IHS Launches Influenza Web Site

The Indian Health Service has launched an influenza surveillance and information-sharing Web site, according to a press release issued by the agency last week.

The site (www.ihs.gov/flu) features information for health professionals on influenza activity in the United States along with information on IHS influenza surveillance activities, reports and educational resources specific to American Indian/Alaska Native people. It also contains links to influenza information for patients and the general public.

Flu season has already begun, although peak season typically runs from November through March. While not certain, as nothing ever is with flu seasons, the Centers of Disease Control and Prevention says it is likely that the 2009 H1N1 viruses will continue to spread along with seasonal viruses in the United States during the 2010-2011 season.

American Indians/Alaska Natives have long experienced an influenza/pneumonia mortality rate that is nearly twice that of the general U.S. population.

The new site, aimed at decreasing the disparity, provides useful information on influenza prevention and treatment, including weekly influenza surveillance updates; vaccination resources, contacts and supplies; prevention guidance from the CDC; and the latest information on resources specific to Native people and the IHS.

There are downloadable brochures, fact sheets, articles and posters available for personal and educational use as well as links to podcasts, videos and public service announcements on seasonal influenza information.

Native Hawaiians More Likely to Suffer Early Death

A University of Michigan study has found that Native Hawaiians are more at risk of suffering an early death than white Americans, as reported by Medical News Today on Sept. 20.

The study shows that Native Hawaiian infants (less than one year old) and young people between the ages of 15 and 34 are especially vulnerable to early death compared to white Americans in the same age groups.

The research also shows that older Native Hawaiians have higher expected death rates than both blacks and whites age 65 and over.

According to the 2000 U.S. Census, there were 874,000 Native Hawaiians/Pacific Islanders in the United States, with Native Hawaiians making up about 46 percent of the race group.

The research, published in the November 2010 issue of the American Journal of Public Health, is the first known study to assess mortality patterns among Native Hawaiians at the national level, including those living outside the state of Hawaii. It was funded by the National Center for Minority Health and Health Disparities.

Alzheimer's Association Opening Office on North Carolina Indian Reservation

The Alzheimer’s Association has partnered with the Eastern Band of Cherokee Indians in North Carolina to open an office and counseling center, as reported by Smoky Mountain News on Sept. 15. This will be the first time the association has had a permanent presence on tribal lands.

The new office and counseling center will officially open on Sept. 20. It will be located in the tribe’s Health and Medical Division Building in Cherokee. There will be festivities to mark the grand opening, and on Sept. 21, which is World Alzheimer’s Day, there will be an awareness walk.

While located on tribal lands, the office and center will serve all residents in counties west of Asheville.

Begay Foundation Opens Soccer Field and Community Park in San Felipe Pueblo

The San Felipe Pueblo in New Mexico has a new community park and soccer field, thanks in large part to a $535,000 grant from the Notah Begay III Foundation, an organization founded by Notah Begay III, the only full-blooded Native American on the PGA Tour.

The $785,000 park and soccer field are a first for the pueblo. With its walking paths, the park provides an outlet for community members to become more physically fit. The centerpiece, though, is the synthetic turf soccer field, which will be home to the San Felipe Soccer Club, an after-school program that the Notah Begay III Foundation has operated since 2005. The club plans to host tournaments, camps and events to promote soccer and good health to neighboring pueblos as well as to help foster relationships with the larger soccer community in the Albuquerque and Bernalillo area.

“The Pueblo has waited nearly a decade for this facility, a park that will allow adults, youth and participants in the San Felipe Soccer Club to increase their physical activity,” said Begay in a press release issued on Aug. 24. “Tribal communities around the entire country are often lacking even the most basic amenities needed to keep their young people active and healthy. This incredible facility is an example of what’s possible when communities unite and work together in the interest of the health and wellness of Native people.”

