar natives vary, from constituting a small minority of the total regional

population (e.g., <1% in Scandinavia) to a near complete majority (e.g., ∼90% in Greenland),

and the Inuit and several other native northern groups have territories that extend across multi-

ple nations (Young & Bjerregaard 2008b, Young 2012). One prominent circumpolar researcher

encapsulated this extreme heterogeneity by comparing the lifeways and health of an Inuit hunter,

a Russian mine worker, and a Norwegian schoolteacher (see Chatwood et al. 2011). Thus, sum-

marizing the health of circumpolar populations is an immense challenge, and consequently, no

review can be truly comprehensive and without critical omissions.

Here, I review the health of circumpolar populations. I begin with an introduction to the

circumpolar region, describing the diverse array of northern environments inhabited by humans,

as well as the cultural and biological adaptations they use to cope with severe climatic and ecological

challenges. I then focus attention on circumpolar peoples, organizing the discussion by region and

concentrating on the indigenous groups for which health data are most available. Next follows

a section on patterns of indigenous circumpolar health and key factors such as diet, physical

activity, and pollution that shape these health outcomes. I then highlight issues of Arctic health

disparities and the risks of global climate change before concluding with a discussion of how

anthropology provides a powerful approach through which to unravel the complex interactions

among environmental exposure, social factors, and underlying genetic susceptibility in shaping

the health of northern populations.

THE CIRCUMPOLAR ENVIRONMENT

Deﬁning “circumpolar” is a surprisingly difﬁcult task because one can delineate the region and

people on the basis of latitude, temperature, permafrost boundaries, political divisions, or demo-

graphics. Here, “circumpolar” refers to Arctic (above ∼66.5◦N) and subarctic (55–66.5◦N) areas;

the terms northern, high-latitude, and Arctic are used synonymously. Given the absence of native

groups at the southern pole, the present review focuses on contemporary northern populations

(Figure 1).

The physical and biological environments in circumpolar regions are diverse and include tem-

perate rainforest, boreal forest (taiga), tundra, and polar desert (Young 2012). A recurring mis-

conception by outsiders is that the Arctic is untouched and pristine; instead, this region has

experienced rapid economic development over the past half-century and has also endured the

effects of environmental contaminants such as persistent organic pollutants (POPs) and heavy

metals (Bjerregaard et al. 2004, 2008; Donaldson et al. 2010). Furthermore, circumpolar regions

are currently experiencing rapid glacial and sea ice melting and decreased permafrost as a result

of global climate change (Anisimov et al. 2007, IPCC 2007).

Circumpolar environments provide a unique set of challenges to human populations, including

prolonged and severe cold stress with average monthly temperatures that can, in certain regions,

drop to −40◦C(−40◦F) (Snodgrass et al. 2007). This type of extreme temperature exposes pop-

ulations to acute cold injuries (e.g., hypothermia and frostbite) and to an increased mortality

70 Snodgrass

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AN42CH05-Snodgrass ARI 18 September 2013 14:43

Arctic Ocean

Alaska (USA)

Canada

Greenland

(Denmark)

Russian Federation

Central Siberia

Eastern Siberia

Chukotka

Labrador

Northwest

Territories

Nunavut

Finland

Norway

Sweden

Denmark

Iceland

Khanty

Mansi

Sami

Nenet

Ket

Yakut (Sakha)

Inuit

(Yup’ik)

Inuit

(Inupiat)

Inuit

Dene/

Athabascan

Yukagir

Even

Chukchi

Aleut

Buryat

Evenki

Nganasan

Pacic Ocean

Atlantic Ocean

Figure 1

Map of the Arctic showing key countries, regions, or political units within countries ( green text) and selected

indigenous circumpolar populations (black text). Locations are approximate and do not accurately show

population overlap or full geographic distribution. Modiﬁed from Arctic Ocean Relief Map by Uwe

Dedering through Wikimedia Commons (original available from http://commons.wikimedia.org/wiki/

File:Arctic_Ocean_relief_location_map.png).

Basal metabolic rate

(BMR): the minimum

energy expenditure

required to maintain

respiration,

circulation, body

temperature, and other

basic somatic functions

risk from respiratory infections and cardiovascular events (M¨

akinen & Rytk ¨

onen 2008, Revich &

Shaposhnikov 2010, Young & M¨

akinen 2010). In addition, northern environments are profoundly

seasonal with extreme variation in photoperiod, they have only sparse vegetation, and the overall

energy availability in these ecosystems is low (Snodgrass et al. 2007, Snodgrass 2012).

Northern populations use a variety of cultural and behavioral adaptive strategies to survive in

circumpolar environments, including tailored clothing and seasonal migratory patterns (Snodgrass

et al. 2007). Indigenous northern groups also utilize several biological adaptations to the cold,

including body size and proportions that minimize heat loss, upregulated basal metabolic rate

(BMR), and vascular responses that conserve heat and preserve functionality (Rode & Shephard

1995; Leonard et al. 2005; Snodgrass et al. 2005, 2007; Leonard & Katzmarzyk 2010). These

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Holocene: the

current geologic time

period (epoch), which

began ∼12,000 years

ago at the termination

of the Pleistocene

biological adaptations appear to consist of a mixture of functional acclimatizational responses and

genetic adaptations (Snodgrass et al. 2007, Beall et al. 2012).

CIRCUMPOLAR PEOPLES

Modern humans ﬁrst permanently settled circumpolar environments only within the past

20,000 years, expanding initially into northern Eurasia and then later to North America and

Greenland (Hoffecker 2005, Snodgrass et al. 2007). The Arctic was not fully settled until the

Holocene; the development of maritime economies and range expansion seen in many contem-

porary indigenous northern groups such as the Inuit occurred only within the past few thousand

years.

Indigenous Arctic populations are immensely diverse. Groups native to the north range in size

from very small (e.g., Ket of central Siberia with ∼1,500 people; Kozlov et al. 2007) to more

numerous populations such as the Inuit (∼165,000 people; Bjerregaard & Young 2008) to very

large groups such as the Yakut (∼440,000 people; Kozlov et al. 2007). Although all groups specialize

to a certain extent in the harvesting of animal resources, traditional subsistence economies vary and

include maritime hunting, taiga hunting and ﬁshing, and the herding of reindeer, horse, and/or

cattle (Cordain et al. 2000, Young 2012). Because a comprehensive discussion of indigenous

circumpolar groups is beyond the scope of this review, the following discussion provides details

on several groups for which health data are available.

Alaska

Administratively part of the United States, Alaska is an enormous (∼1.5 million km2) yet sparsely

populated state with a total population of approximately 650,000 (Young & Bjerregaard 2008b).

The indigenous population of Alaska (collectively termed Alaska Natives) constitutes nearly 20%

of the population and consists of Inuit (sometimes called “Eskimo”), American Indian, and Aleut

(Berner 2008). Although early Russians and Americans inﬂuenced Alaska’s development beginning

in the eighteenth century, it was not until the mid-twentieth century that Alaska experienced

substantial economic development and industrialization (Young 2012). Most Alaska Natives today

reside in small, remote communities.

Inuit are the direct descendants of the Thule, a group of specialized whale hunters that emerged

from the Bering sea coast ∼2,000 years ago. The Thule then spread eastward and later transformed

into the Inuit ∼500 years ago (Hoffecker 2005). Traditional Inuit subsistence broadened to include

focus on caribou and smaller marine mammals (Bjerregaard & Young 2008). Most Inuit today still

rely on subsistence ﬁshing, hunting, and gathering. At present, Inuit in Alaska number ∼47,000

and are composed of two major groups, the Inupiat and the Yup’ik (Berner 2008). The closely

related Siberian Yup’ik (Yuit) are found on Russia’s Chukchi Peninsula.

