Subsistence Health in Rural Communities Engaging Students in Biomedical Research

Rural communities often face unique health challenges that fall under the One Health paradigm which advocates that humans, animals, and the environment share one health because their interactions are extensive and they have all-encompassing impacts on one another. Communities in extremely remote areas live in closer proximity to animals and are more directly dependent on environmental factors as determinants of health outcomes. Furthermore, these communities face educational challenges that lead to an underrepresentation of their citizens in the biomedical workforce, either as researchers or health professionals. The Biomedical Learning and Student Training program at the University of Alaska, Fairbanks (UAF) takes a One Health approach to engage students from rural Alaska, one of the most remote areas in North America. Subsistence lifestyles are especially common and greatly impact the well-being of communities and individuals. The One Health concept resonates with rural Alaskans. 

To make the relevance of this concept even more recognizable to citizens in these remote communities, UAF coined the term Subsistence Health. Subsistence Health refers to the benefits and hazards, as well as, the security and sustainability of subsistence foods. As such, it is the conceptualization of the environment, animals and humans interacting in a quintessential example of One Health. Examples of Subsistence Health issues in Alaska include: cardiovascular and metabolic health benefits of the polyunsaturated fatty acids of marine fishes, mercury and its concentration in marine food chains, reduced availability of salmon due to vanishing populations, and potential pathologies causing dramatic declines in caribou herds. A focus on these issues brings biomedical research into the experiential sphere of students in isolated rural Alaskan communities which are often connected only by air travel to other communities and especially education centers. 

BLaST is a partnership between the University of Alaska Fairbanks, the University of Alaska Southeast, and Ilisagvik College and is funded as part of the National Institutes of Health Diversity Program Consortium. By focusing our outreach and research activities on the themes of Subsistence Health and One Health, we reach students and communities that often dismiss basic biomedical research as having little direct relevance to their lives and cultural experience. Incorporating the general One Health paradigm and the specific Subsistence Health paradigm into genuine research experiences for undergraduate students, especially those from remote communities, increases the participation of underrepresented groups in biomedical research. 

BLaST students benefit from research experience which has been designated a high impact practice in higher education, and the field of One Health research from the broadened and diversified experience base of its practitioners. The participation of communities and individuals whose health is directly affected by One Health issues is crucial to expanding research approaches and improving implementation in regions where One Health outcomes often determine individual and public health. Thus, our BLaST program benefits both its student participants and the field of One Health research from the broadened and diversified experience base of its practitioners. The participation of communities and individuals whose health is directly affected by One Health issues is crucial to expanding research approaches and improving implementation in regions where One Health outcomes often determine individual and public health.

Within the BLaST program, the One Health and Subsistence Health theme are the basis of experiential learning, which is the central premise in our approach to research and education. Experiential learning is based on active experimentation by the learner, resulting in direct experiences that the student reflects upon, and leading to abstraction and continued experimentation based on previous experiences. This repeating cycle leads to optimal learning outcomes. Combining experiential learning with our newly coined term of Subsistence Health within the One Health paradigm assures that the BLaST program provides relevant and engaging experiences for rural Alaskan students.

Engagement of BLaST students is further enhanced by providing tiered-group mentoring to complement the experiential learning activities of the program, especially the active participation in genuine research projects connected to the One Health theme. In tiered-group mentoring, multiple researchers at a variety of career stages mentor each undergraduate student. The range of mentors includes senior faculty, junior faculty, postdoctoral fellows, staff research technicians, graduate students, and fellow undergraduate students. Tiered-group mentoring provides students with advice and role models from all aspects of the research enterprise and facilitates students' self-identification as part of the scientific community. Self-identification as a scientist is enhanced by interaction with role models at different career stages investigating One Health and Subsistence Health questions that are germane to life in the far North.

In summary, the BLaST program utilizes One Health and Subsistence Health approaches to engage students from educationally underserved areas in the natural sciences. Successful student engagement is predicated on presenting the natural sciences as culturally and personally meaningful. BLaST’s One Health approach improves health of the environment, animals and people, and it broadens participation of Alaska’s youth in science education and meaningful research. We believe this approach, ultimately, will strengthen post-secondary education and enhance One Health research leading to more Alaskans pursuing health-related professions. Furthermore, the success of our approach will lead to its implementation in other rural areas of North America, which will contribute to the NIH goal of increasing the diversity of the biomedical workforce by increasing participation of people from backgrounds historically underrepresented in biomedical research careers.

Karsten Hueffer, DVM*, PhD, FHEA; Arleigh Reynolds, DVM, PhD, DACVN; Barbara Taylor, PhD

Work reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under three linked awards number RL5GM118990, TL4 GM 118992 and 1UL1GM118991. The work is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health.