Health

All Alaska students could be provided free breakfast and lunch at school, under a new bill in the Alaska Legislature.

Democratic Rep. Maxine Dibert of Fairbanks prefiled the legislation, House Bill 12, ahead of the legislative session that began on Tuesday. The bill would direct the state to provide sufficient funding to all districts to have breakfast and lunch for any student who requests it, free of cost.

“I’ve seen the effects of feeding our kids, and especially during COVID, when all kids got lunches and breakfast at no cost,” said Dibert, who has been a teacher. “So it was just very enlightening, and I would love to see that again for our families and for our students and for our school staff.”

During the COVID-19 pandemic, federal relief funding allowed schools to provide free meals due to federal waivers. But those funds sunsetted in 2022, resulting in some school districts struggling to fill the gap.

Last year, over half of Alaska’s students — 51% — were eligible for free or reduced price meals. An estimated 46%, or roughly 48,000 students, were enrolled to receive free school meals.

As an elementary school teacher in Fairbanks for 22 years, Dibert said she herself sometimes paid for her students to eat, rather than see them go hungry.

“Over the years, if a student didn’t have enough money, or their bill wasn’t paid, oftentimes I would even pay with my account,” she said. “I don’t know entirely how big those bills got, because I was on the classroom side of it. But I did really not like seeing kids come into the classroom sad that they couldn’t get breakfast or lunch.”

Dibert, who is Koyukon Athabascan, also cited the current Yukon River salmon crash leaving communities and families who subsisted and shared fish going without.

“My grandparents lived out on the Yukon River, and as a child, they would always send us salmon from the Yukon River. And we always would have food on our table, lots of salmon,” she said. “So with no salmon on the Yukon, I know that’s a hardship to feed families, and it’s costly to families. So in that aspect, this bill could be very beneficial to ease the pain there, to help feed kids.”

Education and health researchers point to universal free meals having multiple benefits for students, including improved academic performance, attendance and student health outcomes.

Dibert said the bill is in the beginning stages of the legislative process, so details will be worked out, but she hopes the program would also promote local foods on school menus, like salmon or moose. “It would be working district by district, for sure,” she said. “I don’t want it to be canned, you know, protein, like, one grain, one fruit.”

The allocations to school districts would also vary by region and food prices, she said, accommodating notoriously higher grocery prices in Alaska’s rural areas.

She said funding the proposal could include some federal or municipal contributions as well.

“It’s not that much to have the opportunity to feed our kids,” she said.

Last year, the Legislature axed funding for making reduced-priced lunches free for low-income students, during budget conference negotiations. The estimated $480,000 in funding was to be taken from the Department of Corrections, but lawmakers voted against it.

Once the bill has been formally introduced during a House floor session, it will next be assigned to relevant committees for discussion and debate in the coming weeks.

The City and Borough of Juneau is warning of a potential measles exposure at Seattle–Tacoma International Airport. The case was reported earlier this month and could impact Southeast Alaska residents. 

According to an alert shared on Friday, an unvaccinated adult experiencing symptoms of the viral infection was traveling through the airport on Jan.10. The infected person flew from Seattle to Anchorage during the afternoon and evening around the same time multiple flights were leaving for Southeast Alaska. 

The person is a Kenai Peninsula resident and was heading home after traveling overseas. They received hospital care in Homer. 

Measles is a highly contagious disease that can spread through the air or by direct contact, according to the Centers for Disease Control and Prevention. It can be especially dangerous for young children and undervaccinated communities. 

The Alaska Department of Health confirmed the case last week. State Epidemiologist Joe McLaughlin said in an interview that the measles, mumps and rubella vaccine can significantly lower the risk of contracting the virus. 

“The measles component of that vaccine is one of the most effective vaccines on the planet. It’s about 97% effective at preventing measles,” McLaughlin said. 

The vaccination rate for kindergarteners in Southeast Alaska was roughly 65% last year. That’s significantly lower than the national average, which is 93%. Both the state and national averages have been dropping since the pandemic. 

McLaughlin encourages people who traveled during the same timeframe as the infected individual to reach out to their health care provider by phone if they begin experiencing symptoms. Those can include a fever, runny nose, cough, red eyes, sore throat and a rash. 

