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Circumpolar health 84. Proceedings of the sixth international symposium on circumpolar health. Edited by Robert Fortuine. Seattle University of Washington Press. 1985. xxiii + 484 pp. figures tables indexes. $40

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BOOK REVIEWS
CIRCUMPOLAR
HEALTH
84. Proceedings of the
Sixth International Symposium on Circumpolar Health. Edited by Robert Fortuine. Seattle: University of Washington
Press. 1985. xxiii + 484 pp., figures, tables,
indexes. $40.00 (cloth).
The International Symposium on Circumpolar Health has established an enviable record of longevity (the first Symposium was
held in 1977).Even more impressive has been
the great success in assembling distinguished researchers from many nations who
present and discuss their latest findings
bearing on health status and health care delivery among Northern peoples. These Proceedings, based on the Sixth Symposium,
follow the now standardized format of publishing numerous papers, some of them expanded versions but most only a few pages
long. The slightly more than 100 finally selected entries, out of the nearly 200 read at
the Symposium, cover diverse health-related
topics organized under the following sections. 1) Introductory Statements and General Statements; 2) Physiology and Pathology
of Cold Climates; 3) Demography, Morbidity,
and Mortality; 4) Infectious Disease; 5) NonInfectious and Chronic Disease; 6) Acculturation, Mental Health, and Substance Abuse;
7) Health Programs and Manpower; and 8)
Progress in Self Determination.
The Proceedings editor, Robert Fortuine,
admirably surmounted obvious difficulties in
selecting papers, and his efforts have produced a highly professional and timely volume. This would be a prohibitively lengthy
review if each paper or even each section
were treated individually. Instead, general
comments will be made on themes and issues
raised in the Proceedings with reference to
particular papers for illustration.
Circumpolar Health '84 should provide a
little of something to everyone in the physical anthropologyhuman biology realm, and
a lot to those who specialize in biomedical
research andor possess a dedicated interest
in human residents of the northern latitudes,
principally from Alaska, Canada, Greenland,
Iceland, and Finland.
The topic of genetic adaptation versus developmental plasticity receives limited attention and is mainly decided on the side of
acclimatization in the case of physiologic response to cold stress (Shepard). Anthropome-
411
trics are very sparsely represented in the
studies (Moffatt et al. deal with growth data
from Quebec Cree children).
As intended, the Proceedings dwell extensively on health-related matters and on the
particular and possibly unique problems facing circumpolar populations. On this point,
the delivery of adequate health care in the
North is compromised by cost factors related
t o generally small, widely dispersed settlements; harsh travel, and living conditions
(Schaefer; McGinnis). Importantly, coursing
through many papers there is a persuasive
argument that the rise in health problems,
hence in health costs, among at least native
North Americans (Eskimos, Inuits, and
Amerindians) has paralleled and likely was
substantially caused by changes in life-style
within an acculturation process. With the
introduction of or accelerated exposure to
new foods, new pathogens, and new behaviors (e.g., smoking and alcohol/drug abuse),
disease patterns among these arctic and subarctic groups have taken on a westernized
appearance with a prevalence of respiratory
and cardiovascular ailments (Carson et al.;
Edwards et al.), diabetes (Young and McIntyre), and mercury toxicity cases (Hansen
reports on a possible mediating effect caused
by high selenium intake in Greenlanders).
An interesting exception is that kinds and
prevalence of cancer among Greenlanders retain the traditional pattern of malignant disorders (Nielson and Hansen). Yet, back again
to the probable westernization effect, poor
dental health (Mayhall; Messer) and even
poorer mental health among young adults
(O'Neil) are described with alarming clarity.
Acculturation apparently promoted psychological problems, which are manifested
quite often in alcohol and drug abuse and in
unusually high suicide rates in young adult
northerners. Stresses from culture contact
are viewed by Berry within a broad explanatory model. His framework seems to approximate reality wherein acculturation may
have both negative and positive aspects, with
the latter leading to adaptive responses.
