US Assistant Secretary of Health Admiral Rachel Levine last week traveled across Alaska to consult with tribal health organizations and learn more about state-specific public health challenges.
Mr. Levine has experience in pediatrics and eating disorders. Her office oversees several professional public health programs, including programs focused on climate and health equity, lingering COVID-19, and minority health issues. In Alaska, we prioritized learning about climate and health equity, LGBTQI+ health, and maternal and child health. She visited villages and cities across the state. In an interview near the end of her trip, she talked about what impressed her about her trip.
The following interview has been edited for length and clarity:
Admiral Rachel Levin: I’m here to hear and learn about Alaska’s public health challenges and to discuss potential solutions. So what left an impression on me was my trip to rural Alaska, Nome, Savonga, Kotzeb, and Utkiachvik, where I not only met the people and health workers there, but simply stayed in those towns and villages. There was also something I did.
Rachel Cassandra: I know you met with your tribal health organization, what did you learn from that meeting?
RL: We learned about the amazing work they do not only in their own towns but also in the villages they serve, but we also heard a lot about the different challenges in doing it. I think they are very innovative and creative in their amazing use of telemedicine in these areas. However, there are sometimes challenges in providing care for people with acute illnesses. This means that stabilization and transportation across the state becomes a challenge in terms of weather effects. Some of the specific issues we heard were the effects of climate change on the way of life in towns and villages. We have seen the impact of climate change on traditional food sources.
radio control: And Alaska has seen overdose rates rise with the prevalence of synthetics like fentanyl. Are there any solutions you would like more states to adopt?
RL: There is no easy solution here. There is no silver bullet. I think there are different prevention strategies being considered in Alaska. I know it is done. I think harm reduction strategies are very important. It may contain naloxone. Naloxone reverses opioid overdose. I think there may be more drugs for opioid use disorder, such as buprenorphine, but there is still a lot of stigma surrounding them as crutches. And we don’t think of it as a crutch. Drug therapy for opioid use disorders is the same as using drugs for other disorders. Again, medicine is not a crutch. It’s not a cure. it’s a treat. And it can be a very powerful treatment.
radio control: I heard from a field leader that eating disorders are on the rise in the state in the wake of the new coronavirus pandemic, especially among young people. What would you like Alaskans to know about eating disorders?
RL: Eating disorders, especially in young people, are treatable. And most young people with anorexia and bulimia can recover completely, but I don’t think many people know about it. I think people tend to think of it as a lifelong disability. Chronic disease can occur, but the vast majority do not. During the pandemic, we certainly saw eating disorders on the rise across the country. As you know, many of the mental health issues facing young people are associated with a lack of adequate eating disorder treatment programs and specialists. I think awareness is really important. Recognizing the signs and symptoms of an eating disorder is important because the deeper it becomes and the longer it lasts, the more difficult it is to treat.
radio control: Mental health and physical health are often considered separately in the United States. There are certainly many intersections. Can you talk a little bit about that?
RL: I have always found the integration of physical and mental health to be very important and interesting to me. And that’s what drew me to adolescent medicine in the first place. And all the physical and mental health issues we’re seeing across Alaska are related, so I think that’s very important, especially now that we’re out of the pandemic. Your mind and body are connected. And I think that’s one of the keys to the future of medicine and public health.
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