Northern Canada

Northern Canada includes the Nunavut, Yukon, and Northwest Territories, which together

comprise ∼40% of Canada (3.8 million km2) (Young & Bjerregaard 2008b). Population density

is extremely low, and the total population of this region is ∼50% indigenous. Two other

regions—Nunavik in northern Quebec and Labrador—are often considered part of northern

Canada. Northern Canada was relatively isolated until the mid-twentieth century, but economic

development and urbanization (primarily connected to mining activities) began to accelerate in

the 1950s. Northern Canada is home to several indigenous groups, including Inuit, Dene First

Nations groups, and M´

etis (a group deﬁned by mixed First Nations and European heritage)

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(Young 2008a,b). The total Canadian Inuit population is ∼51,000 people, of which the largest

population concentration is in Nunavut (∼22,000) (Young & Bjerregaard 2008b).

Greenland

Greenland is enormous in area (>2 million km2) but has a total population of only ∼57,000

people (Bjerregaard & Stensgaard 2008). Although politically part of Denmark, Greenland has

considerable political autonomy but relies on substantial subsidies from Denmark. Greenland did

experience some development in the early twentieth century, but it was not until the past 50 years

that it experienced major social and economic transformations.

Greenland Inuit, known as kalaallit, comprise ∼90% of Greenland’s population (Bjerregaard

& Stensgaard 2008). Elements of Greenland Inuit culture are unique and come from extensive

connections with European societies. They do, however, have close genetic and linguistic ties with

the Inuit population in North America. The traditional diet was based on a maritime economy

focused on ﬁsh and marine mammals.

Scandinavia

Scandinavia, which includes the Nordic countries of Norway, Sweden, and Finland, has a total

combined population of nearly 19 million (Hassler et al. 2008b, Young & Bjerregaard 2008b).

The total land area is ∼1.1 million km2of which ∼380,000 km2is in northern areas.

The indigenous population of the region, the Sami (formerly “Lapp”), historically occupied a

region called S´

apmi, which stretched across northern Scandinavia and into Russia’s Kola Peninsula

(Hassler et al. 2008b, Young 2012). The size of the Sami population is not well-known but

is estimated at 80,000–110,000 people (Hassler et al. 2008b). Traditionally, Sami subsistence

centered on seal hunting but was later transformed around the sixteenth century into an economy

focused on nomadic reindeer herding (Hassler et al. 2008a,b; Broadbent 2010); today, most Sami

are integrated within larger Scandinavian society. Socioeconomic indicators are fairly similar

between the Sami and the non-Sami population in countries such as Sweden, although some

evidence indicates that reindeer-herding Sami have lower incomes and less education (Hassler

et al. 2008b).

Northern Russia

Northern Russia is an enormous region (>9 million km2) that stretches across Asia from the Kola

Peninsula to Chukotka (Young & Bjerregaard 2008b). The total population of northern Russia is

∼7.2 million, with an indigenous population [i.e., the 40 groups of “Numerically Small Peoples”

of northern Russia (e.g., Evenki, Nenet, Ket, Nganasan, Chukchi, and Yup’ik)] of ∼280,000

people. In addition, several other ethnic groups such as the Yakut (∼440,000 people) and Buryat

(∼445,000 people) reside in this region and are considered by most researchers to be indigenous

(that approach is followed in this review), yet they are not recognized as indigenous by the Russian

state and instead termed ethnic minorities (see Kozlov et al. 2007). The traditional subsistence

economy varies among indigenous northern Russians and includes maritime hunting, reindeer

hunting, taiga hunting and ﬁshing, reindeer herding, and horse and cattle herding.

Indigenous Siberians experienced profound changes in lifeways during the Soviet period, and

after the collapse of the Soviet Union in 1991 unleashed catastrophic political and economic

changes, these populations again experienced major transformations that forced many to renew

their reliance on traditional subsistence activities (Snodgrass et al. 2007, Kozlov & Lisitsyn 2008).

The aftereffects of these profound transitions continue to impact native Siberians.

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The Evenki are a Tungusic-speaking group of reindeer herders from the northern Siberia

taiga who number ∼35,500 (Forsyth 1992, Leonard et al. 2002). They traditionally were highly

nomadic and occupied a large geographic area. Additional information on the Evenki can be found

in Leonard and coworkers (1994, 1999, 2002).

The Yakut (Sakha) are concentrated in northeastern Siberia and make up ∼45% of the popula-

tion of the Sakha Republic (Kozlov et al. 2007). Members of the Turkic language family, the Yakut

traditionally practiced a complex but variable subsistence strategy focused primarily on transhu-

mant horse and cattle pastoralism (Forsyth 1992, Snodgrass et al. 2005, Crate 2006). The Yakut

have experienced particularly rapid shifts in lifeways over the past decade as a result of regional

economic development (Snodgrass et al. 2007).

CIRCUMPOLAR HEALTH: AN OVERVIEW

Information on circumpolar health is incomplete and uneven, with major gaps in data availability.

Surveillance and reporting are far better in regions such as Alaska and northern Canada and less

comprehensive in northern Russia. This issue is compounded by the failure to disaggregate data

by ethnicity or locale in much of the epidemiological literature.

In this overview of health in the Arctic, I ﬁrst describe macrolevel health indicators such as life

expectancy and infant mortality and then discuss several key health issues: (a) cardiovascular and

metabolic diseases; (b) cancers; (c) infectious diseases; (d) mental health, accidents, and violence;

and (e) alcoholism, smoking, and substance abuse.

Life expectancy at birth shows enormous variation among indigenous circumpolar populations,

from relatively high among the Sami (∼75 years in males, ∼80 years in females) to very low among

indigenous Siberians (∼45–55 years in males, ∼55–65 years in females) (Kozlov et al. 2007, Hassler

et al. 2008c, Kr ¨

ummel 2009, Young 2012) (Table 1). Data generally show a pronounced disparity

in life expectancy in indigenous northern populations compared with nonnative Arctic groups and

national populations (Chatwood et al. 2012). For example, life expectancy at birth among the Inuit

is lower than among non-Inuit residents but ranges from 4.6 to 12.2 years lower, depending on

country (Kr ¨

ummel 2009). The fall of the Soviet Union in 1991 led to immediate and dramatic

declines in health and life expectancy among indigenous Siberians that paralleled but exceeded

those documented among the majority population (Leonard et al. 2002, Notzon et al. 2003, Kozlov

et al. 2007, Sorensen et al. 2009, Young 2012). Infant mortality rates are also relatively high among

most native northerners (>10 per 1,000 live births); in several places such as Nunavut, Greenland,

and northern Russia, infant mortality rates are two to three times higher than national levels

(Kozlov et al. 2007, Odland & Arbour 2008, Kr ¨

ummel 2009, Young 2012).

Cardiovascular and Metabolic Diseases

In all indigenous circumpolar populations except the Sami, obesity is at moderate to high lev-

els and has become increasingly prevalent over the past several decades (Snodgrass et al. 2006a,

Jørgensen & Young 2008, Jørgensen 2010, Chˆ

ateau-Degat et al. 2011, Young 2012). A compre-

hensive study of Inuit in Canada, Greenland, and Alaska showed obesity [body mass index (BMI)

≥30.0] at 16% and 26% in men and women, respectively, but more recent data suggest that

these prevalence rates have increased substantially (Young et al. 2007, Zienczuk & Egeland 2012).

Obesity has also emerged as an important health issue among indigenous Siberians (Snodgrass

et al. 2006a); however, these rates (e.g., 13% in males and 21% in females among the Yakut;

Snodgrass et al. 2010a) are currently moderate. Few data on obesity exist for children, but what

data are available do indicate that obesity is a growing problem for children as young as preschool

74 Snodgrass

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Table 1 Summary of the health information and key risk factors for selected indigenous peoples from circumpolar regions.

