H1D4IHS0246

Yukon-Kuskokwim Health Corporation Special Diabetes Program for Indians 2023 Diabetes Prevention and Control Project - The Yukon-Kuskokwim Delta region is located in the southwest corner of Alaska. The geography of the region consists primarily of Arctic tundra and is dominated by both the Yukon and Kuskokwim rivers.

Demographically, over 95% of the people in the region are Alaska Native. Dotted along these rivers, with only the river to connect them, are the 48 remote village locations and the roughly 30,000 individuals that inhabit them. YKHC is responsible for providing healthcare to these individuals and is the only local care option for Alaska Native beneficiaries.

YKHC's (Yukon-Kuskokwim Health Corporation) Joint Commission accredited hospital is located in the hub city of Bethel (pop. 7,000) yet also serves the expansive 75,000 square mile service area through village-based health clinics. These clinics are staffed by locally trained community health aides. However, in recent years, it has become increasingly challenging to meet staffing demands to be able to keep all of the clinics open on a reliable and routine basis.

Because air, boat, and snowmobile travel are the only options for moving people throughout this remote region, SDPI funds are utilized to a great extent to simply provide access to medical care and prevention education. SDPI funds are also utilized to extend access to care through dynamic telecommunications and advanced clinical staff. Video-teleconference equipment is available in all locations, enabling appointments to be performed by certified diabetes educators, registered dietitians, nurses, primary care providers, and board-certified pharmacists. This equipment has served as a vital lifeline both prior to and throughout the COVID-19 pandemic.

Extremely remote and isolated, the YK Delta's tribes and its people are not afforded many of the lifestyle accommodations that most Americans take for granted. Remote villages, which contain 72% of the region's population, continually face a lack of basic infrastructure. Access to clean running water and basic sanitation is still a major challenge in a region without the benefit of connecting roadways between the vast majority of villages. These realities are both born from and create various logistical challenges unique to this area.

One such challenge is extremely high energy costs that must be incurred to simply move people, goods, and services. These factors combine to result in a lack of fresh or healthful food choices in most local stores. In spite of the region being culturally tied to healthy 'native foods' such as salmon, caribou, various marine mammals, and tundra berries, a true 'subsistence' lifestyle has become less and less of a practical endeavor due to aforementioned energy cost issues and recent changes to state and federal hunting/fishing regulations.

To add a further layer of complexity, the Arctic environment presents a challenge in terms of growing local fruits or vegetables suitable for sustaining large numbers of individuals. Unfortunately, these factors have created ideal conditions for 'food deserts' in most villages and causing high rates of food insecurity across the region.

YKHC has been a recipient of the SDPI grant for the last 25 years. The diabetes department has changed over the last quarter of a century in terms of staffing models and overall goals to provide the highest level of care to the YK Delta population to prevent and manage diabetes. SDPI funds are used to provide healthcare access and resources to this remote region in numerous ways to promote better health.

Yukon-Kuskokwim Health

NOT APPLICABLE

93.237 - Special Diabetes Program for Indians Diabetes Prevention and Treatment Projects

IHS Division of Grants Management (DGM) [HHS - IHS]

HIS Office of the Director [HHS - IHS]

Bethel, Alaska United States

City-Wide

Special Diabetes Program for Indians (HHS-2023-IHS-SDPI-0001)

Amendment Since initial award the total obligations have increased 213% from $1,872,028 to $5,866,084.