Center for American Indian Community Health to be Created at KU Medical Center

Researchers from the University of Kansas Medical Center and the American Indian Health Research and Education Alliance have joined forces to create the Center for American Indian Community Health, according to a press release issued by KU on July 30.

The initiative, which is being funded by a $7.5 million grant from the National Center for Minority Health and Health Disparities, will set up a pipeline to attract American Indian high school and college students to the KU School of Medicine’s master’s of public health degree program and other graduate programs to increase the number of Native people entering the health professions and conducting health research. Medical center faculty are already working with Haskell Indian Nations University to identify potential students for the master's of public health program.

Five years ago, there were no American Indian students in the program, the release said. Three Native students have already earned degrees; five more are now enrolled and several more have applied for the fall semester.

The new Center for American Indian Community Health will enhance work that began in 2005, when KU Medical Center joined with seven other academic and community organizations to form AIHREA. AIHREA, whose mission is to improve the health of American Indians through quality participatory research and education, has partnerships with government agencies and institutions involved in Native American health and health research.

“Our goal is to train and educate the next generation of Native health researchers and health care professionals, hoping that they will return to their communities and help to address health disparities,” said Christine M. Daley, associate professor of preventive medicine and public health at the School of Medicine, the director of AIHREA and one of the principal investigators on the project.

Simple Interventions Slow Trends in Native American Childhood Obesity

Childhood obesity is an epidemic in Indian Country, with almost 50 percent of its kids overweight, but tribal communities are not powerless in the fight against it. In fact, as a recent feasibility study concludes, there are simple ways that they can intervene and help stop the trend.

The study, conducted by Kaiser Permanente and the Northwest Portland Area Indian Health Board (NPAIHB) from 2001 to 2006, is the first to target obesity prevention among Native American children starting at birth. It included 205 families from three tribes in Oregon and Washington.

The research focused on interventions, community-wide and in-home, all designed by tribal community health workers. The goals were to increase breastfeeding initiation and duration, limit the introduction of sugar-sweetened beverages to infants and toddlers and promote the consumption of water for thirst among toddlers.

The community-wide interventions, designed in six-month cycles, had five strategies: raising awareness, providing health education, facilitating individual behavior change, augmenting public health practices and modifying environments and/or policies related to breastfeeding, sugar-sweetened beverages and water consumption.

Most community-wide interventions were media-based, like brochures, videos, newspaper articles and flyers. Yet the tribes also made environmental, public health practice and policy changes. One created a breast-feeding room at its clinic; another passed a resolution to stop buying sugar-sweetened beverages for tribally sponsored events; and one negotiated with the hospital to which it contracted out pregnancy care to not give out formula packs to new mothers.

The in-home interventions were customized to the needs of the family, such as a new mother having difficulty breastfeeding, and were tested with just two of the three tribes.

The results were positive. Although Body Mass Index (BMI), a measure of weight in relation to height, increased for all of the children in the study, the rise was far less in the tribes that received the community intervention and in-home visits. BMI scores increased by 30 percent in the tribe that received community intervention alone, but they rose by only 8 percent in the tribes that received both interventions.

Just as positive were the signs that Native American people are ready to make behavior changes. In a survey given at the end of the intervention, the families were asked about their confidence level in drinking more water and fewer sugar-sweetened beverages: 90 percent said they were confident they could help their family drink more water and 82 percent said they would limit sugar-sweetened beverages.

Njeri Karanja, lead author and investigator with the Kaiser Permanente Center for Health Research, also sees the participant retention numbers as indication that they are ready. “Eighty-percent of the parents came back and brought their children to be measured,” she said.

While the three tribes that participated seemed ready to take the leap, what about the nation’s other 561 tribes? Are they ready to create and commit to similar intervention plans, ones that may include changes in practices and policies?

“I think a lot of tribes, given the recent increase in diabetes and seeing it occurring at younger and younger ages, are ready for that. They want to see their children have a good quality of life. They know their health system, [which is] critically under-funded, is going to be affected by increasing numbers of people with diabetes,” said Tam Lutz, study co-author and junior investigator with the NPAIHB.