Additional information and sources are provided in the text

Region Indigenous people Overall health and key health challenges

Main lifestyle, innate,

and environmental risks

Alaska (USA) Inuit, Aleut •Overall good health; modest disparities with

nonnative Alaskans and other US residents

•Life expectancy at birth lower than other US

residents by ∼5–7 years

•Modest CVD burden; high levels of obesity;

moderate hypertension and T2D

•High rates of alcoholism, suicide, and accidents

•Modestly elevated infectious disease burden

•Dietary change

•Low activity levels

•High smoking levels

•High rate of alcoholism

•Psychosocial stress

•Pollution

•Poor living conditions

•Climate change

Northern Canada Inuit, Dene (First

Nations)

•Regional variation; better health and fewer disparities

in Yukon and NWT, worse in Nunavut

•Life expectancy lower than that of other Canadians,

especially Nunavut with ∼8–10-year difference

•Modestly elevated CVD burden; high levels of

obesity; moderate hypertension and T2D

•Cancer risk especially high in Nunavut

•High rates of suicide, accidents, and injuries

•Higher infectious disease risk, especially in Nunavut

•Dietary change

•Low activity levels

•High smoking levels

•Psychosocial stress

•Pollution

•Poor living conditions

•Climate change

Greenland

(Denmark)

Inuit •Overall good health; pronounced disparities with

nonnatives in Greenland and Denmark generally

•Life expectancy lower in Greenland by ∼10 years

•Modest CVD burden; high levels of obesity;

moderate hypertension and T2D

•Cancer risk relatively high

•Severe mental health challenges

•Modestly elevated infectious disease burden

•Dietary change

•Low activity levels

•High smoking levels

•Psychosocial stress

•Pollution

•Poor living conditions

•Climate change

Scandinavia

(Norway, Sweden,

Finland)

Sami •Overall excellent health; minimal disparities with

nonnative population, although perhaps poorer

health among reindeer herders

•Life expectancy high and not signiﬁcantly different

from national populations

•Low CVD burden; low levels of obesity,

hypertension, and T2D

•Modestly elevated mental health challenges

•Dietary change

Northern Russia Evenki, Khanti,

Mansi, Yakut

(Sakha)

•Overall poor health; pronounced disparities

compared with nonnative population

•Life expectancy lower by ∼10 years (but Russia low

in general, especially among men)

•High infant mortality rate

•High CVD burden (especially stroke) but relatively

low T2D

•Moderate obesity levels and very high hypertension

rates

•Modestly elevated infectious disease burden

•Very high rates of alcoholism, suicide, and violence

•Dietary change

•Low activity levels

•High smoking levels

•Very high rates of

alcoholism

•Psychosocial stress

•Pollution

•Poor living conditions

•Climate change

•Adaptive pattern that

may predispose to high

blood pressure

Abbreviations: CVD, cardiovascular disease; NWT, Northwest Territories; T2D, type 2 diabetes.

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CVD: cardiovascular

disease

Metabolic syndrome

(MetS):

a constellation of risk

factors, including

central obesity and

insulin resistance, that

contribute to the

development of CVD

T2D: type 2 diabetes

( Jørgensen & Young 2008, Galloway et al. 2010). The association between obesity and cardio-

vascular disease (CVD) among the Inuit is distinct, with fewer metabolic consequences of excess

adiposity compared with other populations (Young 2007, Young et al. 2007).

The Inuit and several other native northern groups were initially thought to be protected from

CVD because several studies in the early twentieth century documented a relatively low cardiovas-

cular burden and a favorable lipid proﬁle (Kozlov et al. 2007, Jørgensen & Young 2008). However,

CVD is now one of the leading causes of death among circumpolar populations (Kr ¨

ummel 2009,

Chˆ

ateau-Degat et al. 2010, Young 2012). Data show considerable regional variation in CVD;

however, Alaska Natives and Sami have a relatively low burden (Young 2012). Pronounced re-

gional variation also exists for cardiovascular risk factors such as hypertension (>140 mm Hg

systolic blood pressure and/or >90 mm Hg diastolic blood pressure). Indigenous Siberians have

extremely high rates (∼20–35%; Kozlov et al. 2007, Snodgrass et al. 2007), whereas other groups

such as the Canadian and Greenland Inuit have somewhat lower levels that are classiﬁed as inter-

mediate globally (19% and 22%, respectively; Jørgensen et al. 2004, Jørgensen & Young 2008,

Chˆ

ateau-Degat et al. 2010). Circumpolar groups in general still have a relatively favorable lipid

proﬁle and low occurrence of the metabolic syndrome (MetS), although recent data from multiple

regions show a rapid pace of health deterioration (Leonard et al. 2005, Boyer et al. 2007, Kozlov

et al. 2007, Snodgrass et al. 2010b, Young 2012).

Studies have historically reported relatively low levels of type 2 diabetes (T2D; fasting glucose

≥126 mg/dl) among northern groups in all circumpolar regions ( Jørgensen & Young 2008).

These prevalence rates have increased somewhat in recent decades but are still generally low in

many groups, especially native Siberians (e.g., Yakut, Khanty, and Mansi), in whom T2D rates

are nearly absent (<5%) and fasting glucose levels among many populations (e.g., Yakut, Khanty,

Mansi, and Chukchi) are quite low (∼80 mg/dl) (Kozlov et al. 2007; Snodgrass et al. 2010a,b;

Young 2012). The Sami also have a relatively low diabetes prevalence (estimated at <5%) and a

low fasting glucose population mean of ∼79 mg/dl (Kozlov et al. 2007, Sj ¨

olander 2011). Fasting

glucose values are higher among Greenlanders (∼104 mg/dl), as well as among Canadian Inuit

(∼92 mg/dl) and Alaska Inuit (∼94 mg/dl), and rates of T2D are ∼7–10% among Inupiat, Aleut,

and Greenland Inuit ( Jørgensen & Young 2008, Snodgrass et al. 2010b, Young 2012).

The main factors that inﬂuence cardiovascular and metabolic risk in northern populations

are diet and physical activity. Native northerners, especially maritime societies such as coastal

Inuit populations, have traditionally consumed diets very high in protein and fats and low in

carbohydrates (Shephard & Rode 1996, Cordain et al. 2000, Kozlov et al. 2007). These traditional

diets, many with high levels of n−3 fatty acids, are protective from cardiovascular and metabolic

conditions (Kozlov et al. 2007, Young 2012). A major dietary shift is occurring across the North as

economic development has accelerated. This transition was perhaps best documented by a study

of northern Canada’s Igloolik Inuit, which tracked changes in health in the same community over

several decades (Shephard & Rode 1996). In addition, a recent study of Greenland and Canadian

Inuit documented high levels of market foods (∼80%): Younger individuals are consuming fewer

n−3 fatty acids and more unhealthy trans–fatty acids (Counil et al. 2008). The transition away

from traditional foods has led to a greater risk of nutrient deﬁciencies (e.g., Vitamin D and iron)

and increased intake of saturated fats, carbohydrates, and overall calories (Kozlov et al. 2007,

Bjerregaard & Jørgensen 2008, Egeland et al. 2011, Andersen et al. 2012, Jamieson et al. 2012).

Food insecurity is also emerging as an important issue in many Arctic populations, although

continued use of traditional foods continues to be protective (Huet et al. 2012, Young 2012).

However, an emerging problem—termed the Arctic dilemma—is that beneﬁcial traditional foods

are now increasingly contaminated with industrial pollutants (Kuhnlein & Chan 2000, Bjerregaard

& Jørgensen 2008, Kr ¨

ummel 2009).

