In the Spotlight

AI/AN Caucus Member Dr. Joe Coulter explains the crisis of unintended deaths and injuries in Indian Country

posted Jun 8, 2017, 6:45 AM by NPA RHEC   [ updated Jun 8, 2017, 6:46 AM ]


An Unintended Legacy: Unintentional Injuries are a Leading Cause of Death for American Indian and Alaska Native Populations
By Joe D. Coulter, Ph. D.


Introduction

It is no secret that American Indian and Alaska Native (AI/AN) populations face unique challenges. Whether it be the extreme remoteness of some tribal lands, the lack of available resources, environmental concerns, or access to adequate healthcare, gaining health equity for AI/AN populations might seem insurmountable. However, given the right amount of focus, resources and involvement from the community, even the most pressing barriers and obstacles to care facing AI/ANs can be addressed – leading to greater health of Native populations.

Among the myriad of challenges faced by American Indians and Alaska Natives, unintentional injuries remains one of the leading causes of death. There are a number of factors that may explain why unintended injuries continue to be a leading cause of death, but the bigger question and the greater challenge is how to reduce unintended deaths and injuries among AI/ANs.


Unintentional Death and Injuries Among the AI/AN Population

For American Indians and Alaska Natives, death and injury rates are staggering compared to those for the non-AI/AN population. For example, while eight percent of the general population will die before they reach 45 years of age, for AI/ANs, that number increases to 25% (one out of four). The sad but true fact is that a quarter of the Native population won’t see their 45th birthday not because of medical, chronic or genetic issues but rather avoidable and preventable unintentional injuries that lead to death. When the data are broken down by age, this is a common trend regardless of which age group is being examined.


Why Unintentional Injuries are So Dangerous

Support for many of the social determinants of health that contribute to a Native person’s overall well-being are lacking for this population. Many factors – such as socioeconomic status, geographic location, access to health care and health services, transportation, nutrition, and lack of physical activity contribute to the problem.

Most Indian tribal lands are located in remote, isolated areas. According to the National Highway Traffic Safety Administration, deaths from car accidents are greater in rural than urban areas. Among AI/AN 19 years old and younger, motor vehicle crashes are the leading cause of unintentional injury-related death, followed by drowning and poisoning.

Being rural alone does not lead to the unintentional death rate crisis that AI/AN people currently face, but it does contribute to another key factor, which is environment. Many tribes and Indian tribal lands are located in areas where the environment can be seen as perilous. Similarly, access to health services is extremely limited in these areas meaning that Native individuals need to travel great distances to receive their medical care. Conversely, medical professionals need to travel great distances to reach those who call for help. Additionally, lack of healthy and/or nutritional options and lack of transportation other than people’s own vehicles exacerbate both the causes of unintentional injuries and death.


What can be Done?

While the statistics paint a bleak picture, there is hope. Although the data on unintentional injury leading to death rates for American Indian and Alaska Natives are striking, they actually show a slight improvement – indicating both the scope of the problem and the fact that small changes, such as education and intervention, can lead to significant improvements. As attention to this issue increases, more solutions can be developed and implemented. By starting with culturally competent, socially acceptable approaches and focusing on each of the aforementioned social determinants, progress can – and will – be made to alleviate the extremely high rates of unintentional injuries and deaths among our Native populations.


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Dr. Joe Coulter is Professor Emeritus, College of Public Health, Carver College of Medicine, The University of Iowa, a member of the National Partnership for Action’s (NPA) AI/AN Caucus and an enrolled member of the Potawatomi Tribe.

Author’s note: all statistics come from the HIS report, "Trends in Indian Health: 2014" unless otherwise noted. For more information, the full report can be found here.

Now Available- Recording from the latest American Indian and Alaska Native Behavioral Health Webinar: Addressing Mental Illness.

posted May 25, 2017, 11:51 AM by NPA RHEC   [ updated May 31, 2017, 9:35 AM ]

The recording of the latest American Indian and Alaska Native Behavioral Health Webinar: Addressing Mental Illness is now available. The webinar focuses on the work of the Hope Squad Program, a school-based peer advocate program that works to prevent suicide and decrease the incidence of untreated mental illness, is now available. The webinar covered the history and creation of the program, how the program is implemented, ways in which the program has been successful, and reasons for implementing a Hope Squad in your community.

Now Available- Recording Of The latest American Indian and Alaska Native Behavioral Health Webinar: The National Tribal Behavioral Health Agenda

posted May 8, 2017, 1:05 PM by NPA RHEC   [ updated May 8, 2017, 1:05 PM ]

The recording of the latest AI/AN Behavioral Health webinar on the National Tribal Behavioral Health Agenda (TBHA) is now available. The TBHA marks the first tribally informed blueprint for improving behavioral health outcomes in American Indian and Alaska Native (AI/AN) communities. During this webinar, NIHB staff will provide an in-depth analysis of the TBHA, including its five foundational elements, and will provide an overview of the various strategies and recommendations it puts forth for addressing behavioral health concerns.

