Arctic Indigenous food systems face significant pressure, necessitating transformative changes to ensure food security. Given that Arctic Indigenous communities' food security is disproportionally being affected by global change, it is important that they develop action plans focused on local agency to meet the challenges they face and leverage food system futures that align with local values. We employ a co-produced participatory scenario planning (PSP) approach that combines PSP with positive scenarios from seeds, leverage points (LP), and intergenerational dialogue to challenge traditional future prospects that tend to be pessimistic and support food security for the Aleut Community of St. Paul Island (ACSPI). Through focus groups, a PSP workshop, and a pathways workshop, this study (i) mobilizes intergenerational community values, develops (ii) four positive future scenarios grounded in these values, and (iii) five pathways to achieve a shared vision of the future food system, and (iv) identifies effective LP for realworld change. The community's shared vision represents a diverse, sovereign local food system rooted in Unangax values. Pathways toward this vision include interventions for local capacity building, economic diversification, local agency, subsistence lifestyles, and community cohesion and health. The paper highlights the transformative potential of co-produced PSP in supporting Arctic Indigenous communities in envisioning and achieving sustainable futures.

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.

Vaccine hesitancy is an ongoing barrier to achieve sufficient COVID-19 vaccination coverage. Although there are many studies globally of vaccine hesitancy based on large survey samples, there are fewer in-depth qualitative studies that explore vaccine hesitancy and acceptance as a spectrum of decision-making. In this paper, we begin to describe vaccination decision-making among 58 adults living in remote Alaska based on three waves of online surveys and follow-up semi-structured interviews conducted between November 2020 and November 2021. The survey question of intention was not a predictor of adoption for about one third of the interviewees who were unvaccinated when they took the survey (n=12, 35%). Over half of all interviewees (n=37, 64%) had vaccine-related concerns, including 25 vaccinated individuals (representing 57% of vaccinated interviewees). Most interviewees reported that they learned about COVID-19 vaccines through interpersonal interactions (n=30, 52%) and/or a variety of media sources (n=29, 50%). The major facilitators of acceptance were trust in the information source (n=20, 48% of the 42 who responded), and learning from the experiences of family, friends, and the broader community (n=12, 29%). Further, trust and having a sense of agency appears to be important to interviewee decision-making, regardless of vaccination status and intention.

Achieving sufficient COVID-19 vaccination coverage has been hindered in many areas by vaccine hesitancy. Many studies based on large survey samples have characterized vaccine refusal, but there are fewer in-depth qualitative studies that explore hesitant adoption: the middle-ground between vaccine acceptance and refusal, and how individuals may move across this continuum depending on their lived experience. For this paper, we use the narratives of 25 adults living in off-road, predominately Alaska Native communities to describe the complex decision-making processes undertaken by 'hesitant adopters', defined in our study as those who completed their initial COVID-19 series despite reporting hesitancy. Interviewees' stories help illustrate how hesitant adopters' decision-making processes involved making sense of information through interactions with trusted individuals, lived experiences, observations, emotions, and personal motivations. For the majority of these hesitant adopters' (n = 20, 80%) interpersonal interactions were key in helping to make the decision to get vaccinated. Over half of the interviewees (n = 14, 56%) described how conversations with individuals they trusted, including healthcare providers, family, friends, and interactions through their professional network made them feel safe. One third of the hesitant adopters (n = 7, 28%) attributed their decision to get vaccinated based on the influence of Alaska Native Elders including their knowledge, personal experiences, as well as being motivated by the desire to protect them. Independent research was also important to about a quarter of hesitant adopters (n = 6, 24%), and for these interviewees it was the process of gathering information on their own and learning from others, especially healthcare providers who could answer their questions and alleviate their concerns. This paper illustrates the temporality of vaccine decision-making: vaccine acceptance for those who are hesitant may be an ongoing process that is influenced by personal experience, relationships, and context.

