"Eating for outsiders": cancer causation discourse among the Iñupiat of Arctic Alaska

Cancer is the leading cause of death among Alaska Natives. Although cancer mortality rates are widely studied, as well as high-risk behaviours in relation to site-specific tumors, little is known about Alaska Native understandings of cancer. This study explores how Iñupiat living in northwest Alaska conceptualize the etiology, transmission and prevention of cancer.

Long-term ethnographic research.

Qualitative research was conducted in northwest Alaska over the course of 30 months, including 8 months accompanying an Iñupiaq family on their seasonal rounds to hunting and fishing camps. In addition, open-ended interviews were conducted with 50 Iñupiaq men and women, and the life histories of 3 Iñupiaq healers were recorded.

Iñupiat spoke of cancer as a germ-induced condition that emerged from the "outside." Routes of infection include the ingestion of contaminated food and water, as well as inhalation or injection of outside agents. "Bad-blood" was considered a precursor to, and product of, cancer. Iñupiaq discourse about cancer prevention focused on consuming foods that strengthened the blood, including meat harvested from the country. Educational efforts that focused on lowering risk by eating diets low in meat and fat and high in fruit and vegetables were rejected as an assault from outsiders on their hunting way of life.

The development of meaningful cancer prevention and early detection programs must be sensitive not only to cultural conceptions of disease but also to relations of power in which recommendations and policies are constituted and asserted.