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AN42CH05-Snodgrass ARI 18 September 2013 14:43

Decreased energy expenditure resulting from declines in habitual physical activity is likely a key

contributor to the increased burden of cardiovascular and metabolic diseases in the Arctic, although

this issue has not been extensively studied (Shephard & Rode 1996, Bjerregaard & Jørgensen 2008,

Dahl-Petersen et al. 2011, Young 2012). Research among the Yakut, for example, has documented

modest physical activity levels, with particularly low levels among those least involved with the

subsistence herding economy and those consuming more market foods (Snodgrass et al. 2006b).

Furthermore, low activity levels in this population have been linked to several health measures,

including chronic inﬂammation and poor lipid proﬁles (Wilson et al. 2013).

One ﬁnal issue related to determinants of cardiovascular and metabolic diseases in indigenous

circumpolar populations is the contribution of genetic factors to risk patterning. This issue remains

unresolved (Hegele & Pollex 2008, Young 2012); studies among the Inuit, for example, show gene

frequencies that simultaneously reduce and elevate CVD risk. Founder effects in some populations

may also shape risk, such as with the high levels of BRCA1 mutations among Greenland natives,

which contribute to breast cancer risk (Fredslund & Bonefeld-Jørgensen 2012).

Cancers

Cancer is one of the leading causes of death in circumpolar populations, with particularly high in-

cidence and mortality among Inuit in Nunavut and Greenland (Friborg & Hassler 2008, Kr ¨

ummel

2009, Young 2012). The cancer proﬁle of most northern populations is distinct; the Inuit, for ex-

ample, have a high incidence of nasopharyngeal and salivary cancers (so-called traditional cancers),

as well as high levels of lung and pancreatic cancers (Friborg & Hassler 2008, Alberts et al. 2012,

Kirkegaard 2012). Researchers have documented an ongoing shift in cancer proﬁle among north-

ern groups with an increase in cancers more common in industrialized populations (e.g., breast can-

cer, uterine cancer, and colorectal cancer), as well as a general increase in cancer incidence (Friborg

& Hassler 2008, Circumpol. Inuit Cancer Rev. Work. Group 2008, Ehrsam Day et al. 2010). Rates

of cancer incidence and mortality are generally low for the Sami (Hassler et al. 2008c). Few high-

quality cancer data are available for northern Russians (Kozlov et al. 2007, Vaktskjold et al. 2008).

One area of considerable concern for native northern populations is the risk of environmental

contaminants contributing to elevated levels of cancer and to other health issues (e.g., reproductive

health and cognitive development) (Bjerregaard et al. 2008, Young 2012). The Arctic is uniquely

vulnerable to pollutants because heavy metals (e.g., mercury) and POPs (e.g., PCBs) from lower-

latitude industrial activities are transported and deposited in circumpolar regions (McConnell &

Edwards 2008). Health risks are particularly acute for native northern populations that regularly

consume large marine carnivores (e.g., polar bear and seal) because long marine food chains

concentrate pollutants (Van Oostdam et al. 2005, Deutch et al. 2007, Donaldson et al. 2010).

Infectious Disease

Beginning several hundred years ago with intensiﬁed contact with Europeans, communicable

diseases such as smallpox and measles had a major impact on the health and demography of in-

digenous circumpolar groups (Waldram et al. 2006, Koch et al. 2008). This infectious disease

burden remained high until societal changes within the past half-century drove most infectious

diseases into steep decline. Despite this decline, the current burden of infectious disease remains

elevated in most circumpolar regions. The pattern of diseases is also unique, with high incidence of

gastrointestinal and respiratory tract infections (especially in Nunavut, Greenland, and northern

Russia), as well as elevated rates of hepatitis, parasitic infections (e.g., trichinellosis), and invasive

bacterial diseases (e.g., Streptococcus pneumoniae) (Koch et al. 2008, Jenkins et al. 2011, Young 2012).

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Of particular note is the high prevalence of Helicobacter pylori infection across much of the Arctic,

which helps explain population variation in the occurrence of peptic ulcers, gastritis, iron deﬁ-

ciency anemia, and several cancers (Baggett et al. 2006, Koch et al. 2008, Wiggins et al. 2008,

de Martel & Franceschi 2009, Tveit et al. 2011). Furthermore, socioeconomic disparities and

the effects of climate change may prevent future declines in infectious disease. One considerable

challenge has been the burden of tuberculosis; although incidence has generally declined in recent

decades, tuberculosis is still at an elevated level in Alaska, Greenland, Nunavut, and northern

Russia (Kr ¨

ummel 2009). Finally, the Arctic has relatively high rates of sexually transmitted infec-

tions, especially gonorrhea and chlamydia; the burden is particularly heavy in Greenland, northern

Canada, and Alaska (Healey & Meadows 2007, Young 2012).

A key determinant of the generally high infectious disease burden in native Arctic populations

is poor-quality housing, which can expose residents to high levels of unclean water and indoor air

pollution (Koch et al. 2008). This is compounded by high rates of smoking and exposure to second-

hand smoke. Furthermore, crowding can increase burden of respiratory infections, especially in

children, and this condition is severe in Nunavut, Greenland, and parts of northern Russia (Young

2012). Poor living conditions result from physical challenges in the northern environment, the

isolation of many native communities, and pronounced socioeconomic disparities (Bjerregaard

et al. 2008, Young & M¨

akinen 2010).

Mental Health, Accidents, and Violence

Injuries, suicide, and violence are major health challenges for Arctic populations, especially native

groups (Young & Hassler 2008). Most indigenous circumpolar populations have a relatively high

level of mental health challenges, including anxiety, depression, and suicide; these conditions

impose a tremendous health burden in Alaska, northern Canada, Greenland, and northern Russia

(McGrath-Hanna et al. 2003, Silviken & Kvernmo 2008, Timonen 2009, Kaiser et al. 2010, Kral

et al. 2011, Young 2012). The suicide rate among Canadian Inuit, for example, is 6–11 times greater

than for other Canadians (Kr ¨

ummel 2009). Suicide, in particular among adolescents and young

adults, has increased recently in a number of circumpolar populations, including Alaska Natives

and Greenland Inuit (Lehti et al. 2009, Timonen 2009). Mortality from accidents (e.g., drowning

and trafﬁc accidents) and violence (e.g., homicide), as well as unintentional injury, are very high in

northern Russia, with mortality linked closely to alcohol abuse (Kozlov et al. 2007). Furthermore,

levels of injury and violence are also elevated in Alaska, northern Canada, and Greenland and are

at least 2–4 times higher than the national rates (Strayer et al. 2010, Young 2012). In contrast,

levels of injuries and violence among the Sami are not particularly high.

A major contributor to mental illness and associated conditions among northern populations

is chronic psychosocial stress linked to rapid economic development and social transformations

over the past half-century (Silviken & Kvernmo 2008). Studies in a number of circumpolar regions

have identiﬁed key factors such as long-term unemployment, acculturation and loss of traditional

values, lack of self-determination, contamination of traditional foods, and discrimination by non-

native populations (Kozlov et al. 2007, Wolsko et al. 2007, Silviken & Kvernmo 2008, Pufall

et al. 2011, Young 2012). Chronic psychosocial stress associated with social change and economic

marginalization contributes to elevated blood pressure and greater cardiovascular risk in mul-

tiple regions. For example, high levels of chronic psychosocial stress associated with economic

development, urbanization, and lifestyle change have been documented among Siberian groups

such as the Khanty, Mansi, and Yakut (Kozlov et al. 2003, Tyrylgin 2007, Sorensen et al. 2009).