Objective:This study employs a strengths-based approach to assess food access in remote Alaska during the COVID-19 pandemic, identifying both the negative consequences of the pandemic on store-bought and subsistence/traditional food access and compensatory strategies used. Design:As a part of a larger study on the impacts of COVID-19 on daily life remote Alaskan communities, study data presented here were collected through key informant interviews (KII) and state-wide online surveys from 21 September 2020 to 31 March 2021 among remote Alaska community members. Setting:This study was conducted with residents of remote communities in Alaska, defined as those off the road system. Remote communities often have small or no grocery stores and rely on subsistence or traditional sources of food. Participants:KII participants (n 36) were majority female (78 %) and Alaska Native (57 %). Survey participants (n 615) were also majority female, 25-54 years old and most had had some post-secondary education or training. Results:Survey and interview data revealed that the pandemic had significant negative impacts on store-bought food access in remote Alaskan communities. Individuals also shared that locally available and wild harvested foods acted as a buffer to some of the loss of access to these store-bought foods, with some people sharing that the harvesting of wild and traditional foods served as a coping strategy during times of pandemic-related stress. Conclusions:The results from this study demonstrate that the remoteness of some Alaskan communities has been both a source of vulnerability and protection in terms of food access.

In many Indigenous Alaskan communities, important components of healthy aging include access to traditional foods and engagement in subsistence activities. Although many Alaska Native people currently reside in cities, the importance of subsistence activity and foods remains crucial and meaningful for healthy aging in both rural and urban locations. This chapter reviews 20 years of research on the role of traditional foods and activities for healthy aging among Alaska Native Elders. Studies demonstrate that engagement in traditional activities and diet promotes greater cardiovascular health, higher intakes of certain vitamins and nutrients, and increases in physical activity. Also highlighted are adaptive strategies older adults employ to obtain these important foods, such as urban harvesting and food-sharing networks. This body of research shows that traditional foods and harvesting activities are culturally meaningful, serve as protective factors against chronic disease, and are vulnerable to rapid social and climate change occurring across the Arctic.

The COVID-19 pandemic has introduced novel stressors. Remote/rural communities have experienced additional difficulties, while also potentially benefitting from unique sources of resilience against such stressors. However, very little research has been conducted in remote/rural communities regarding coping and stress/violence. This study examines coping strategies and household stress/violence in remote Alaska communities across the pandemic through three online survey waves (November 2020–September 2021) (total n = 1,020). Across all waves, personal care was reported most frequently followed by social activities, religious activities, and traditional/subsistence activities. Substance use combined (alcohol, nicotine, marijuana) and seeking counselling were less frequently reported, with significant differences across gender and age categories. Less than 10% of individuals reported physical violence towards children and/or other adults within the household. Overall, these findings indicate that individuals are primarily relying on positive coping strategies to contend with additional stress brought into their lives by the COVID-19 pandemic.

Objective: This study evaluated the relationships between the occurrence of recent and recurring natural disasters on the incidence of acute and chronic health outcomes at the census tract level in 500 cities across the United States between 2001 and 2015. Methods: Using the Centers for Disease Control and Prevention (CDC) 500 cities data set, the CDC Social Vulnerability Index, and the US Small Business Administration (SBA) Disaster Loan Database, we modeled the incidence of self-reported, poor mental and physical health, or a clinical diagnosis of high blood pressure or asthma in census tracts (N = 27 204 tracts in 500 cities) that had experienced recent or recurring natural disasters while controlling for social and environmental risk factors. Results: Communities that experienced a natural disaster in the previous 5 years compared to those that had not had a higher incidence of poor mental health (RR: 1.02, 95% CI: 1.01-1.02), poor physical health (RR: 1.03, 95% CI: 1.02-1.04), high blood pressure (RR: 1.04, 95% CI: 1.02-1.05), and asthma (RR: 1.01, 95% CI: 1.01-1.02). The incidence of these poor health outcomes increased 1-2% with each additional year that a community experienced a disaster. Conclusions: Prevention and preparedness plans that work to build resilience in communities before disasters should focus on closing the gap in environmental and social determinants that have been linked with disproportionate health burdens and slow recovery post-disaster.

