Despite many improvements, healthcare accessibility disparities are still rampant in Arctic states, even for primary healthcare (PHC). Bearing in mind the Arctic practical limitations, how can Arctic states further improve the health of their inhabitants living in the Arctic?
Committee on Environment, Public Health and Food Safety I
Chaired by Šimon Prek (CZ). Covered by Dora Kurobasa (HR)
The Arctic is home to more than 4 million people, scattered around the region in often very remote and isolated communities. Due to the low population density of the region and the rather unfavourable natural conditions for infrastructure, development, and transportation, a lack of healthcare accessibility is one of the main challenges to upholding a good quality of life for all the inhabitants of the Arctic.
Moreover, the region consistently struggles with worker retention, as many healthcare practitioners have difficulties adjusting to the environment or wish for more social interactions. In short, the Arctic has historically been unable to provide infrastructure and healthcare means that would meet all the needs of its inhabitants. Even in cases where considerations were made for these needs, it has failed to account for the well-being of the people who make the wheels of healthcare turn.
Executive summary
Listen to the audio Topic Overview
The unique nature of the Arctic region and the dynamics between its various populations put forward challenges in healthcare accessibility incomparable to the rest of the world. These challenges constitute historical factors of colonisation and its effects on Indigenous populations, geographical factors such as proximity to providers and healthcare facilities, and societal factors such as isolation and a lack of self-actualisation of workers. The most apparent of these is the availability of primary health care and healthcare in general throughout the Arctic region. We can separate healthcare into three types: primary (PHC), secondary (SHC) and tertiary (THC). Primary healthcare is most often carried out by doctors and nurse practitioners and serves to identify illnesses and injuries and either administer sufficient care, or coordinate specialist care that could be found within secondary and tertiary healthcare. In the Arctic, PHC providers are most often found solely in bigger settlements and towns. This leaves remote communities with little options for quick access to qualitative healthcare; from the inaccessibility to insufficient infrastructure, the standard of healthcare in the rural Arctic is in dire straits.

Self-actualisation of workers describes how content a worker is in their respective field of practice, how the circumstances of this practice affect their well-being and personal life, and the general state of satisfaction that their labour can provide.

Thus far, many attempted solutions have focused solely around infrastructure improvements, failing to consider the mental health and well-being of the healthcare practitioners who came to the Arctic. Furthermore, access to healthcare in the Arctic has often compromised on the needs and ancestral practices of its Indigenous population by national standardisation of healthcare across all territories.1 The questions will arise the deeper we will delve into the different aspects of the issue; where can tangible improvements in healthcare infrastructure be made, considering the landscape and remoteness of many Arctic regions? What role do the Arctic’s Indigenous people play in this, and how can they be best integrated into the policy-making process? And what about the low numbers and lack of consideration for the needs of healthcare professionals? All of these questions and many more will have to be considered in order to come up with successful solutions.
Lavoie et al. (2021) Historical foundations and contemporary expressions of a right to health care in Circumpolar Indigenous contexts: A cross-national analysis in Elementa: Science of the Anthropocene Link.
  • Areas reached only by sea or through air
  • Insufficient railway connections
  • Poor accessibility by car

Remote communities
  • Often without PHC providers
  • Difficult to access
  • State-sceptic and healthcare-sceptic communities

Lack of PHC providers in rural areas
  • Long waitlists for patients
  • Often difficult to access
  • Insufficient resources and further specialised care
Land disputes
  • More than 200 land claims raised by First Nations populations are currently under review in Canada
  • Land Back movement and its traction in Northern America
  • 80% of all Swedish hydropower plants are located on Sámi-claimed land, resulting in land degradation

Resource disputes
  • Sámi lands are resource rich - Beowulf Mining
  • Lack of state protection due to foreign investment in mining sites

Indigenous peoples
  • Language Barriers at PHC providers
  • Healthcare scepticism among isolated communities and traditionalist populations
  • Many indigenous people claim persisting discrimination from their respective States
Novelty Viruses and Illnesses
  • High susceptibility to novelty viruses due to pre-transition state of indigenous and rural epidemiological transition
  • Proportionately suffering from modern causes of death (e.g. cancer)

