Health Aides Provide Medical Services in Some of America’s Most Rural Places

Alaska presents some unique challenges when it comes to delivering health care to rural residents. Telemedicine is helping to solve some of those challenges.

Laurel Wood, former immunizations director for the Alaska Department of Public Health, told attendees Monday at the CSG/CSG West Health Committee meeting that Alaska is one-fifth the size of lower 48 states. It is twice as large as Texas, but it has a population density of just 1.2 people per square mile.

Community health aides and dental health aides are crucial to providing needed health services to residents of more than 700 rural villages, many of which aren’t accessible by road.

“These are local people from those communities,” said Torie Heart, director of of the Community Health Aide Program for the Alaska Native Tribal Health Consortium. “People have historically called this the eyes and ears of physicians. Really, it’s someone on the ground with the patient and somehow communicating with a clinician at a regional hub.”

Community health and dental health aides receive training on how to provide basic diagnostic and treatment services. They can treat things like common infections, provide immunizations, fill a cavity and do a simple tooth extraction. They work in consultation with a licensed physician or dentist.

“This is a great improvement,” said Mary E. Williard, director of the dental health aide therapist educational program for the Alaska Native Tribal Health Consortium. “The care being delivered consistently on the ground in the community is providing for continuity of care. … It’s also allowing us to provide a high level of care.”

Heart said the community health aide program has trained 550 providers who are responsible for more than 200,000 patient encounters a year. There are 25 certified dental health therapists, Williard said, providing services to more than 40,000 people in 81 communities.

“After you pay for the dental therapists and their assistants and all their supplies and facilities,” Williard said, “the tribal programs were netting about $125,000 to $245,000 after that per year. It’s a $9 million economic activity increase in Alaska through this program; more than half of that spent in rural Alaska.”