Abstract Background Despite leading national rates early in the pandemic, COVID-19 vaccine coverage in Alaska currently ranks 26th nationwide. Prevailing literature primarily reports urban or aggregated data. Here instead, we further characterize the complex decision-making around the COVID-19 vaccine based on in-depth interviews with Alaskans living off the road system. Methods We conducted 38 semi-structured in-depth interviews by phone with remote Alaska residents. Interviewees were survey respondents who had self-selected for a follow-up interview, and were predominately Indigenous, female, with post-secondary education. Interviews occurred in February and July 2021, after emergency use COVID-19 vaccine approval. Results Of 38 interviewees, 16 (42%) were “low intention” or “deliberating” vaccine acceptance based on their survey responses. Of these, 13 (81% of low-intention/deliberating) got vaccinated between the survey and follow-up interview timeframes. Vaccinated interviewees were motivated by individual-level perceptions of benefits (n = 18, 82%), protecting others (n = 6, 27%), and current or potential requirements (n = 7, 32%). Over half (n = 22, 58%) had vaccine-related concerns, including 13 (46%) of those vaccinated. Concerns primarily pertained to safety (n = 18, 47%), especially potential side effects (n = 11, 29%). Interviewees reported using multiple sources to make their decision, including media (n = 18, 49%) and interpersonal interactions (n = 16, 42%). Confidence among vaccinated/high-intention interviewees was attributed to trusting the source and/or information (n = 14, 44%), learning from others (n = 9, 28%), and personal experiences (n = 8, 25%). Scientific knowledge does not appear to have been a dominant factor for decision-making. Unvaccinated/low-intention interviewees (n = 5) desired more time and information. Conclusions This paper illustrates how vaccine hesitancy and acceptance are dynamic decisions that are influenced by complex processes involving knowledge circulation and reception. These results show that even those who respond that they will “definitely not” get vaccinated may change their minds at some future point. Further, vaccinated individuals may still have vaccine-related concerns. These findings indicate that building vaccine confidence involves a combination of consistent messages disseminated through a variety of media, as well as interpersonal interactions and observations. Trusting the source and/or understanding the information, as well as having a sense of agency appears to be important to interviewee decision-making, regardless of vaccination status and intention.

Given the dynamic nature of the ongoing pandemic, public knowledge and perceptions about COVID-19 are evolving. Limited transportation options, inconsistent healthcare resources, and lack of water and sanitation infrastructure in many remote Alaskan communities located off the road system have contributed to the experience of the COVID-19 pandemic in these areas. We used longitudinal surveys to evaluate remote Alaskan residents' early vaccine acceptance, vaccine uptake and motivations, risk perceptions regarding COVID-19 vaccines, and likelihood of getting a booster. Slightly over half of respondents showed early vaccine acceptance (November/December 2020), with the highest rate among those over the age of 65 years. However, by March 2021, 80.7% of participants reported receiving the COVID-19 vaccine or planning to get one. Of the unvaccinated, reasons for not getting a vaccine included concerns about side effects and not trusting the vaccine. By September 2021, 88.5% of people had received two doses of a COVID-19 vaccine and 79.7% said they would get the booster (third dose) when it became available. There were misconceptions about vaccine recommendations for pregnant women and effects on fertility and DNA. Although initial vaccine concerns may have subsided, the booster rollout and forthcoming vaccines for youth under 12 years of age present new hurdles for vaccine communication efforts.