1918's Influenza
  • Indigenous mortality rate three to eight times higher than in comparable white-dominant regions
  • No previous exposure to similar influenza viruses raised mortality rates in rural and isolated communities exponentially
Land use
  • Environmental damage through resource depletion, de-vegetation, and damaging natural habitats
  • Lack of motivation for further settlement
  • Large oil and gas reserves contra further protection of the environment

Natural obstacles
  • Harsh weather conditions
  • Often unfavourable land to build infrastructure on

Allocation of capital
  • Rural areas remain underfinanced compared to urban areas
  • Remoteness of many communities make systematic investments into infrastructure difficult
Historical Context
The region’s public health crisis is an age-old issue. Considering the remoteness of many Arctic communities, one might expect them to be well protected against deadly pandemics. However, through history, we can see this has not been the case. The most prominent example would be the influenza epidemic after World War I, which viciously swept through remote areas of the Arctic. Multiple factors, such as a lack of immunisation through prior exposure, an information deficit due to poor communication, pre-existing health conditions and the desperate lack of adequate healthcare infrastructure, contributed to the Arctic epidemic.2

Most importantly, rural and especially indigenous populations struggle with being stuck in the pre-transition state of the epidemiological transition. For example, in the 1700s, a tremendous influx of gold-diggers, fur trappers and settlers in Alaska led to a gradual tuberculosis outbreak. Consequently, in 1930 the illness accounted for almost 35% of all Native Alaskan deaths.3 Sadly, over the course of history, entire communities have been wiped out due to the Arctic’s poor healthcare response and infrastructure.4
Historical Context
However, there have also been bright points in the Arctic’s response to pandemics and other healthcare crises. For example, many Indigenous Arctic communities have shown high vaccination rates and general pandemic resilience during the COVID-19 pandemic, based on an Indigenous-led healthcare response, and community-developed vaccination campaigns.5
The epidemiological transition describes changing patterns of population distribution through the lens of mortality statistics, life expectancy, and leading causes of death. Being in the pre-transition state of this process, the rural and indigenous populations of the Arctic are more vulnerable to diseases and viruses than the urban populations.
Vaxx Fest, a Stoney Nakoda Nation and the Tsuut’ina Nation-led vaccination campaigns presented through the lens of the "teaching of the buffalo", contextualising modern healthcare issues through the lens of ancestral First Nations knowledge.
Arctic Council (2020). Historical Context: Influenza And Other Epidemic Infectious Diseases In The Arctic Link.
Bennett, Mia (2020) What The Arctic Reveals About Coronavirus in Journal of the North Atlantic & Arctic Link.
Tiwari et al. (2022) The second year of pandemic in the Arctic: examining spatiotemporal dynamics of the COVID-19 “Delta wave” in Arctic regions in 2021 in International Journal of Circumpolar Health Link.
 Arctic Council, Sustainable Development Working Group Link.
Arctic Council, Saami Council Link.
Arctic Council, Indigenous People’s Secretariat Link.
International Union for Circumpolar Health,  About Link.
Region Västerbotten, Information in English Link.
Key Stakeholders
The Centre For Rural Medicine in Västerbotten10 collects data and analyses trends and possible solutions in healthcare, digitalisation of healthcare, and infrastructure deficits within sparsely populated northern regions of Sweden. Its findings are essential for developing rural healthcare policy and ensuring that rural populations are represented in the legislative process.
The International Union for Circumpolar Health (IUCH)9 is the largest international non-governmental organisation dedicated strictly to healthcare issues faced by the Arctic regions. It bolsters the exchange of essential medical knowledge, researches Arctic-specific healthcare issues, and supports legislative efforts in developing both physical and digital healthcare infrastructure across the region.
The Sustainable Development Working Group of the Arctic Council 6 executes the decisions made by the Arctic Council Ministers in areas of sustainable development, especially in infrastructure, healthcare, protection of Indigenous heritage, and transportation. Its current priorities within these thematic groups lie in the circular development of the educational system, streamlining investments into long-term infrastructure solutions, and developing and implementing essential know-how in collaboration with Indigenous and rural communities. The Arctic council unifies the most powerful drivers of change in the region - the Member States of the Council - and their respective legislative priorities, ensuring a people-focused policy in all areas of development in the region.
Indigenous and Rural Populations have the most interest in mitigating disparities in access to healthcare. There are organisations and lobbies with considerable influence on decision-making bodies, such as the Saami Council7, united under the Indigenous People’s Secretariat (IPS) of the Arctic Council.8 The IPS was established in 1994 to better facilitate the participation of Indigenous peoples in Arctic governance, yet many essential takeaways for effective healthcare policy still lie with traditional communities beyond the Arctic Circle.
Fundamental Challenges
Lack of PHC Providers
Transportation Infrastructure
Practicioner Burnout
Indigenous Populations
Retention of Workers
In general, populations around the Arctic circle have to travel far not only for specialised healthcare facilities, but also for PHC providers in general. Due to the small size and general remoteness of the communities, the amount of healthcare specialists is limited and simply cannot bear the needs of small communities.12
Another way infrastructure influences the disparity in access to healthcare is the lack of transportation options. For many communities, but especially for those only accessible via the sea or air, poor weather conditions as well as railway closures or insufficient transportation connections.13 prevent quick access to healthcare.14