The study, funded by the Indian Health Service and National Institutes of Health through the Native American Research Center for Health, has been published online in the Journal of Community Health.

BIE and Nike Enter MOU to Promote Healthy Lifestyles

Assistant Secretary-Indian Affairs Larry Echo Hawk announced last week a memorandum of understanding (MOU) between the Bureau of Indian Education (BIE) and Nike, Inc.

Under the MOU, signed on May 12, the two have agreed to collaborate on promoting healthy lifestyles and choices for all American Indians/Alaska Natives through program activities, like co-sponsored educational/information events, marathons and sports demonstrations.

They have also agreed to collaborate to improve communications with tribes and tribal organizations in the exchange of information relevant to healthy lifestyles to combat diseases such as diabetes, which affects nearly 13 percent of the AI/AN population.

Nike has been working with tribal communities for about 10 years, which includes providing grants for sports and physical fitness programs.

Free Diabetes Screening Puts Native People at Risk

Anyone who went to the Indian Pueblo Cultural Center in Albuquerque on April 24 for a free diabetes screening conducted by students from the University of New Mexico School of Medicine Physician Assistant program may have been exposed to diseases like Hepatitis B and C and/or HIV.

The exposure, according to a news report published by The New Mexico Independent on May 14, is the result of the students reusing “finger pricking” blood sugar testing devices meant for one patient, which exposed patients to another person’s blood. Making matters worse, the students had not been properly trained to use the device and did not keep records of the people it used them on.

Though the university says the risk of exposure is slight, it still wants to get in contact with the 51 to 55 people who were tested that day.

To learn more about the incident or to find out who to contact, go to: http://contact.health.unm.edu/

Study Shows Greater Reproductive Health Risks for Urban AI/AN Women

American Indian and Alaska Native women living in urban areas are more likely than non-Hispanic whites to report non-voluntary first sexual intercourse, unintended and teen pregnancies, unprotected first sex and first sex with older partners, according to a study released last week by the Urban Indian Health Institute, a division of the Seattle Indian Health Board.

Here are some highlights from the report:

• About 17 percent of urban AI/AN women have experienced non-voluntary sex their first time, compared to 8 percent of white women.
• Nearly 14 percent of urban AI/AN women said their first sex partner was seven or more years older, compared to 9 percent of white women.
• Urban AI/AN who had unprotected sex in the past year, had sex before age 15 and who had more than two sex partners in the past three months are 77 percent more likely to have had an unintended pregnancy than whites with the same sexual risk status.
• Urban AI/AN reports of two or more abortions are twice that of NH-whites (10 percent vs. 5 percent).

To view the full report, click here.

Sault Tribe Promotes Fitness with “Cash” Competition

The Sault Tribe Strategic Alliance for Health has teamed up with Blue Cross Blue Shield of Michigan to offer an incentive-driven walking competition to residents, according to a piece published yesterday in the Daily Press of Escanaba, Mich.

Called “Let's Get Moving,” the competition gives cash awards to Sault communities that are the most active. There are four communities that will be participating.

Prizes will be based on how many miles residents within each community log from May 1 to June 30. The community with the most average miles per team member will receive $2,000 from Blue Cross Blue Shield; second-place gets $1,500; third-place $1,000; and fourth-place $500. Winners are required to use the prize money in a way that will help keep community members active.

Campaign Urges Native Parents to Protect Preteens with Vaccines

The Centers for Disease Control and Prevention and the Indian Health Service have jointly launched a campaign to educate American Indian and Alaska Native parents and other caregivers about the importance of a preteen medical check-ups and vaccines.

One goal of this campaign is to encourage parents to take their preteens in for an 11- or 12-year-old check-up, during which the doctor takes a complete medical history, screens for diseases like diabetes, discusses teen issues (such as puberty) and ensures that immunizations are up to date.

