T. Kue Young (senior ed.) and Rajiv Rawat, Winifred Dallmann, Susan Chatwood and Peter Bjerregaard (eds.), Circumpolar Health Atlas (Toronto: University of Toronto Press, 2012)

 

The Atlas contains five sections, each divided into a number of chapters. The first two, “The Circumpolar World” which introduces the Arctic geographically and “Circumpolar Peoples” which outlines the main populations, their histories and cultures, make for a clear, if relatively basic, introduction to the Arctic that would be suitable for anyone wishing to embark on Arctic studies in any field or someone who simply has a general interest in the High North. These chapters are beautifully illustrated with maps, satellite images, portraits, photos of fauna and flora, and shots of industrial activities, traditional and modern. The care that has been taken over the illustrations is remarkable in a book that is basically meant to be about health indicators.

 

Only half way through the book do we come to the “health” data but this is in no way a criticism of the Atlas. Indeed, the book is far more appealing for the inclusion of this guided tour to an area that remains a mystery to so many of the populations of Arctic countries residing south of the 66th parallel.  The information presented is not aimed at statisticians; Health Transitions serves that purpose. Instead, the Atlas is aimed at health workers, administrators, policy-makers, teachers and researchers in the Arctic as well as the general reader (Preface, p. ix). For that reason the information is presented with a minimum of text and a maximum of illustration, including many kinds of graphs and data tables alongside maps. All this is complimented by the use of yet more photographs. I believe there is not a single page beyond the Preface that contains bare text.

 

Three parts focus on health: these are Health Status (considering bare outcomes), Health Determinants (offering explanations for the outcomes) and Health Systems (examining health-care provision). Within Health Status, the editors have chosen to focus on the following: child health, reproductive health, infectious diseases, cancer, cardiovascular disease, diabetes and obesity, accidental or violence-related injuries, and mental health. The stark contrast between the health outcomes of natives and non-natives across the North-American continent and Russia become immediately apparent and remain striking through this whole part. The differences in Scandinavia are considerably less pronounced. (Iceland has no indigenous population). Data is also disaggregated according to sex, which also points to some of the social circumstances behind the results which are examined in the following part. In Health Determinants, the authors consider a number of factors to explain the results, namely: genetics, climate, socio-economic conditions, environment and pollution (including climate changes to the environment), nutrition and activity, and substance abuse. Part five concludes the Atlas by summarizing health-care provisions, with a focus on governance and organization, financing and expenditure, health-care facilities, and health-care education and research in the High North. Most notable is not the well-known difference between public and private health-care provision between different Arctic states but rather the discrepancy between financial inputs (i.e. healthcare spending) and health outputs (i.e. life expectancy) (p 160).

 

An editorial decision was made to dispense with footnotes and detailed referencing to maintain the reader-friendly style of the book but a short bibliography is included. Those seeking more academic information are directed to Health Transitions. However, the absence of an index poses a greater inconvenience and is a rather surprising decision, given that even the most common or garden family atlas, even a child’s atlas, would usually include one.

 

One could cruelly describe the Atlas as a “dumbed-down” version of Health Transitions and in some ways, it is. But it is the better for being so. Too much academic work remains on the shelf, shared only between an elite crew of specialists without ever becoming accessible to the majority of people about whom the subject pertains. The Atlas takes a unique, comparative research project and allows anybody to understand it. The result is a visually stunning and delightful piece of work that mixes serious issues with the ease and pleasure of a coffee-table art book.

 

Many reviews end with a comment regarding to whom one might recommend a book. In this case, not only would I recommend the Atlas in some kind of hypothetical manner but I really will recommend it to everyone working on Arctic issues, as an introduction for students of circumpolar studies or researchers coming to the area for the first time, a quick reference tool for those who need simple but accurate health data, or to more seasoned Arctic scholars just to enjoy the pictures.