Lastly, the lack of Indigenous participation in the general development of the Arctic’s healthcare structures is reflected in various barriers that are unique to Indigenous populations. One of these barriers is language; oftentimes practitioners cannot speak Indigenous languages, leading to misdiagnoses and shallow relationships between the practitioners and their patients.17
The lack of infrastructure only further worsens this burden by concentrating the patients of a whole region into the waitlists of one or two practitioners, leading to high waiting times, insurmountable amounts of work and potential burnout of the practitioners.16
Overall, the lack of Indigenous representation on the individual as well as structural, decision-making levels leads to inadequate access to healthcare information and general mistrust of the healthcare system among many Indigenous people.18
Furthermore, even if healthcare is relatively accessible in a region, the issues of retention of practitioners and the conditions of labour come into play. Practising healthcare in isolated regions often comes with the burden of leaving behind one’s family and friends, forgoing access to the benefits of urban lifestyles, and working in under-resourced conditions instead of in state-of-the-art healthcare centres.15
All healthcare systems in the Arctic take on similar challenges; from long distances between people through an often harsh climate to limited resources, the Arctic’s governments face unique challenges in ensuring equitable access to healthcare.11
 Lavoie et al. (2021) Historical foundations and contemporary expressions of a right to health care in Circumpolar Indigenous contexts: A cross-national analysis in Elementa: Science of the Anthropocene Link.
Huot et al. (2019) Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals in International Journal of Circumpolar Health Link.
Povoroznyuk et al. (2022) Arctic roads and railways: social and environmental consequences of transport infrastructure in the circumpolar North in Arctic Science Link.
Huot et al. (2019) Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals in International Journal of Circumpolar Health Link.
Oostever and Young (2015) Primary health care accessibility challenges in remote Indigenous communities in Canada’s north in International Journal of Circumpolar Health Link.
Dione et al. (2010) Innovations in health service organisation and delivery in northern rural and remote regions: a review of the literature in International Journal of Circumpolar Health Link.
Huot et al. (2019) Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals in International Journal of Circumpolar Health Link.
Richardson and Crawford (2020) COVID-19 and the decolonization of Indigenous public health in Canadian Medical Association Journal Link.
Through measures such as Decentralised Nursing Education19 carried out by the University of Tromsø and the Swedish county of Norrbotten’s “Distance Spanning Healthcare20”, actors in Arctic States have been trying to combat the issues of worker retention in rural healthcare. This has been done by establishing more healthcare education possibilities in rural areas, such as by the University of Tromsø. Another benefit has been the consequent life-long education opportunities and student involvement in rural healthcare practice by the means of stipends and fellowships. Improving healthcare worker retention is also a primary objective of national and international policy.
The Framework for Remote Rural Workforce Stability21 is focused on rural European workforces and the obstacles to worker retention, such limited career progressions or a missing sense of community. In healthcare itself, the Alaska Health Workforce Coalition 2017-2021 Action Agenda22 has significantly improved the numbers of PHC providers throughout the remote regions of Alaska. It has managed to implement digitalisation and community-building tools to better meet the needs of healthcare practitioners in its rural areas. All of this has been done by uniting essential governmental structures, healthcare NGOs, and worker’s organisations in pursuing creative solutions to the issues at hand.
The Arctic Council, particularly the Sustainable Development Working Group, have developed three significant projects that currently shape the state of healthcare accessibility. The One Arctic, One Health23 policy attempts to find layered solutions to issues of human, environmental, and animal health through efficient knowledge-sharing and developing practical solutions for improved health care practices. Furthermore, the Arctic Council is responsible for carrying out the Arctic Maritime and Aviation Transportation Infrastructure Initiative24, focused on improving the shipping and transportation routes in the Arctic sea and throughout remote regions. It is also responsible for utilising the Arctic Investment Matrix25 to better implement digital solutions and mitigate connectivity issues in the region, thus indirectly further helping digitalisation of healthcare the Arctic desperately needs.
Measures in Place
 Norbye and Skaalvik (2013) Decentralized nursing education in Northern Norway: towards a sustainable recruitment and retention model in rural Arctic healthcare services in International Journal of Circumpolar Health. Link.
Overview of SCIROCCO good practices (2017) Norrbotten, Sweden: Distance spanning healthcare. Link.
Making it Work (2019) Framework for Rural Remote Workforce Stability. Link.
Alaska Health Workforce Coalition (2017) 2017 – 2021 ACTION AGENDA. Link.
Arctic Council (2022) One Arctic, One Health. Link.
Arctic Council (2022) Arctic Maritime and Aviation Transportation Infrastructure Initiative. Link.
Arctic Economic Council (2022) Arctic Investment Matrix. Link.
The Arctic offers a unique set of circumstances that prevent simple solutions from being efficient. The bond it has with its ancestral peoples continues to challenge them and reward them; the legacy of colonialism and settlement faces off against the tight sense of community and belonging often fostered in Indigenous and rural populations. There exists much to explore within the socio-economic context of the situation; with intersectional issues of retention of workers, lack of infrastructure, transportation inadequacies and bureaucratic complications are essential to mitigating the gap in healthcare accessibility, it is only the exploration of all policy avenues that will ultimately drive the Arctic regions to more cooperation, sustainability, and equitable development.