Finally, psychological issues in circumpolar populations must be interpreted within a framework

that considers seasonality in temperature and photoperiod because these environmental factors can

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inﬂuence thyroid function and impact behavior and mental health (Leonard et al. 2005, Palinkas

& Suedfeld 2008). For example, studies have documented relatively high prevalence of seasonal

affective disorder (SAD) and other seasonal negative mood states among some Arctic groups, in-

cluding Inuit from Canada and Greenland; the most elevated levels have been found at the highest

latitudes (Haggarty et al. 2002, Kegel et al. 2009).

Alcoholism, Smoking, and Substance Abuse

Alcoholism, smoking, and substance abuse are major health issues for most indigenous northern

populations, and they also contribute to an increased risk of CVD and cancer and to accidents

and violence (Spein 2008, Young 2012). Alcoholism is most severe in northern Russia, with levels

of alcohol use higher than the general Russian population and uncharacteristically high among

women (Kozlov et al. 2007). Alcoholism in Russia has become a greater problem with the social and

political transformations of the past several decades (Tyrylgin 2007). Smoking is at an astonishingly

high level across much of the Arctic, including in an estimated 50–80% of northern Russian

Natives, 60% of Greenlanders and Nunavut residents, and 84% of Nunavik Inuit (Kozlov et al.

2007, Spein 2008, Chˆ

ateau-Degat et al. 2010, Young 2012). The Nunavik study documented that

all adult participants under 40 years old were current smokers. Smoking, as well as the use of

smokeless tobacco, is also high in children and adolescents in many native communities (Kozlov

et al. 2007, Spein 2008). Cigarette smoking is a major contributor to lung cancer in circumpolar

populations, including among the Inuit for whom lung cancer incidence and smoking prevalence

are thought to be the highest in the world (Friborg & Hassler 2008, Spein 2008). Finally, several

studies (e.g., Segal & Saylor 2007) note substance abuse problems with cocaine, marijuana, and

inhalants among Alaska Natives.

HEALTH DISPARITIES AND THE LEGACY

OF ECONOMIC DEVELOPMENT

Pronounced health disparities have been documented for much of the Arctic, yet this issue has

not attracted the same level of attention as has inequality or poor health in other parts of the

world (Chatwood et al. 2012). Although much of the Arctic is politically located within some

of the world’s most developed countries, most circumpolar regions show pronounced and, for

some, worsening health disparities compared with the national populations, as well as a strong

northern versus southern health gradient (Kr ¨

ummel 2009, Chatwood et al. 2012, Young 2012).

For example, there is a 10-year gap in life expectancy between Canadian Inuit and the general

Canadian population (Sheppard & Hetherington 2012).

The range of health disparities in the Arctic is enormous, varying from virtually nonexistent to

extreme (Bjerregaard et al. 2008, Chatwood et al. 2012). At one end of the spectrum are the Sami

with overall favorable health indicators and no or minimal health disparities compared with the ma-

jority Scandinavian population. At the other end of the spectrum are indigenous northern Russians

with extremely poor health indicators and marked disparities compared with Russia as a whole.

Despite important improvements in health over the past half-century, most circumpolar pop-

ulations have seen lower-than-expected gains in life expectancy and infant survival, and the in-

fectious disease burden remains stubbornly high. With increases in chronic disease over the past

several decades, there are reasons for concern about a double burden of disease. Furthermore, the

enormous toll of mental health–related issues (e.g., alcoholism, suicide, and violence) creates a

triple burden of disease for many circumpolar populations.

This pattern of health disparities has developed for several reasons. First, although most

northern regions are rich in natural resources (e.g., oil and mineral wealth), their economies

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are generally resource extractive, and thus regional wealth does not necessarily translate into

health beneﬁts for all. Second, with the exception of the Sami, marked socioeconomic disparities

between indigenous and nonindigenous residents contribute to chronic psychosocial stress,

differences in living conditions, and other factors that inﬂuence risk for chronic conditions,

infectious disease, and mental illness (Bjerregaard et al. 2008, Young 2012). However, the case of

the Sami shows that these disparities are not inevitable but instead a product of social, economic,

and historical factors in each country (Norum & Nieder 2012). The overall excellent health

of the Sami has been attributed to relatively slow regional acculturation processes, which have

preserved key protective elements of traditional Sami culture, and to the generally favorable

socioeconomic conditions (e.g., educational attainment) that are similar to those in non-Sami

Scandinavian populations (Hassler et al. 2008a). Third, economic development in most of the

Arctic has been particularly rapid and intense, which has placed a heavy emotional strain on

populations who are experiencing profound shifts in lifeways and traditions (Bjerregaard et al.

2004). Finally, high levels of environmental pollution contribute to disease burden, and these

effects are typically most severe among native communities in remote locales.

CLIMATE CHANGE AND ITS EFFECTS ON CIRCUMPOLAR HEALTH

Indigenous circumpolar groups today are threatened by continued regional economic development

and pollution and are also uniquely vulnerable to the effects of global climate change. A number of

studies have documented the occurrence of climate change in circumpolar regions, most notably

pronounced warming, with predictions for mean annual temperature increases of 3–7◦Cbythe

end of the twenty-ﬁrst century (Parkinson & Evenga˚rd 2009, Willis & MacDonald 2011, Revich

et al. 2012). Climatic change in the Arctic is more rapid than in other regions and has already led

to glacial and sea ice melting and decreased permafrost (Anisimov et al. 2007, IPCC 2007).

The effects of climate change on health are not simple and thus difﬁcult to predict. However, key

issues include (a) shifts in weather patterns and environmental conditions (Parkinson & Evenga˚rd

2009, Brubaker et al. 2011); (b) higher sea level, which threatens coastal communities (Anisimov

et al. 2007); (c) altered access to traditional lands and foods, with effects on diet and emotional

well-being (Parkinson & Evenga˚rd 2009, Brubaker et al. 2011, Cunsolo Willox et al. 2012,

Ford 2012); (d) disruption of water supplies, with concomitant increase in infectious disease

burden (Evengard et al. 2011, Ford 2012); and (e) range expansion of parasitic zoonoses into

more northern areas ( Jenkins et al. 2011, Revich et al. 2012). In fact, climate change has already

affected circumpolar lifeways and health, including precipitating increased food insecurity among

Canadian and Greenland Inuit (Beaumier & Ford 2010, Goldhar et al. 2010) and damaging

community water infrastructure among rural Alaskans, increasing hospitalization rates for

respiratory and skin infections (Hennessy et al. 2008, Evengard et al. 2011). In short, circumpolar

populations are serving as the bellwethers of global climate change. Despite this threat, research

has shown many examples of resilience in the face of environmental challenges, as well as effective

community-based strategies to mitigate the consequences of climate change (Brubaker et al.

2011, McClymont Peace & Myers 2012).

INTEGRATIVE ANTHROPOLOGICAL APPROACHES

TO CIRCUMPOLAR HEALTH

An anthropological approach to circumpolar health provides a powerful lens through which

to consider how evolutionary forces shape susceptibility to disease. Furthermore, this holistic,

integrative approach allows researchers to elucidate how cultural and individual factors interact

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with underlying genetic susceptibility within the context of a particular environment to structure

health risk. This section provides an example of how an evolutionary and biocultural approach

can be used to understand the myriad factors that shape circumpolar health.

Indigenous Siberians such as the Yakut and Evenki display a cardiovascular risk proﬁle that

contrasts markedly with many lower-latitude groups and includes extremely high levels of hy-

pertension and stroke and moderately high but increasing obesity, yet a relatively favorable lipid

proﬁle and a low prevalence of T2D (Snodgrass et al. 2007). This contrasts with other popu-

lations that have experienced recent economic development, which have a chronic disease risk

proﬁle characterized by moderately elevated blood pressure, high levels of obesity, very high T2D

risk, and an unfavorable lipid proﬁle (Weyer et al. 2000, McDade & Nyberg 2010). This regional

variation, with few exceptions (Snodgrass et al. 2007, McDade & Nyberg 2010, Liebert et al.