Three vaccines are specifically recommended for the preteens: MCV4 (meningitis); Tdap (tetanus, diphtheria, and pertussis or “whooping cough” booster); and for girls, the human papillomavirus (HPV) vaccine (protects against cervical cancer). Annual seasonal flu shots and vaccination against H1N1 are also recommended for preteens.

Posters and flyers educating parents about the preteen check-up and preteen vaccines were developed and can be ordered or downloaded from the campaign Web site: www.cdc.gov/vaccines/preteen/aian.

Other campaign activities include outreach to Native media, partnerships with American Indian and Alaska Native organizations that reach parents and healthcare providers and a community-based education project in New Mexico.

H1N1 PSA Campaigns Targeting Native Americans Unveiled

On Jan. 12, the U.S. Department of Health and Human Services unveiled two new public service announcement (PSA) campaigns targeting American Indians and Alaska Natives, urging them to get vaccinated for the H1N1 flu.

At a press conference announcing the campaigns, HHS Secretary Kathleen Sebelius said the virus has hit Indian Country especially hard, citing a CDC report released last month that showed that Native Americans are four times more likely to die from H1N1 than the general population.

Sebelius said American Indians/Alaska Natives are at a greater risk because they have higher rates of conditions such as asthma, diabetes and heart disease. It is also due to the higher numbers that live in poverty and that lack access to medical care.

“And this message is really urgent in Indian Country,” she said.

The HHS and IHS hope that the PSAs, produced for radio and TV, get that message out. The announcements give strategies for preventing the virus, like hand washing, coughing/sneezing into a sleeve and staying home from work if sick. They also stress getting vaccinated.

The series of six TV PSAs feature Cherokee actor Wes Studi. There are also regional PSAs starring Sebelius and IHS Director Dr. Yvette Roubideaux.

In addition to getting vaccinated, Roubideaux encourages people to educate everyone on how to take precautions and prevent spreading the virus.

As of mid-November, there were 47 million H1N1 cases in the United States, with more than 200,000 hospitalizations and nearly 10,000 deaths, Roubideaux said. And she stressed that there may be a third wave, as influenza typically peaks from January to March.

For more information on H1N1, go to www.flu.gov.

Native People More Likely to Die from Swine Flu

American Indians and Alaska Natives have an H1N1 mortality rate four times higher than persons in all other racial/ethnic populations combined, according to a report published last month by the Centers for Disease Control and Prevention.

The report, based on data collected between April 15 and Nov. 13 in 12 states, did not pinpoint the reasons for the disparity in death rates. It suggests, however, that it may be related to a high prevalence of chronic health conditions, such as diabetes and asthma, among Native people, which predisposes them to influenza complications; poverty/poor living conditions; and delayed access to care.

College Football Star Rolls Out Health Program to Native American Kids

College football star Myron Rolle, in partnership with the U.S. Department of the Interior, is rolling out a program to DOI-funded schools that will educate Native American students on important health issues as well as engage them in outdoor physical fitness activities.

Click here to read more on American Indian Report.

Tribes Overpaying for Medical Services

During just one three-month period in 2008, the Indian Health Service and tribes paid $14 million over the Medicare rate for medical services, according to a Health and Human Services Inspector General’s report released last week. The money for the services comes from the Contract Health Services program -- a program so cash-strapped every year that it cannot cover medical care for tribal members for a full fiscal year, giving rise to the wry admonishment frequently heard in Indian Country … “Don’t get sick after June.”

Between January and March last year, IHS and tribes paid above the Medicare rate for 22 percent of hospital claims, resulting in $1 million in overpayments. But most overpayments were for hospital outpatient claims. If IHS and tribal payments for non hospital claims were capped at the Medicare rate, they could have saved as much as $13 million between January and March 2008.

While 22 percent of hospital claims were paid above the Medicare rate, the resulting overpayments only accounted for 3 percent of the total $33 million that IHS and tribes spent on hospital claims between January and March 2008, according to the report. IHS and tribes paid above the Medicare rate for 71 percent of non hospital claims. Most of these claims paid above the Medicare rate were for physician services.