The Developmental Origins of Health and Disease (DOHaD) hypothesis derives from the epidemiological and basic/mechanistic health sciences. This well-supported hypothesis holds that environment during the earliest stages of life-pre-conception, pregnancy, infancy-shapes developmental trajectories and ultimately health outcomes across the lifespan. Evolutionary anthropologists from multiple subdisciplines are embracing synergies between the DOHaD framework and developmentalist approaches from evolutionary biology. Even wider dissemination and employment of DOHaD concepts will benefit evolutionary anthropological research. Insights from experimental DOHaD work will focus anthropologists' attention on biochemical/physiological mechanisms underpinning observed links between growth/health/behavioral outcomes and environmental contexts. Furthermore, the communication tools and wide public appeal of developmentalist health scientific research may facilitate the translation/application of evolutionary anthropological findings. Evolutionary Anthropology, in turn, can increase mainstream DOHaD research's use of evolutionary theory; holistic, longitudinal, and community-based perspectives; and engagement with populations whose environmental exposures differ from those most commonly studied in the health sciences.

OBJECTIVES:Evidence that fetal development has long-term impacts on health has increased interest in maternal-fetal nutrient exchange. Although maternal metabolism is known to change during gestation to accommodate fetal nutrient demands, little is known about these modifications outside of a Western, clinical context. This study characterizes maternal metabolic adaptations to pregnancy, and their associations with offspring birth weight (BW), among women living in the Philippines.METHODS:Fasting glucose, triglycerides, insulin, leptin, and adiponectin were assessed in 808 participants in the Cebu Longitudinal Health and Nutrition Survey (Metropolitan Cebu, Philippines). Cross-sectional relationships between metabolites and hormones and gestational and lactational status were evaluated. Among the subset of currently pregnant women, associations between maternal glucose and triglycerides and offspring BW were also examined.RESULTS:Women in their second and third trimesters had significantly lower fasting glucose and adiponectin compared to nulliparous women, and leptin levels and triglyceride levels were notably higher late in pregnancy (all P < .05). Among pregnant women, fasting glucose was a positive predictor of offspring BW, but only in males (P = .012, R2  = .28). Hormones and metabolites in post-partum women trend back toward levels found in nulliparous women, with some differences by breastfeeding status.CONCLUSIONS:We find evidence for marked changes in maternal lipid and carbohydrate metabolism during pregnancy, consistent with known adaptations to support fetal growth. The finding of sex-specific relationships between maternal glucose and offspring BW adds to evidence for greater impacts of the maternal-gestational environment on biology and health in male offspring.

The gestational milieu is an important influence on fetal development and long-term disease risk. Here we assess relationships between maternal pregnancy inflammation, indicated by C-reactive protein (CRP), and offspring anthropometric outcomes measured soon after birth. Data come from female participants (n=327, age 24.4–30.2 years) in a longitudinal study located in Metropolitan Cebu, Philippines. Between 2009 and 2014, pregnancy interviews (n=429) were conducted during which questionnaire and anthropometric data were obtained along with dried blood spot cards for CRP measurement. Offspring body weight, length, head circumference and five skinfold thickness measures were obtained soon after birth. Maternal pregnancy CRP was borderline (−1.11±0.64 days/log-mg/l; P<0.1) inversely related to gestational age at delivery, but did not increase the likelihood of preterm delivery. After adjusting for maternal pre-pregnancy body mass index, height, pregnancy adiposity, age, parity and other covariates, CRP was significantly, inversely related to offspring body weight (−0.047±0.017 kg/log-mg/l), length (−0.259±0.092 cm/log-mg/l) and sum of skinfolds (−0.520±0.190 mm/log-mg/l) (all P<0.05), and borderline inversely related to offspring head circumference (−0.102±0.068 cm/log-mg/l; P<0.1). Notably, relationships were continuous across the full CRP range, and not limited to unusually high levels of inflammation. These findings point to an important role of maternal non-specific immune activation as a predictor of offspring birth outcomes. In light of evidence that early life microbial, nutritional and stress experiences influence adult inflammatory regulation, these findings point to inflammation as a potential pathway for the intergenerational transmission of maternal experience to offspring health.