For this to succeed, we need to understand the delicate interplay of all circumstances surrounding the issue at hand. From the essential perspectives and solutions offered by the Sámi community and communities throughout the circumpolar regions, to the rural-urban divide and the lasting legacy of colonialism that stains Arctic countries to this day; the only true solution is one that considers and respects all the angles, bringing forth an interconnected healthcare system that leaves no single person behind.
Download pdf
In case you need it
We gathered all the essential information of your TO is a PDF document for your convenience.

Click on the button below to download your Topic Overview, but be aware that the PDF document might not contain all the information from the website (pictures, videos, visuals, etc).
Motion for a resolution
Submitted by:
Wilma Åkebring (SE), Maiken Elise Bakker (NO), Katharina Brun (AT), Eleni Charalambous (CY), Miguel C o e l h o Costa (PT), Séléna Elhafidi (LU), Kaltra Hudhra (AL), Max Jensen (DK), Samvel Mailyan (AM), Szymon Miotk (PL), Lara Mrzljak (HR), Elaine Murphy (IE), Paulien Verhulst (BE), Fenna Winter (NL), Šimon Prek (Chairperson, CZ)
The European Youth Parliament aims to facilitate easier access to healthcare services within the Arctic through bettering transportation infrastructure, digitalisation of healthcare, connectivity of the region and the capacities and capabilities of healthcare workers. It aims to facilitate public and private investments into essential projects that increase the response capacity of the healthcare systems within the Arctic States. Finally, it strives to develop dedicated working groups and legislative bodies to facilitate an interconnected, efficient, and just healthcare provision throughout the region,