2013), has attracted little attention.

Recent research among the Evenki, Yakut, and Buryat has considered whether metabolic adap-

tation to the cold and marginal northern environment (i.e., upregulated BMR) structures chronic

disease risk (Snodgrass et al. 2007, 2008; Leonard et al. 2009). BMR was found to be positively

correlated with blood pressure, even when controlling for a variety of potentially confounding

factors (e.g., body composition, age, smoking, and extent of urbanization). This research also

documented a negative association between BMR and low-density lipoprotein (LDL) cholesterol.

Taken together, these data suggest that, at least for indigenous Siberians, biological adaptation

to the circumpolar environment contributes to an increased risk of hypertension but a lower

risk of dyslipidemia. Although this research is preliminary, it does suggest that adaptation to the

northern environment, combined with the unique Russian political factors that have marginalized

native groups, structures the distinctive chronic disease proﬁle seen among indigenous Siberians.

More generally, it emphasizes the need to consider regional adaptive patterns when investigating

global health variation and underscores the importance of developing innovative models to

understand disease patterns that integrate environmental exposure with underlying differences in

susceptibility.

ARCTIC HEALTH RESOURCES, RESEARCH NETWORKS, AND INITIATIVES

Arctic Health (http://www.arctichealth.org/) is a National Institutes of Health and University of Alaska–sponsored

website that serves as a clearinghouse for circumpolar health information and includes a comprehensive publication

database and links to the Alaska Native Tribal Health Consortium’s Digital Stories health-related video collection

(http://www.youtube.com/user/ANTHCDigitalStories).

The International Journal of Circumpolar Health (http://www.circumpolarhealthjournal.net/index.php/ijch/

index) is an open-access journal and is the main publication for articles on the health of indigenous northern peoples.

The International Union for Circumpolar Health (IUCH; http://www.iuch.net), an international nongovern-

mental organization, is a key network that links researchers and policy makers interested in the health and well-being

of circumpolar groups; it also brings together regional circumpolar health organizations from the United States,

Canada, Greenland, Scandinavia, and Russia (Bruce 2011). The International Congress on Circumpolar Health

(ICCH; http://www.iuch.net/meetings.php) is the main international conference on circumpolar health and is

held every three years (Bjerregaard et al. 2004).

The International Polar Year (IPY; http://www.ipy.org/), which occurs approximately every 50 years, is a key

circumpolar research initiative and project sponsor. The most recent IPY, the fourth, took place in 2007–2008 and

focused attention on the health and well-being of circumpolar populations (ICSU 2004, Parkinson 2011).

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SUMMARY POINTS

1. Circumpolar populations are diverse in their traditional subsistence means and culture,

genetic backgrounds, and the environments they inhabit. The unique stressors of the

circumpolar environment present challenges to which these populations have adapted

through cultural, behavioral, and biological means.

2. Summarizing the health of circumpolar populations is challenging because of pronounced

regional differences. Overall health and well-being range from excellent among the Sami

of Scandinavia to extremely poor among the socially and economically marginalized

native populations of northern Russia.

3. These regional health differences are shaped by unique population histories, variation

in diet and activity patterns, socioeconomic disparities with nonindigenous groups, en-

vironmental pollution, and biological factors.

4. Economic development has brought with it some positive elements, including increases

in life expectancy and a lower burden of infectious disease. However, recent social and

economic changes have also precipitated a rise in chronic diseases and mental health

challenges.

5. Climate change is already affecting the lifeways and health of circumpolar peoples, and

its effects will accelerate in the coming century.

6. An anthropological approach that integrates evolutionary and biocultural perspectives

provides a powerful tool for examining circumpolar health as it considers environmental

exposure, sociocultural factors, and underlying differences in susceptibility.

DISCLOSURE STATEMENT

The author is not aware of any afﬁliations, memberships, funding, or ﬁnancial holdings that might

be perceived as affecting the objectivity of this review.

ACKNOWLEDGMENTS

I thank Bill Leonard and Heather McClure for their valuable comments and suggestions on an

earlier draft of this article.

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Scandinavia, the Sami? Glob. Health Action 4:8457

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environmental contaminants in Arctic Canada: a review. Sci. Total Environ. 351–52:165–246

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logical Perspectives. Toronto: Univ. Tor. Press. 2nd ed.

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akinen TM. 2010. The health of Arctic populations: Does cold matter? Am.J.Hum.Biol.

22:129–33

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Annual Review of

Anthropology

Volume 42, 2013

Contents

Perspective

Ourselves and Others

Andr´eB´eteille pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp1

Archaeology

Power and Agency in Precolonial African States

J. Cameron Monroe pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp17

The Archaeology of Illegal and Illicit Economies

Alexandra Hartnett and Shannon Lee Dawdy pppppppppppppppppppppppppppppppppppppppppppppp37

Evidential Regimes of Forensic Archaeology

Zo¨e Crossland ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp121

Biomolecular Archaeology

Keri A. Brown and Terence A. Brown ppppppppppppppppppppppppppppppppppppppppppppppppppppp159

Biological Anthropology

Agency and Adaptation: New Directions in Evolutionary Anthropology

Eric Alden Smith ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp103

Teeth and Human Life-History Evolution

Tanya M. Smith pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp191

Comparative Reproductive Energetics of Human

and Nonhuman Primates

Melissa Emery Thompson pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp287

Signiﬁcance of Neandertal and Denisovan Genomes

in Human Evolution

John Hawks ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp433

Linguistics and Communicative Practices

Ethnographic Research on Modern Business Corporations

Greg Urban and Kyung-Nan Koh ppppppppppppppppppppppppppppppppppppppppppppppppppppppppp139

vii

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Language Management/Labor

Bonnie Urciuoli and Chaise LaDousa pppppppppppppppppppppppppppppppppppppppppppppppppppppp175

Jurisdiction: Grounding Law in Language

Justin B. Richland pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp209

Francophonie

C´ecile B. Vigouroux ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp379

Evidence and Authority in Ethnographic and Linguistic Perspective

Joel Kuipers ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp399

International Anthropology and Regional Studies

Anthropologizing Afghanistan: Colonial and Postcolonial Encounters

Alessandro Monsutti pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp269

Borders and the Relocation of Europe

Sarah Green pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp345

Roma and Gypsy “Ethnicity” as a Subject of Anthropological Inquiry

Michael Stewart pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp415

Sociocultural Anthropology

Disability Worlds

Faye Ginsburg and Rayna Rapp ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp53

Health of Indigenous Circumpolar Populations

J. Josh Snodgrass pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp69

The Anthropology of Organ Transplantation

Charlotte Ikels ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp89

The Anthropology of International Development

David Mosse ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp227

The Nature/Culture of Genetic Facts

Jonathan Marks pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp247

Globalization and Race: Structures of Inequality, New Sovereignties,

and Citizenship in a Neoliberal Era

Deborah A. Thomas and M. Kamari Clarke pppppppppppppppppppppppppppppppppppppppppppppp305

The Politics and Poetics of Infrastructure

Brian Larkin pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp327

The Anthropology of Radio Fields

Lucas Bessire and Daniel Fisher ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp363

viii Contents

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AN42-FrontMatter ARI 18 September 2013 17:41

Theme: Evidence

The Archaeology of Illegal and Illicit Economies

Alexandra Hartnett and Shannon Lee Dawdy pppppppppppppppppppppppppppppppppppppppppppppp37

Evidential Regimes of Forensic Archaeology

Zo¨e Crossland ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp121

Biomolecular Archaeology

Keri A. Brown and Terence A. Brown ppppppppppppppppppppppppppppppppppppppppppppppppppppp159

