Health research in Greenland: start with the children.

Public Health in the Arctic regions For obvious reasons, information on how best to establish an efficient and competent public health system in sparsely populated arctic regions is of great interest in all arctic regions. It is unfortunately an enterprise with a slow start. And experience shows that money alone will not solve all problems. We believe that public health should take a life-course approach, starting at conception, or at best before, at the time of pregnancy planning and focus upon living conditions for children. Most of the determinants of life expectancy are established early in life. Pregnancy and delivery are a challenge for health planning. The high rate of child mortality and children’s diseases in rural areas, as well as few midwives in these areas, often lead to deliveries far from the local community and the family. The family that should be together to plan their new family role and their responsibility for the child. Health service in arctic regions includes rapid turnover of expatriate health care professionals. Education of local health care workers should start in the Greenlandic school system and later be taken over by the local health education system. This strategy includes postgraduate education of the staff of health professionals, with a gradual transmission of responsibility to local staff, especially concerning health promotion together with the local community. Health service research and research-based education are important for this development. Organisation and logistics are financial challenges for the public health system in Greenland. Telemedicine is one of the answers to some of the logistical health problems. This new technology should be subject to the same evaluation as other technologies (1,2).