II 113th CONGRESS 1st Session S. 271 IN THE SENATE OF THE UNITED STATES February 11, 2013 Mr. Begich introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To improve Arctic health.

1. Short title This Act may be cited as the Better Health in the Arctic Act . 2. Findings Congress finds the following: (1) The United States is an Arctic nation with— (A) an approximately 700-mile border on the Arctic Ocean; (B) more than 100,000,000 acres of land above the Arctic Circle; and (C) an even broader area that is defined as Arctic by temperature, including the Bering Sea and Aleutian Islands. (2) The Arctic region of the United States— (A) is known to the indigenous population as Inuvikput, or the place where we live ; and (B) is home to an indigenous population that has subsisted for millennia on the abundance of marine mammals, fish, and wildlife, many species of which are unique to the Arctic region. (3) Since 1959, temperatures in the Arctic region of the United States have warmed by 3 to 4 degrees Celsius, a rate of increase more than twice the global average. The Arctic ice pack is rapidly diminishing and thinning, and the National Oceanic and Atmospheric Administration estimates the Arctic Ocean may be ice free during the summer months in as few as 30 years. (4) These changes are having a significant impact on the communities and ecosystems of the indigenous people of the Arctic, and the marine mammals, fish, and wildlife upon which the indigenous population depends. (5) The negative impacts of climate change include health problems, which are even more exacerbated among indigenous people of the North. (6) Northern people have shorter life expectancy and increased mortality related to suicide and injuries, when compared to populations living in more moderate climates. (7) Among the greatest health disparities affecting Arctic people are higher rates of alcohol abuse, Fetal Alcohol Spectrum Disorder (FASD), diabetes, high blood pressure, injury, and cancer. The FASD prevalence rate among Alaska Native people (4.8) is 3 1/2 times that for all Alaskans (1.4). (8) Rates of suicide in Alaska are among the highest in the Nation, with the suicide rate among Alaska Native people about 3 times that of non-Native Alaskans and 4 times that of the national average of the United States. (9) Alaska Native children are more than twice as likely to live in poverty than Alaskans of other races, 25.7 percent compared to 10.9 percent. (10) It is unclear why many of these health problems are greater among northern people or whether the health problems are related to toxic influences, socioeconomic status, cultural change, distance from sophisticated medical care, or other factors. (11) More research is necessary into the causes of disparities in rates of particular public health problems in the Arctic and intervention into the prevention and treatment of these problems. 3. Study of mental, behavioral, and physical health issues, including alcohol abuse, in the Arctic (a) Study authorized The Arctic Research Commission established under section 103 of the Arctic Research and Policy Act of 1984 ( 15 U.S.C. 4102 ) shall, in collaboration with Federal health agencies, directly or through contract, prepare and submit to Congress a 2-year study to examine the science base, gaps in knowledge, and strategies for the prevention and treatment of mental, behavioral, and physical health problems, including alcohol abuse, faced by populations in the Arctic, with a focus on Alaska. (b) Authorization of appropriations There are authorized to be appropriated to carry out this section a total of $1,200,000 for fiscal years 2014 and 2015. 4. National Arctic Health Science Policy (a) Updating 1984 policy The Director of the National Institutes of Health shall, in collaboration with other governmental agencies and private and nonprofit entities involved in Arctic health issues, develop a national Arctic health science policy. In developing the policy, the Director shall review and take into consideration the National Arctic Health Science Policy developed by the American Public Health Association Task Force in 1984. (b) Desk for Arctic Health Section 401(c) of the Public Health Services Act (42 U.S.C. 281(c)) is amended by adding at the end the following: (3) Desk for Arctic Health (A) Establishment Within the Division, there is established a Desk for Arctic Health. (B) Duties The Desk for Arctic Health shall— (i) work with the Interagency Arctic Research Policy Committee established under section 107(b) of the Arctic Research and Policy Act of 1984 ( 15 U.S.C. 4106(b) ) to ensure adequate health representation from Federal agencies; (ii) collaborate and consult with governmental entities and United States nongovernmental organizations involved in Arctic health issues, including the State of Alaska, University of Alaska, and entities that handle issues regarding the health of the indigenous people of the Arctic; and (iii) collaborate with the Canadian Institutes of Health Research on indigenous Arctic people health issues, in accordance with the 2004 agreement between the National Institutes of Health and the Canadian Institutes of Health Research, and with other international entities dealing with pan-Arctic health issues. . 5. Arctic health impact assessments Part P of title III of the Public Health Service Act ( 42 U.S.C. 280g et seq. ) is amended by adding at the end the following: 399V–6. Arctic health impact assessments (a) Findings Congress finds the following: (1) The health impact assessment process can be a valuable tool for better Arctic health by objectively evaluating the potential health benefits and risks of a project or policy before the project or policy is built or put into place. (2) Health impact assessments can provide recommendations to increase positive health outcomes and minimize adverse health outcomes. (3) A major benefit of the health impact assessment process is that it brings public health issues to the attention of people who make decisions about areas that fall outside traditional public health arenas, such as transportation or land use. (b) In general The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish a program at the National Center of Environmental Health of the Centers for Disease Control and Prevention to foster advances and help provide technical support in the field of Arctic health impact assessments. (c) Definition of health impact assessments In this section, the term health impact assessment means a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population. .