He said the state hasn’t confirmed any other Alaska cases yet, but noted that the incubation period can last up to 21 days after initial exposure.  

“We still have a little ways to wait to see if we’re going to see any secondary transmission or secondary cases as a result of exposure to this person who was infected,” he said. 

The World Health Organization declared measles had been eliminated in the U.S. in 2000, but the CDC warned last year that a recent spike in cases threatened to reverse that status. In Alaska, measles outbreaks are relatively rare. This is the first confirmed case in the state since 2019.

Robert F. Kennedy Jr. is poised to be the country’s new Health and Human Services secretary with the incoming Trump administration. If confirmed, Kennedy has pledged to advise all U.S. water systems to remove fluoride from public water.

But, a growing number of cities in the U.S. have already done that on their own — and residents’ teeth offer a preview of how that policy could affect dental health nationwide. Juneau pulled fluoride from its tap water nearly two decades ago. 

On Thursday in Juneau, Dr. Yvonne Tijerina-Burleson used a tiny brush to paint topical fluoride on a patient’s teeth at SouthEast Alaska Regional Health Consortium’s Dental Clinic. She explained what she was doing out loud.

“Dry, dry, dry. Paint, paint, paint,” Tijerina-Burleson said. “Simple, with some amazing benefits.”

The patient chose a marshmallow-flavored treatment. 

“It smells really good — these would be great candles,” she said, laughing. 

Applying topical fluoride is a typical practice for most dentists across the U.S. But in Juneau — it’s an especially critical one. That’s because it hasn’t been in city water for nearly two decades. And since then, data shows kids in Juneau have started getting cavities at a higher rate.

“Fluoride has as we would say, a carioprotective effect, like it can prevent cavities, it can slow down the disease process,” said Dr. Dane Lenaker, the medical director of dental services for the SEARHC clinic. “Fluoride can help remineralize and strengthen the teeth.”

Around 70% of the U.S. population has access to fluoridated tap water. Dental experts and studies say it helps prevent cavities. 

“Fluoride, if you’re not getting it in the water system, and it’s not getting incorporated into your teeth that way – this is another way that it basically gets painted onto your teeth,”  Lenaker said. 

Public health officials say putting a small amount of fluoride in the water supply is an easy and cost-effective way for large-scale cavity prevention. But some researchers and critics – like RFK Jr. –  argue it may lead to health issues. 

RFK Jr. called fluoride industrial waste and associated it with issues like lower IQ in children. There is some evidence of that at high levels of exposure, but not at the level that goes into U.S. water supplies. 

There are conflicting narratives, but one thing is clear — the U.S. is seeing more and more cities opt out of fluoridated tap water. 

About two decades ago, Juneau residents overwhelmingly voted to remove fluoride from the local water supply. If Juneau’s dental health now is any indicator of what’s in store for cities that might follow RFK Jr.’s advice — America could be seeing a lot more cavities.

What does research say?

“I think Juneau offered us a good example of some of the challenges we set ourselves up for when we decided to stop fluoridating the water,” said Jennifer Meyer, a public health researcher. 

Meyer conducted a study published in 2018 that shows that kids in Juneau have needed more dental work since they stopped getting fluoride from the water.

“Places that are going to cease fluoridation, just hold on to your pocketbook, because it’s going to get expensive,” she said. 

The Centers for Disease Control and Prevention would agree with that claim. Meyer’s study focused specifically on the teeth of children under six in Juneau. She used a set of Medicaid dental claims to get data for about 1,900 kids.

“What we know happens is, over time, you start to see kids with more and more decay, and some with some really advanced decay,” she said. 

Her study found that when the water had fluoride in it, kids had an average of 1 1/2 cavity-related procedures per year. But, once it was gone, that went up to about 2 1/2 procedures a year.

Her Juneau-specific study’s conclusion is not far off from what other researchers say. The CDC calls the fluoridation of drinking water one of the greatest public health interventions of the 20th century, attributing it to averting millions of cavities in the decades it’s been implemented. 

