224151 Reducing Outmigration by Addressing the Health Needs and Concerns of Rural Alaskans

Tuesday, November 9, 2010 : 1:15 PM - 1:30 PM

David Driscoll, PhD, MPH, MA , Institute for Crcumpolar Health Studies, University of Alaska, Anchorage, Anchorage, AK
Bruce Dotterrer, MS , Institute for Circumpolar Health Studies, University of Alaska - Anchorage, Anchorage, AK
Jenny Miller, DrPH MS MPH , Department of Health Sciences, University of Alaska Anchorage, Anchorage, AK
Hannah Voorhees, MA , Anthropology, University of Pennsylvania, Philadelphia, PA
Rural Alaska is experiencing an increasing rate of rural to urban migration, or “outmigration” compared to historical trends. Outmigration threatens the long-term sustainability of Alaska's isolated communities and creates unexpected demands on social services in metropolitan areas. Previous attempts to address the determinants of outmigration have emphasized the role of economic push factors such as under-employment and high fuel costs. This study is the first to assess the role of health concerns and health care needs as determinants of outmigration in Alaska. The research design consisted of two iterative phases; first, a comprehensive review of published and gray literature relevant to rural health and migration in Alaska, and second, in-depth interviews with a purposive sample of rural Alaskans who had recently moved from rural to urban settings. Our findings revealed three determinants of increased outmigration from rural to urban Alaska: (1) an aging segment of rural Alaskans require long-term care and support that cannot currently be met in village settings; (2) obstacles to timely pediatric, mental health, and substance abuse treatment in rural settings; and (3) the need for social support networks for rural Alaskans moving to urban settings lead to ripple outmigration of friends and family. We present statistical, historical, and narrative data describing the growing influence of health concerns and health care needs on outmigration in this under-served population, and conclude with recommendations to improve rural community health care and allow rural Alaskans to live and grow old in their own communities.

Learning Areas:
Advocacy for health and health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe the growing problem outmigration from rural to urban Alaska. Demonstrate the health-related determinants of outmigration. Identify local health policy solutions to serve rural Alaskans and reduce outmigration.

Keywords: Community Health Planning, Health Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Principal Investigator for this study, and led all aspects of the development and implementation of the research design.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.