Berry is clearly calling for an increased cultural awareness that is to be gained through
more and better ethnographic research in the
North.
Beyond the recognition of contributory and
causal conditions underlying ill health and
less than adequate health care systems
throughout many northern communities lies
412
BOOK REVIEWS
attributed to holistic medicine and even
adopting a plural medical system by combining traditional with western medicine
(Haroldson).
One of the more anthropologically oriented
papers (O’Neil) makes a cogent argument for
continued research in the North to be better
focused on health rather than on disease.
Health problems do in fact characterize these
and prior Proceedings. Possibly the appeal of
this argument will attract many physical anthropologists to reading Circumpolar Health
’84, because it does provide a rich biomedical
background for examining ongoing human
adaptability in arctic and subarctic peoples.
a n innovative solution that commands major
attention in the Proceedings, especially so in
the final section. The solution seems quite
straightforward. In simplistic terms, it is letting the people speak for themselves. More
formally, there is reference to self-determination and local control. Explicit definition
is offered by Andrew and Sarsfield, who urge
that health care and policy decisions be
structured within a relevant cultural context. This calls for the people who receive
medical care to take a more active part in
their well-being, which can in some instances
necessitate altering life-styles, and, in cultural historical terms, to return to the old
ways. The concept is placed into action
through the “Spirit Movement,” espoused by
the Northwest Alaska Native Association
(NANA). As described by Mala, this movement stresses self-responsibility and other
values ingrained in traditional culture. It
also appears to be incorporating some aspects
ROBERT
MEIER
Department of Anthropology
Indiana University
Bloomington, Indiana
-
BEHAVIOR
AND PATHOLOGY
OF AGINGIN RHEsus MONKEYS.Edited by Roger T. David
and Charles W. Leathers. New York: Alan
R. Liss, Inc. 1985. xviii + 359 pp., figures,
tables, index. $88.00 (cloth).
The 18 papers presented here provide several models of the behavioral and pathological effects of aging. The empirical and
theoretical works are based on a 29-yearstudy of rhesus macaques. By maintaining
control over all environmental factors during
the study in a n attempt to reflect only agerelated factors, a unique opportunity to observe anatomical, physiological, neurological, and behavioral components of aging was
provided.
The chapters, each presenting a different
model of aging, are partitioned into five sections. Section I contains chapters outlining
the history of the project, the relationship of
these studies to theories of aging, and data
on basic pathology and cell growth. Chapter
1 details the behavioral studies conducted
throughout the tenure of the project. A retrospective analysis of baseline behavior of
surviving and nonsurviving animals provided some information for prediction of survival based on task performance. In chapter
2 a n attempt is made to relate the findings
in chapter 1 with those from other species.
Additionally, effects of pathological features
on behavior were suggested. Antemortem
and postmortem procedures at euthanasia,
gross anthropometric measures, and pathology are presented in chapter 3. In chapter 4,
work on chemical estimation of age in humans and sea mammals is extended to rhesus. Cell proliferation and the decline in the
replicative potential of aortic cells as a function of age are discussed in chapter 5, while
chapter 6 addresses the type and variation of
amount of epithelium in the larynx with respect to age.
Section I1 consists of five chapters on the
sense organs, brain, and behavior. A model
of structural, functional, and organizational
age-related changes of the brain is presented
in chapter 7. Chapters 8 and 9 provide a
summary of auditory and visual changes
with senescence. Coordination of behavioral
and pathological procedures provides insight
into the basis of presbyacusis and ability for
self-correction of optical defects, respectively.
The structure of the primate tongue is described in chapter 10, and notation is made
of a lack of age-related changes. The results
of a descriptive study of behavioral idiosyncrasies are also presented in chapter 10, and
analogies to human behavior are made.
Endocrine functions serve as the focus of
the two papers in section 111. Circulating hor-
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