Another study by the State of Alaska showed a small sample size of children in Juneau had a higher increase in cavities compared to the state as a whole in years after fluoride was removed from the water. 

The American Dental Association shared a statement this fall that endorsed water fluoridation, saying there is clear and compelling evidence around the benefits of it.

Not everyone is convinced.

David Ham is one of the advocates who wanted to remove fluoride from Juneau’s water. He said he doesn’t have a problem with fluoride on his teeth. He has a problem with drinking it. 

“I used a fluoride toothpaste, and then I could spit out the toothpaste and not swallow it and ingest a questionable substance into my body,” Ham said. 

He said he sees the value in fluoride but argues that it can be administered in ways other than putting it in the water supply. But not everyone has access to regular dental care or fluoride pills. Health officials say fluoridated water is especially important for kids and vulnerable populations. 

“We all want to have a silver bullet solution to a problem. But there isn’t, because life isn’t like that. Fluoride, this fluoride issue, is not like that,” Ham said. “There are steps you can take that don’t involve telling everybody to drink fluoride.”

Now, no one in Juneau drinks fluoride — it’s an all-or-nothing situation. And the city’s experience shows that when people have to opt in to use fluoride — it can lead to more cavities.

Correction: A previous version of this story stated the wrong year in the photo caption. 

How much are Alaskans willing to pay for produce that is homegrown? A newly published study has some answers: a significant premium, especially when they have information about the benefits of locally grown food.

Alaska grocery shoppers on average were willing to pay $1.90 extra for a head of lettuce if it was labeled as “Alaska Grown,” the study found. When given information about locally grown products’ benefits to health, the environment and the state economy provided by products with the “Alaska Grown” label, that premium jumped to $3.31 on average, the study found.

The study is based on surveys and interviews of shoppers at Anchorage grocery stores and farmers markets. The surveys and interviews were conducted by University of Alaska Anchorage students; the study was led by Qiujie Zheng, an associate professor of business analytics at the University of Maine. Zheng was previously at UAA.

While the surveys and interviews were conducted several years ago, in 2018, Zheng said she believes the results still stand.

The COVID-19 pandemic that came later may have changed food consumption patterns worldwide, she said by email. “However, due to Alaska’s unique geographical location, I believe that the state’s agricultural supply and consumers’ fresh produce options have remained relatively stable over the past few years,” she said.

There has been no interruption in the Alaska Division of Agriculture’s annual Alaska Grown $5 Challenge program, a summer and fall campaign that encourages residents to spend at least $5 a week on locally grown food, she noted. The information the researchers used from the state has been consistent, she added.

It was important to study consumer preferences for Alaska Grown products because the subject has gotten much less attention than consumer attitudes about local foods elsewhere, Zheng said.

And Alaska has reasons to bolster its local sources of food, she said.

“Alaska’s unique geographical location significantly influences its food supply. Since the majority of Alaska’s food is imported, Alaska’s food supply is vulnerable to supply chain disruptions and natural disasters,” she said by email. “A stronger local food system could improve the resilience of the state’s food supply. Understanding consumers’ preferences for local foods and identifying potential marketing and communication strategies are critical before promoting local food in Alaska. This helps strengthen the local food network, and, in the long run, enhances the resilience of Alaska’s food supply.”

The study also analyzed consumer preferences about lettuce labeled as organic and lettuce grown through the hydroponic method, which uses a water-based nutrient solution as a substitute for soil.

Taken in isolation, the Alaska Grown premium that consumers were willing to pay was higher than that for organic food and for hydroponic-grown lettuce. Without being given extra information about benefits, consumers were willing to spend $1.74 more for organic lettuce and 73 cents more for hydroponic-grown lettuce.

Consumer preferences were more complicated when the Alaska Grown, organic and hydroponic labels were combined and when additional information was provided, the study found.

Two health-related bills that faced unusual deaths in last year’s session of the Alaska Legislature have been resurrected as new bills for lawmakers to consider this session.

A list of bills filed before the start of the session as of Friday includes a measure sponsored by Rep. Andrew Gray, D-Anchorage, who seeks to require warning signs at bars, liquor stores and other beverage-selling establishments about the link between alcohol consumption and cancer. Under the measure, House Bill 37, the signs would be updates of health warnings already required at such establishments, with more simplified visuals and a notice that “Alcohol use can cause cancer, including breast and colon cancers.”