A. Acknowledging the insufficient transportation options in the rural areas of the Arctic prevent quick healthcare access to its inhabitants due to poor weather conditions, railway closures and insufficient road connections,

B. Bearing in mind there are only few adequately resourced healthcare centres outside of Arctic urban areas,

C. Having devoted attention to the higher risk of Indigenous People experiencing chronic medical conditions,

D. Aware the language barriers, racial discrimination and anti-Indigenous biases lead to misdiagnoses and shallow doctor-patient relationships,

E. Alarmed by the lack of Indigenous representation in the primary healthcare landscape of the Arctic regions, leading to general mistrust of its systems,

F. Keeping in mind the inaccessibility of broadband in the Arctic Region hinders progression towards healthcare digitalisation,

G. Taking into consideration that existing data on the current healthcare workforce is neither qualitative, nor reliable, making unclear where and what resources are needed,

H. Taking note that the research regarding e-healthcare1 has been mainly focused on urban areas and has failed to account for more rural areas,

I. Deeply concerned by the constant replacement of doctors in the Arctic with locum doctors, leading to medical mistrust longer diagnosis times needed, and lack of primary healthcare (PHC) continuity2,

J. Regretting the regional external factors of cost of living, travel costs, and career opportunities being responsible for a comparative lack of healthcare workforce in the rural Arctic,

K. Fully alarmed by the disproportionate workload falling on healthcare professionals in the Arctic and causing burnout,

L. Bearing in mind that isolated citizens often have to leave their local communities for an extended period of time in order to be in a ‘safe distance’ from a medical facility for reasons such as chronic illnesses and pregnancies;

1. Directs the Directorate General for Budget (DG-BUDG) to restructure the Horizon 2027 funding by:
a. incentivising the development of climate resilient transportation infrastructure in rural Arctic regions,
b. assessing the amount and targets of infrastructure and transportation funding utilising the Rural Access Index3,
c. establishing a 4-year evaluation period of the implementation efficiency in line with the conclusion of Horizon 2027;

2. Further directs DG BUDG to expand the Horizon 2027 Initiative by funding emergency medical equipment supply projects in under-equipped rural areas of Arctic States, based on the Centrality 2020 index4;

3. Calls upon the Indigenous Peoples’ Secretariat to establish a working group responsible for solidifying healthcare provision to Indigenous Peoples through:
a. drafting guidelines on adaptation and needs of Indigenous People regarding discrimination for relevant healthcare stakeholders,
b. evaluating the commitment of Arctic States to anti-discriminatory healthcare legislation within a periodical timeframe of 5 years;

4. Invites the Ministries of Education of Arctic States to adopt preventive health education measures within the Arctic region based on the Sammen redder vi liv5 campaign, preventing risk in case of emergencies in rural areas by:
a. offering first aid workshops to increase young people’s knowledge,
b. conducting public health campaigns in order to inform inhabitants of signs of illness and healthcare accessibility,
c. assuring wide availability of critical medical handheld equipment, such as defibrillators;

5. Strongly recommends Arctic States codify the cultural autonomy and negotiation rights over critical services, such as healthcare, following the example of the Finnish Act on The Sámi Parliament of 19956;

6. Asks the Arctic Council to expand on the existing implementation of subsea optic fibre broadband cables to reach all rural and island communities of the Arctic;

7. Instructs the European Investment Bank to increase funding to private sector specialist treatment innovation projects, with regard to:
a. supervising the correct implementation of these funds within the Arctic States through the European Court of Auditors,
b. basing the funding rate increase on existing Eurostat data on the population and healthcare capacities of rural areas,
c. utilising the European Fund for Strategic Investment to garner private investment capital;