UA Awards Certificates in Public Health to Nine Navajo CHRs

The University of Arizona Mel and Enid Zuckerman College of Public Health and Diné College, a Navajo tribal college, have awarded the first Certificates in Public Health to nine Native American students, according to a press release issued by UA.

The students, who received the certificates at a commencement ceremony at Diné College on May 7, are all Community Health Representatives (CHRs) for the Navajo Nation.

Navajo Tribal CHRs live and work in Navajo communities, providing the tribe’s citizens with hands-on care and information on current medical topics and staying healthy. They are full-time, paid employees of the Navajo Nation government.

The Navajo Nation has 110 chapters, and each chapter has at least one CHR. The entire Navajo CHR/Outreach program currently has about 160 employees. Navajo CHRs are required, in accordance with the tribe’s federal contract, to complete the certification.

The joint certification program launched in 2006, but this is the first year that the certificates were jointly awarded by UA Zuckerman College of Public Health and Diné College. The 12-credit program is tailored to the Navajo Nation’s public health needs and concerns.

Yvette Roubideaux Sworn in as IHS Director

The Indian Health Service has a new director. Dr. Yvette Roubideaux, M.D., M.P.H., a member of the Rosebud Sioux, was sworn in on May 12, less than a week after she was confirmed by the U.S. Senate.

As IHS director, Roubideaux will administer a $4 billion, nationwide program that provides health care to approximately 1.9 million American Indians and Alaska Natives.

Roubideaux previously worked for IHS as a clinical director and medical officer at the San Carlos Service Unit on the San Carlos Apache Indian reservation and as a medical officer at the Hu Hu Kam Memorial Indian Hospital on the Gila River Indian reservation.

She recently served as assistant professor of family and community medicine at the University of Arizona College of Medicine and has conducted extensive research on American Indian health issues.

You can find out more about Roubideaux in the IHS Director’s Corner on the IHS Web site.

Calif. Health Clinics Struggle In Face of State Cuts

The Native American Health Center in Sacramento is the only community clinic in California’s capital city that is still providing full dental services, but with funding cutbacks the clinic will soon have to turn away adults. The clinic, which serves any race, will continue to serve children and will serve adults only in emergencies. 

The state’s decision to eliminate adult dental benefits, know as Denti-Cal, has the Indian clinic and other cash-strapped community health centers struggling to survive at a time when their cliental is growing most. Read more about it here. 

NCAI Statement on Daschle Nomination to HHS

National Congress of American Indians (NCAI) President Joe A. Garcia released the following statement in response to news reports that President-Elect Barack Obama intends to select former Senator Tom Daschle as Secretary of Health and Human Services.

 

"Given the severity of the health care crisis in Indian Country we are very encouraged to hear that President-Elect Barack Obama is likely to nominate someone like Sen. Tom Daschle as Secretary of Health and Human Services, who has a strong background on tribal issues and understands the realities of the Indian health care system. His past experience and profound expertise on Indian issues will be a tremendous benefit to Indian Country. Sen. Daschle was a strong advocate for Native Americans as the Senate Majority Leader and has always advocated strongly for Native people as a representative from South Dakota. We look forward to working with him to bring the Indian Health Service into the 21^st century and address the profound health disparities in tribal communities."  

Baucus Plan Calls for Increased Funding for IHS

Senate Finance Committee Chairman Max Baucus will announce his blueprint for health reform at noon today. Baucus describes the plan as his vision for both policy and the process in the upcoming health care reform debate. Noteworthy for Indian Country,  Baucus acknowledges that federal spending on health care for Native Americans is far short of what is needed. His plan would increase funding for IHS and encourage Native Americans to enroll in other programs, such as Medicare, Medicaid and CHIP for those who are eligible to defray the costs borne by the IHS directly. Read the entire plan here.