Gray sponsored a similar bill last session, House Bill 298. It got folded into another alcohol-related measure, House Bill 189, a bill that would have lowered the allowable age for workers serving alcohol from 21 to 18. The combined bill passed – but it got final approval from the state House a few minutes after midnight on the 121st day, the session adjournment deadline. Citing that reason, Gov. Mike Dunleavy vetoed it, as he did with four other bills that passed after the midnight deadline.

Gray’s bill comes as outgoing U.S. Surgeon General Vivek Murthy is calling attention to the link between alcohol consumption and cancer.

Earlier this month, he issued a detailed advisory about the connection between alcohol and several forms of cancer, including cancers of the breast, colon and rectum, esophagus, voice box, liver, mouth and throat.

“Alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity,” the advisory said. In 2019, an estimated 96,730 cancer cases were related to alcohol consumption, and an estimated 741,300 cancer cases worldwide in 2020 were attributable to its consumption, the advisory said.

Another bill among the prefiled list as of Friday was a new attempt at imposing a state tax on electronic cigarette products, known as vapes, as well as some new age restrictions for purchase. The measure, Senate Bill 24, is sponsored by Senate President Gary Stevens, R-Kodiak.

Alaska state tobacco tax was last changed in 2006, years before vaping became popular, especially among youth. This is Stevens’ third attempt at a bill he believes will curb youth use of e-cigarette products.

The bill that Stevens introduced in 2023, Senate Bill 89, would have applied the tax and also raised the state’s age limit for buying those products from 19 to 21, matching federal law.

It was similar to a Stevens-sponsored bill that the Legislature passed in 2022, though with some modifications to how the tax was calculated. Dunleavy vetoed that bill, citing his objections to any new taxes.

After the Senate passed the second version, Senate Bill 89, the House made substantial changes to it. The House stripped out the e-cigarette tax provisions but added in provisions that lowered state taxes on marijuana, a product that is legal in Alaska, before returning it to the Senate for final passage.

Stevens and others in the Senate majority opted against passing the altered bill. After adjournment, Stevens said he and his colleagues had too little time to review the late marijuana-related changes. He killed the underlying bill, even though it was his own. “You can’t get too much in love with your own legislation,” he said at the time.

Cigarette smoking among Alaska high school students has declined dramatically over the past decades, but in recent years, vaping became more popular, according to youth surveys.

There has been a similar pattern in other states, according to health officials.

More recent results from the state’s Youth Risk Behavior Survey show a decline in use of e-cigarette products. While over 26% of youth respondents in the 2019 survey said they regularly use such products, that rate dropped to 17.3% in 2023, according to the survey.

After months of stalemate, Juneau’s city-owned hospital and the employee union that represents roughly 70% of its staff have finally come to an agreement over a new contract. 

At a meeting Monday night, the Juneau Assembly unanimously approved it.  

The International Longshore and Warehouse Union Healthcare Unit 2201’s previous three-year contract expired on July 1. But negotiations for a new one had stalled over disagreements with Bartlett Regional Hospital administration on how much wages should increase. 

At the time, the union wanted to see a 12% pay bump over the next three years, but Bartlett was only willing to offer 8.25%. The difference between the two is about $5.2 million in the hospital’s annual budget. 

The contract approved by the Assembly on Monday gives an 11% pay increase for union employees over the next three fiscal years. They’ll get a retroactive lump sum of about .5% for the time they worked since July without an agreement. 

This comes as the hospital tries to recover after a difficult financial year. Last spring, hospital leaders shared it was facing a multimillion-dollar budget crisis that threatened bankruptcy. 

To get back on track, the hospital cut back staffing and closed programs like the Rainforest Recovery Center and its crisis care unit last summer and fall. 

A recent financial update shared by the hospital in late December showed it was now making steady positive income for the first time in years. 

In a statement shared with KTOO, union leadership said the hospital could be doing more to recruit and retain employees, but called the contract agreement a “good step in that direction.”