The health of elders: a comparison of communities across the Bering Strait.

Abstract

OBJECTIVE: Compare the self-reported health status of a cohort of 58+ individuals in sixteen communities on either side of the Bering Strait. STUDY DESIGN: Multi-method including formal surveys and ethnographic research. METHODS: Approximately 1,146 survey questionnaires were completed. A sample of 747 of these interviews were used for this analysis, of which 88 were 58+ years of age and 659 were adults 18-57. RESULT: On all self reported measures of general health, chronic illness and depression, Russian elders reported higher rates of poor health than did their American congeners. However, the segment of the sample in most distress was Russian adults 18-57. Not one of these 361 individuals reported their health as "very good", while nearly a third reported poor health and chronic illness. In addition, about 2/3rds (compared to half the Russian elderly) reported a constellation of symptoms related to depression. Psychologically (using these measures) the most resilient cohort were Alaskan elders. One result of this research that is of tremendous concern is the fact that over two thirds of the STN males, both Alaskan and Russian, under the age of 58 smoke. This is an extraordinary proportion and is easily double the rate for individuals of similar age within the U.S. CONCLUSIONS: For Alaskan elderly, no other segment in the U.S. faces the level of difficulty in access to health services even though these services are incomparable by Russian standards. In addition, the extremely high levels of behavioral risk from smoking and other factors indicate substantial difficulties and increasing demand for health services in the near future. In comparison Russian elderly populations face almost uni-maginable difficulties.