Covering Indian Country – November 2019

November 2019

Spotlight: Johns Hopkins Center for American Indian Health

Left to right: JHCAIH staff members Francene Larzelere, MS (White Mountain Apache); Allison Barlow, PhD, MPH, MA; and Novalene Goklish, MS (White Mountain Apache)

For the past 30 years, the Johns Hopkins Center for American Indian Health (JHCAIH) has partnered with Native communities to address serious health disparities.

Headquartered in Baltimore, MD, the Center uses home-visiting programs to help prevent obesity and diabetes among American Indian children and adolescents. The programs tap into participants’ strengths and promote protective factors, such as cultural identity and family connections.

"We’re really holistic," says Allison Barlow, PhD, MPH, MA, Director of JHCAIH. “Rather than focusing narrowly on diet and exercise, we prevent diabetes by teaching problem-solving and coping skills and providing social support.”

Notably, JHCAIH’s programs are all implemented by Native family health coaches or facilitators.

"We have an amazing team of people who work hard to ensure program sustainability."
— Allison Barlow, Director, JHCAIH

Recently, on the Center’s behalf, Barlow accepted the 2019 Native American Child Health Advocacy Award from the American Academy of Pediatrics.

The award primarily recognizes her team’s efforts to develop, evaluate, and scale up the Family Spirit program, an early childhood home-visiting program focused on promoting parents’ and children’s psychosocial and behavioral health. It has scaled to over 125 tribal communities across 20 states. Its latest iteration, Family Spirit Nurture, is aimed at preventing early childhood obesity.

"To promote the best possible diet for infants and toddlers, Family Spirit Nurture trains parents to understand their children’s cues,” explains Barlow. “Typically, a parent may feed a baby who is fussing to try to calm him or her down, but often, fussy babies are tired, uncomfortable, or sick, rather than hungry."

Although JHCAIH is well-known for its work with Navajo and White Mountain Apache communities in the Southwest, its programs encompass other regions, as well. “The exciting news is that we just opened our Great Lakes hub in Duluth, MN,” Barlow says.

That hub, directed by Melissa Walls, PhD (Bois Forte and Couchiching First Nation Anishinaabe), will enhance JHCAIH’s ongoing efforts. For example, their newest program will address stress as a mediator of obesity and diabetes in Ojibwe communities across the Upper Midwest.

Preventing diabetic eye disease

November marks the arrival of both National Diabetes Month and Diabetic Eye Disease Awareness Month.

Diabetes can damage different parts of the eye and cause vision loss. Fortunately, early detection, timely treatment, and appropriate follow-up care may save a person’s sight.

The National Eye Institute recommends that people with diabetes get comprehensive dilated eye exams (PDF, 1 MB, 2 pp) at least once a year to help prevent diabetes-related vision loss.

Promoting tobacco-free and smoke-free lives

Observed this year on November 21, the Great American Smokeout encourages people to take steps toward tobacco-free lives.

Cigarette smoking is the world’s most common preventable cause of death and illness. Using smokeless tobacco also contributes to high disease rates. Additionally, new data show an association between the use of electronic cigarettes (vaping) and lung injuries.

To help prevent vaping-related illness, the Oglala Sioux Tribal Council recently banned the sale, possession, and use of e-cigarettes on the Pine Ridge Reservation in South Dakota.

Is your community ready to develop and implement policies that promote tobacco-free and smoke-free lives? Check out the National Native Network website, which offers:

• a commercial tobacco smoke-free tribal policy toolkit and
• examples of commercial tobacco and e-cigarette smoke-free policies, codes, ordinances, and resolutions

Addressing the impact of Alzheimer’s disease

November is National Alzheimer’s Disease Awareness Month, an ideal time for conversations about how dementia impacts Native communities.

To help tribal leaders start these conversations, the Healthy Brain Initiative (HBI) offers several one-page handouts and a comprehensive Road Map for Indian Country (PDF, 12.3 MB, 44 pp).

The Road Map offers 8 public health strategies to inform and shape responses to Alzheimer’s disease. It also highlights opportunities for community action and examples of ongoing programs to address dementia in Indian Country.

Marketplace health care coverage options

December 15 is the deadline to apply for or re-enroll in Health Insurance Marketplace coverage with a start date of January 1, 2020.

Review tips for using the Marketplace and an enrollment checklist (PDF, 160 KB, 3 pp) to make the process quicker and easier.

Marketplace plans are for people who don’t already have coverage through a job, Medicare, Medicaid, or the Children’s Health Insurance Program. Veterans who are not enrolled in TRICARE or other health care coverage can use the Marketplace to get coverage, too.

New toolkit to improve access to cancer screenings

The National Indian Health Board (NIHB) released a new health systems improvement toolkit (PDF, 4.3 MB, 84 pp) to help tribal health programs increase access to breast, cervical, and colorectal cancer screenings. The toolkit provides:

• an overview of the cancer burden in Indian Country
• a guide to cancer screening tests and guidelines and
• implementation plan worksheets and templates

NACCHO course on causes of health inequity

A web-based course, Roots of Health Inequity, is available at no cost to help public health professionals address systemic differences in health and wellness.

Created by the National Association of County and City Public Health Officials (NACCHO), the interactive course explores the influence of different aspects of social justice on disease rates and life expectancies.

Exhibits highlight AI/AN contributions to health and science

Observed each November, Native American Heritage Month celebrates American Indian and Alaska Native (AI/AN) cultures and traditions. In that spirit, the David. J. Sencer CDC Museum in Atlanta, GA, opened 2 exhibits on AI/AN contributions to public health and science.

• Changing Winds: Public Health and Indian Country focuses on how tribal nations use traditional knowledge and cultural practices to address health challenges.
• Roots of Wisdom: Native Knowledge. Shared Science demonstrates how 4 indigenous communities have reclaimed age-old practices to restore and sustain ecoystems.

Both exhibits will run through May 1, 2020.