View it here: https://drive.google.com/file/d/0B3J1kFXVQHf1TVJtOEVwcWVldm8/view

Register For The American Indian And Alaska Native (AI/AN) Webinar On Addressing Mental Illness

posted May 5, 2017, 12:16 PM by NPA RHEC   [ updated May 8, 2017, 7:03 AM ]

The webinar will take place on May 18 at 3-4 p.m. EST and will feature the Hope Squad Program, a school-based peer advocate program that works to prevent suicide and decrease the incidence of untreated mental illness.The webinar will cover the history and creation of the program, how the program is implemented, ways in which the program has been successful, and reasons for implementing a Hope Squad in your community.

Learn more and register:
http://tinyurl.com/HopeSquadRegistration

Mountain States RHEC Will Host Native American Cultural Competency Webinar

posted Jan 24, 2017, 11:00 AM by NPA RHEC   [ updated Apr 21, 2017, 10:34 AM ]

The Mountain States RHEC will host a webinar training series on the history of tribes and treaties, utilization of CLAS Standards and cultural sensitivity when working with tribal communities and the impact of cultural needs assessments. 

To learn more and register: 
https://explorepsa.adobeconnect.com/rhec8/event/event_info.html


Tribal Epidemiology Centers Strengthen the Public Health Capacity of Communities

posted Apr 26, 2016, 7:03 AM by NPA RHEC   [ updated Apr 21, 2017, 10:35 AM ]

Through the years, American Indian and Alaska Native (AI/AN) populations have been underrepresented in the data surveillance that informs health decisions at the federal, state, tribal and local level. In an effort to provide much-needed data to policymakers and local leaders, including tribal leadership, the Indian Health Service (IHS) established Tribal Epidemiology Centers (TECs) in 1996. To view/download the full article please see below.

Native CDFIs Providing Hope via Financial Literacy, Economic Opportunity

posted Apr 26, 2016, 6:59 AM by NPA RHEC   [ updated Apr 21, 2017, 10:35 AM ]

In the language of the tribal Native American group, the Lakota, there is no traditional word for money. That makes the work of the Four Bands Community Fund, a nonprofit and Native Community Development Financial Institution (CDFI) all the more important. The organization’s mission is to create economic opportunity for residents of the Cheyenne River Indian Reservation in South Dakota and also to help the people better understand the basics of money. To view/download the full article please see below.

Affordable Care Act Messaging for American Indians and Alaska Natives

posted Feb 19, 2016, 2:09 PM by NPA RHEC   [ updated Apr 21, 2017, 10:35 AM ]

The Affordable Care Act offers many opportunities to American Indians and Alaska Natives (AI/ANs) who lack health insurance coverage. The National Indian Health Board, American Indian Health & Family Services, and the Alaska Native Tribal Health Consortium have many lessons learned to share from their past outreach and enrollment efforts related to enrollment under the Affordable Care Act. This webinar, held in December 2015 provided tribes, tribal organizations, and RHEC members with effective messaging strategies and outreach practices for AI/ANs that encourage enrollment in the Health Insurance Marketplace, Medicaid, and the Children’s Health Insurance Program. View a replay of the webinar below.

ACA _webinar.mp4


Public Health Accreditation Webinars

posted Feb 19, 2016, 2:08 PM by NPA RHEC   [ updated Apr 21, 2017, 10:36 AM ]

Are you interested in learning all about Public Health Accreditation? With funding from the Office of Minority Health-National Partnership for Action, The National Indian Health Board and Association of State and Territorial Health Organizations (ASTHO) hosted two webinars on Public Health Accreditation. The webinars were created with Tribal communities in mind, but the information can also benefit other public health professionals who work with Tribes, would like to work with Tribes or have a general interest in learning more about accreditation. Robin Wilcox, Chief Program Officer for the Public Health Accreditation Board was the featured speaker for both webinars and the 2nd webinar featured a Tribal Councilperson who focused on the policy levers around Tribal accreditation. Listen to a replay of the two webinars featuring an overview of the Public Health Accreditation process and an in depth look at the standards and measures used to provide guidance to health departments preparing for accreditation.

Public Health Accreditation: Part 1 
Public Health Accreditation: Part 2


Tribal Epidemiology Centers Webinar

posted Feb 19, 2016, 2:05 PM by NPA RHEC   [ updated Apr 21, 2017, 10:36 AM ]

On February 23, 2015, the American Indian and Alaska Native Health Equity Caucus hosted the webinar Tribal Epidemiology Centers: Addressing American Indian and Alaska Native Health Disparities. The webinar provided an overview of the Tribal Epidemiology Centers and urban Indian Health Institute, their findings to date on the challenges in addressing health disparities, and how RHECs and RHEC members can partner to promote health equity for American Indians and Alaska Natives (AI/ANs). With 566 federally recognized tribes and an estimated 5.2 million AI/ANs living in the United States, this population continues to experience some of the greatest health disparities in the U.S. The collective burden of historical trauma, toxic stress, and adverse childhood experiences impacts social determinants of health such as access to educational and job opportunities. For example, life expectancy for AI/ANs is lower than the average U.S life expectancy by 5 years.

A recording of the webinar can be viewed below.

Tribal Epidemiology Centers_Addressing AIAN Health Disparities


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