Teeth and Human Life-History Evolution

Tanya M. Smith pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp191

The Nature/Culture of Genetic Facts

Jonathan Marks pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp247

Evidence and Authority in Ethnographic and Linguistic Perspective

Joel Kuipers ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp399

Signiﬁcance of Neandertal and Denisovan Genomes

in Human Evolution

John Hawks ppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp433

Indexes

Cumulative Index of Contributing Authors, Volumes 33–42 ppppppppppppppppppppppppppp451

Cumulative Index of Article Titles, Volumes 33–42 ppppppppppppppppppppppppppppppppppppp455

Errata

An online log of corrections to Annual Review of Anthropology articles may be found at

http://anthro.annualreviews.org/errata.shtml

Contents ix

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The Annual Review of Statistics and Its Application aims to inform statisticians and quantitative methodologists, as

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table of contents:

• What Is Statistics? Stephen E. Fienberg

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Jesse A. Berlin, Martijn Schuemie, J. Marc Overhage,

Marc A. Suchard, Bill Dumouchel, Abraham G. Hartzema,

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in Criminology, Developmental Psychology, and Beyond,

Elena A. Erosheva, Ross L. Matsueda, Donatello Telesca

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• StatisticalEvaluationofForensicDNAProleEvidence,

Christopher D. Steele, David J. Balding

• Using League Table Rankings in Public Policy Formation:

Statistical Issues, Harvey Goldstein

• Statistical Ecology, Ruth King

• Estimating the Number of Species in Microbial Diversity

Studies, John Bunge, Amy Willis, Fiona Walsh

• Dynamic Treatment Regimes, Bibhas Chakraborty,

Susan A. Murphy

• Statistics and Related Topics in Single-Molecule Biophysics,

Hong Qian, S.C. Kou

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and Insurance, Paul Embrechts, Marius Hofert

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Beyond COVID: towards a transdisciplinary synthesis for understanding responses and developing pandemic preparedness in Alaska

Article

Full-text available

Sep 2024
INT J CIRCUMPOL HEAL

Pandemics are regularly occurring events, and there are foundational principles of pandemic preparation upon which communities, regions, states, and nations may draw upon for elevated preparedness against an inevitable future infectious disease threat. Many disciplines within the social sciences can provide crucial insight and transdisciplinary thinking for the development of preparedness measures. In 2023, the National Science Foundation funded a conference of circumpolar researchers and Indigenous partners to reflect on COVID-19-related research. In this article, we synthesise our diverse social science perspectives to: (1) identify potential areas of future pandemic-related research in Alaska, and (2) pose new research questions that elevate the needs of Alaska and its people, pursuant of a specific body of pandemic knowledge that takes into account the ecological and sociocultural contexts of the region. In doing so, we highlight important domains of research in the social sciences from transdisciplinary perspectives, including the centering of Indigenous knowledges and needs, the contexts of risk perception and resilience, food and housing security, and more. We highlight the contributions of social sciences to pandemic knowledge and provide a foundation for future pandemic-related research in Alaska.

Voices from the North: Exploring Sámi People’s Perspectives on Environmental Change and Mental Well-Being: A Systematic Literature Review

Article

Full-text available

Jun 2024

Circumpolar Indigenous People, such as the Sámi, confront significant challenges stemming from environmental shifts and interrelated issues, profoundly affecting their mental health. Nonetheless, they possess invaluable knowledge and capabilities to navigate and adapt to these transformations. This review aims to investigate peer-reviewed scientific literature, exploring the nexus between environmental changes and mental well-being within the broader Circumpolar Indigenous community, with a special focus on the Sámi People. Conducting a systematic literature review with two arms, one encompassing the broader Circumpolar Indigenous population and the other focusing specifically on the Sámi, followed by thematic analysis, we delved into their experiences of environmental changes, perceptions regarding the intertwining of environmental shifts and mental well-being, and insights into protective factors and resilience-promoting elements. By engaging with Indigenous perspectives, public health initiatives can pinpoint and leverage existing strengths within Indigenous communities and families to bolster their ability to navigate environmental shifts and safeguard mental well-being. However, our review highlighted a lack of scientific investigation of ’strength-based’ factors fostering mental resilience among Indigenous populations inhabiting the Circumpolar North, such as the Sámi. Future qualitative research can address this gap, incorporating the viewpoints of individual Circumpolar Indigenous groups to explore both their distinctiveness and interconnectedness.

Bioethics Recommendations to Increase Culturally Informed Global Health Survey Research: A Framework for Centering Community Engagement

Article

Feb 2025
AM J HUM BIOL

Global health projects—a source of inspiration and collaboration for applied human biology—benefit scholars, governments, NGOs, and aid organizations. While such research is intended to improve population health, direct benefits to individuals and communities are often excluded from published works and/or not considered in study designs and framing. This exclusion is increasingly recognized as a colonial legacy that hinders global health equity, particularly for Indigenous and other marginalized populations. Collaboration and community engagement are avenues for addressing these injustices, but they require planning, intention, and resources. Drawing on our collective experience and ongoing dialogues about community engagement in human biology, we propose six recommendations to increase equity in global health research. These include: (1) Incorporating trusted local specialists and stakeholders at all project levels; (2) disseminating health information to participants in strengths‐based and culturally meaningful ways and contributing to solutions wherever possible; (3) investing in local healthcare, research, and infrastructure; (4) making study results/data available to stakeholders; (5) working within data frameworks that respect community sovereignty; and, (6) applying culturally informed bioethics frameworks. Our discussion highlights persistent needs to address community rights and benefits and to dismantle colonial legacies within global health and human biology while recognizing structural barriers to implementing these needed changes, particularly within the context of global health projects wherein human biologists are not the main power brokers or resource holders. When interfacing with global health, human biologists must continue to pursue health equity and decolonization through implementing critical, culturally informed bioethics frameworks centering community engagement.

Managing the risks of emerging contaminants–establishing a national strategy guided by Indigenous perspectives

Article

Mar 2025
Integrated Environ Assess Manag

Chemicals play an important role in maintaining our quality of life. Unfortunately, inappropriate chemicals and waste management result in the accumulation of contaminants in our environment that pose a risk to exposed biota and humans. Being cognizant of Indigenous knowledge and values within the management of chemicals and waste represent key components of environmental justice, but they are not being included in current global programs. Here, we describe the process leading to the development of an independent and nonpartisan national strategy to manage emerging contaminants in New Zealand that is reflective of Māori cultural perspectives. An inclusive partnership-based approach was used to capture a broad selection of views and perspectives to provide opportunities to engage with representatives from a range of sectors including scientists, members of the wider community, and Māori partners for the development of the strategy. A series of workshops was held over several years that helped refine the strategy document to ensure that it was fit for purpose with a clear implementation pathway to maximize uptake and achieve the inspirational shared vision. This initiative highlighted the need to invest significant time and effort up front to develop strong relationships across sectors required for success. All parties involved must operate with respect to ensure that advantages and reciprocity of all knowledge systems are recognized and valued to achieve objectives for chemical sustainability.