8. Invites the Arctic Council in cooperation with European Commission to establish a new Arctic healthcare-specific working group, known as the Arctic Health Coalition, imbuing the following legislative abilities and objectives:
a. collecting and analysing healthcare data throughout the Arctic region,
b. developing healthcare policy proposals on the basis of the analysed healthcare data,
c. facilitating digital knowledge-sharing among rural and urban healthcare practitioners within the arctic region;

9. Designates the Arctic Health Coalition to lessen the language barriers between Indigenous patients and non-Indigenous practitioners by delivering the following policies of:
a. developing voluntary bi-annual educational programmes for healthcare practitioners in the Arctic on the Indigenous culture and language, in cooperation with the region’s Indigenous Peoples,
b. making artificial and human translators widely available for all Indigenous patients and practitioners,
c. implementing the Teach-Back Method7 in all Arctic countries’ healthcare guidelines and training for practitioners;

10. Encourage the Ministries of Health of the Arctic States to establish a dedicated eHealth sub- department regulating and developing eHealth8-based solutions;

11. Directs the European Space Agency (ESA) to re-establish the TelAny project to streamline telemedicine development in the rural Arctic;

12. Further directs the ESA to expand the scope of the project to non-European Arctic States;

13. Calls upon the Sustainable Development Working Group of the Arctic Council to develop a unified Arctic system of telemedicine9 to facilitate:
a. increasing possibilities for remote patient monitoring,
b. ensuring easy access to the recommended biyearly medical check-ups,
c. providing quality mental healthcare for patients and practitioners alike;

14. Urges the Ministries of Education of the Arctic States to employ the Bodø modele10 in their respective medical school curricula, stabilising the amount of rural general practitioners and other medical workers;

15. Calls upon the Arctic States to work in cooperation with their respective healthcare trade unions to modify the working hours of healthcare practitioners based on the criteria of:
a. allowing more flexibility in the selection of working hours,
b. preventing multi-day shifts,
c. creating space for lifelong education programmes implemented within the benefit structure of the worker’s contracts;

16. Recommends the Arctic States implement benefit provisions for the healthcare workers in rural Arctic regions concerning childcare, transportation costs, and accommodation subsidies.

Please submit a short form if you want to report any bugs or errors
E-healthcare is the process of utilising network and technology tools to streamline operations, improve medical care and patient involvement in treatment; in short, the digitalisation of medicine.

Primary healthcare continuity has been proven to be an efficient mitigator of negative healthcare outcomes, whereas a long-time coupling of a general practitioner and patient reduces negative outcomes by 25%.
The Rural Access Index is a global transportation development tool developed by the World Bank, defined as “the proportion of the rural population who live within 2 km of an all-season road.”

Centrality 2020 is a Norwegian municipality centrality index that enumerates the proximity of rural municipalities to urban centres.
Sammen redder vi liv, or “Saving Lives Together”, is a Norwegian campaign aimed at reducing the risk and increasing the survival rates of time-critical emergency incidents, such as cardiac arrest, stroke, and serious injuries. 6 Act on The Sámi Parliament provided Finnish Sámi with representation in the state structure and with legislative ability, among other things, to protect Sámi cultural heritage.

Act on The Sámi Parliament provided Finnish Sámi with representation in the state structure and with legislative ability, among other things, to protect Sámi cultural heritage.
The Teach-Back method is a confirmation mechanism of if the patient understands the information relayed to them. It is carried out by the healthcare worker asking the patient to restate what was said to them in their own words.

eHealth is defined as “healthcare practice supported by electronic processes” including technology such as electronic health records, patient administration systems and lab systems.

Telemedicine facilitates remote clinical solutions, such as diagnoses and treatments, as a means of treatment for patients in remote areas.

The Bodø model refers to a programme of Bodø university undertaken by 24 students during the last two years of their undergraduate education. The programme aims at increasing the number of practitioners in the municipal areas of Bodø and retaining practitioners in the area after graduation.
Made on