Circulating Epstein–Barr Virus Antibody Levels as a Biomarker of Socioecological Adversity in Amazonian Ecuador

Article

May 2025
AM J HUM BIOL

Objectives Circulating Epstein–Barr virus antibodies (EBV‐Ab) are used as a biomarker of chronic stress in high‐income settings, but their relevance in environments with a high burden of infectious disease, nutritional constraints, and limited resources is less clear. We investigated EBV‐Ab as a biomarker of adversity in a setting where local ecology and economy may affect immune development differently than in wealthy countries. Methods We measured EBV‐Ab in finger‐prick dried blood spots collected from Indigenous Shuar ( n = 433) and non‐Indigenous Colonos ( n = 84) ranging from < 1 to 87 years old in Amazonian Ecuador. For a subset of adults (≥ 15 years, n = 210), we collected socioeconomic information (income, education, and occupation) and assessed household‐level market integration. We determined the most important predictors of EBV‐Ab for adults and children using multi‐model averaging of linear regression models. Results Male children (< 15 years) had lower EBV‐Ab than female children (model averaged β [SE]: −0.238 [0.066]). For adults, Shuar had higher EBV‐Ab than Colonos (model averaged β [SE]: 0.235 [0.113]), and high systolic blood pressure was an important predictor of elevated EBV‐Ab (model averaged β [SE]: 0.088 [0.047]). Individuals who reported unpaid domestic work as their primary occupation had higher EBV‐Ab than agricultural workers (model averaged β [SE]: 0.302 [0.113]). Individuals living in houses with more market‐sourced infrastructure had lower EBV‐Ab (model averaged β [SE]: −0.088 [0.068]). Conclusions Circulating EBV‐Ab may capture context‐specific aspects of socioecological adversity in Amazonian Ecuador, highlighting disparities in EBV‐Ab between Indigenous and non‐Indigenous Ecuadorians and differences in immune function related to market integration.

Fatty acids in the meat and by-products of reindeer from northwestern Siberia, Russia

Article

Mar 2025

Products derived from semi-domesticated reindeer are a fundamental component in the traditional diet of indigenous peoples in northwestern Siberia, but information on the fatty acid composition of reindeer tissues is lacking. We assayed fatty acids in the meat, heart, kidney, and spleen collected from adult reindeer. The fatty acid profiles varied significantly, with the lowest dissimilarity observed between the heart and kidney and the greatest dissimilarity between the meat and spleen. Saturated fatty acids were predominantly represented by palmitic and stearic acids, while oleic acid accounted for the majority of monounsaturated fatty acids. Linoleic, arachidonic, and docosapentaenoic acids were most common among polyunsaturated fatty acids. Comparable total fatty acid levels were detected in the meat (20.8±0.3 mg g–1) and heart (20.6±4.7 mg g–1), followed by spleen (15.6±4.0 mg g–1) and kidney (14.7±0.3 mg g–1). All the products can be considered as beneficial for human consumption, with the heart being the most favorable in terms of preventing cardiovascular diseases. Nevertheless, the meat derived from Siberian reindeer exhibited the lowest n-6/n-3 among other members of the family Cervidae, probably due to spatial variations in reindeer diets and climate conditions.

Somatic Symptoms Are Associated With Elevated Blood Pressure and Epstein–Barr Virus Antibodies Among Shuar of the Ecuadorian Amazon

Article

Nov 2024
AM J HUM BIOL

Introduction This study tests the hypothesis that self‐reported somatic symptoms are associated with biomarkers of stress, including elevated blood pressure and suppressed immune function, among Shuar adults living in the Ecuadorian Amazon. Methods Research was conducted in three Shuar communities in the Upano Valley of the Ecuadorian Amazon and included the collection of biomarkers and a structured morbidity interview. Participants self‐reported somatic symptoms such as headaches, body pain, fatigue, and other bodily symptoms. We examined whether the number of somatic symptoms reported was associated with measures of immune (Epstein–Barr virus [EBV] antibodies) and cardiovascular (blood pressure) functioning in 97 Shuar adults (37 women, 60 men; ages 18–65 years). Multivariate linear regression analyses were used to examine the relationships among somatic symptoms and stress biomarkers, controlling for age, sex, body mass index (BMI), active infection, level of education, and income. Results Controlling for relevant covariates, Shuar adults reporting the highest level of somatic symptoms (three symptoms) were more likely to exhibit elevated systolic ( β = 0.20, p = 0.04) and diastolic blood pressure ( β = 0.23, p = 0.03), in comparison to adults reporting no symptoms. Shuar adults reporting two symptoms, compared to no symptoms, were more likely to exhibit elevated EBV antibody concentrations ( β = 0.34, p = < 0.01). Conclusions These preliminary findings demonstrate that somatic symptoms reported by Shuar men and women are associated with physiological measures widely associated with chronic psychosocial stress. These findings complement the cross‐cultural literature in medical anthropology documenting the close connection between the expression of somatic symptoms and stressful life circumstances and highlight the important role that human biologists can play in exploring biocultural phenomena.

Climate Change and Human Health in the Arctic: A Review

Article

Full-text available

Jun 2024

Elena Grigorieva

Over recent decades, the Arctic has begun facing a range of climate-related challenges, from rising temperatures to melting ice caps and permafrost thaw, with significant implications for ecosystems and human well-being. Addressing the health impacts of these issues requires a comprehensive approach, integrating scientific research, community engagement, and policy interventions. This study conducts a literature review to assess the effects of climate change on human health in northern latitudes and to compile adaptation strategies from the Arctic countries. A literature search was performed between January and April 2024 for papers published after 2000, using the electronic databases Web of Science, Pubmed, Science Direct, Scopus, Google Scholar, and eLibrary.RU, with specific questions formulated to direct the search: (i) What are the climate changes? (ii) How does climate change affect human health? (iii) What adaptation measures and policies are required? The key phrases “climate change”, “human health”, “adaptation practices”, and “Arctic” were employed for searching. Ultimately, 56 relevant studies were identified, reviewing health risks such as infectious diseases, mental health issues, and diseases connected with extreme weather events; wildfires and their associated pollution; permafrost degradation; pure water; and food quality. The paper also examines mitigation and adaptation strategies at all levels of governance, emphasizing the need for international cooperation and policy action to combat negative health outcomes, investments in healthcare infrastructure, emergency preparedness, and public health education. Incorporating diverse perspectives, including Indigenous knowledge, Community-Based Adaptation, EcoHealth and One Health approaches, is crucial for effectively addressing the health risks associated with climate change. In conclusion, the paper proposes adaptation strategies to mitigate the health impacts of climate change in the Arctic.

Fatty acid composition of two small fish in the Gyda River (Kara Sea Basin, Northwestern Siberia, Russia)

Article

Apr 2024
J FOOD COMPOS ANAL

Variation in diurnal cortisol patterns among the Indigenous Shuar of Amazonian Ecuador

Article

Mar 2024
AM J HUM BIOL

Objectives The hypothalamic–pituitary–adrenal (HPA) axis and its primary end product, the glucocorticoid cortisol, are major components of the evolved human stress response. However, most studies have examined these systems among populations in high‐income settings, which differ from the high pathogen and limited resource contexts in which the HPA axis functioned for most of human evolution. Methods We investigated variability in diurnal salivary cortisol patterns among 298 Indigenous Shuar from Amazonian Ecuador (147 males, 151 females; age 2–86 years), focusing on the effects of age, biological sex, and body mass index (BMI) in shaping differences in diurnal cortisol production. Saliva samples were collected three times daily (waking, 30 minutes post‐waking, evening) for three consecutive days to measure key cortisol parameters: levels at waking, the cortisol awakening response, the diurnal slope, and total daily output. Results Age was positively associated with waking levels and total daily output, with Shuar juveniles and adolescents displaying significantly lower levels than adults ( p < .05). Sex was not a significant predictor of cortisol levels ( p > .05), as Shuar males and females displayed similar patterns of diurnal cortisol production across the life course. Moreover, age, sex, and BMI significantly interacted to moderate the rate of diurnal cortisol decline ( p = .027). Overall, Shuar demonstrated relatively lower cortisol concentrations than high‐income populations. Conclusions This study expands the documented range of global variation in HPA axis activity and diurnal cortisol production and provides important insights into the plasticity of human stress physiology across diverse developmental and socioecological settings.