Covering Indian Country – January 2020

January 2020

Spotlight: Northwest Justice Project

Left to right: NJP Native American Unit staff members Janel Riley (Laguna Pueblo), Camille McDorman, Cina Littlebird (Laguna Pueblo), and Jennifer Yogi

Social determinants of health, such as access to health care services, contribute significantly to disparities, especially in Indian Country.

Efforts to expand access to care are more likely to be successful when we address common administrative hurdles. For example, sometimes people are denied health care benefits because language or literacy issues prevent them from telling their story in a way that adequately substantiates their eligibility.

In other cases, access to care is directly influenced by one or more legal issues. For instance, American Indians and Alaska Natives (AI/ANs) are significantly more likely than White people to have administrative disqualifications from employment (ADEs), which can hurt people's ability to support their families or meet medical needs. The problem is compounded when someone with ADEs survives a crime, such as sexual assault, and is unable to obtain medical or behavioral health services in a timely fashion.

"Health care access is so closely correlated with resource access," says Cina Littlebird (Laguna Pueblo), a staff attorney in Northwest Justice Project's (NJP's) Native American Unit. "And often people have a whole host of legal problems that impede access to medical care."

Organizations like NJP play a significant role in efforts to address social determinants of health. A nonprofit with 18 offices throughout Washington state, NJP provides free legal services to low-income people.

"We look at what will help folks gain more stability when experiencing poverty, and access to care is a main piece of that."

— Cina Littlebird, Staff Attorney, NJP's Native American Unit

NJP's staff handles a variety of civil (non-criminal) cases, including those involving denial, termination, and reduction of benefits or health care services. The Native American Unit focuses on areas of critical and unique importance to AI/AN clients. Examples include Indian Child Welfare Act cases, discrimination in schools, and issues arising from a client's survival of domestic violence, sexual assault, wage theft, or other crimes.

Counseling and other health services can go a long way toward helping crime survivors recover, but people often require financial assistance to access such services. To that end, the Native American Unit helps clients access resources available through the nonprofit Victim Support Services, the Washington State Labor and Industries' Crime Victims Compensation Fund, and restitution in collaboration with prosecutors. This work is in addition to other general civil legal support the unit offers crime survivors.

January: Keep active in winter

Health observances

Promoting early detection of cervical cancer

January is Cervical Health Awareness Month, and this year, Turquoise Tuesday falls on January 21. Both health observances highlight the importance of routine screening for cervical cancer.

Women are more likely to survive cervical cancer if the disease is detected early and treated promptly. Through its Screen Our Circle program (PDF, 364 KB, 1 p), the American Indian Cancer Foundation (AICF) awards grants to urban clinics for interventions that increase cervical and breast cancer screening rates among Native women.

Additionally, AICF's website features webinars on cervical cancer, as well as a cervical cancer infographic (PDF, 292 KB, 1 p) that explains screening guidelines for average-risk women in different age groups.

Making your fitness journey fun

In observance of Healthy Weight Week (January 21–25), check out AYA: Your Fitness Journey, an interactive mobile walking app presented by Chickasaw Nation.

Available on the Apple App Store and Google Play, the app tracks steps, provides goal-setting challenges, and tells stories featuring fictional Chickasaw characters from different historical time periods.

As users continue their journey to improved fitness, they have opportunities to explore points of interest, learn Chickasaw words, and hear traditional Chickasaw prayers.

The word Aya means "to go" or "to journey" in the Chickasaw language.

Additional resources

Indigikitchen addresses nutrition-related health disparities

Poor nutrition contributes to disproportionately high rates of diabetes and heart disease in Native populations. Education regarding healthy cooking and food-tasting opportunities can help address those disparities.

Using digital media, Indigikitchen gives people the tools they need to find and prepare Indigenous foods, such as wild game, berries, corn, squash, and wild rice. The website includes healthy recipes and brief, easy-to-follow cooking videos.

Additionally, to foster appreciation for traditional foods, Indigikitchen staff visit different communities and conduct cooking demonstrations and classes, school residences, and educational lectures.

Preventing and managing opioid withdrawal in infants

New clinical recommendations (PDF, 551 KB, 27 pp) to screen for and treat neonatal opioid withdrawal syndrome are now available online.

The document is intended to help Indian Health Service (IHS), tribal, and urban Indian health care facilities provide supportive, culturally appropriate care to mothers and infants affected by prenatal opioid exposure.

IHS and the American Academy of Pediatrics Committee on Native American Child Health released the recommendations, which include input from tribal leaders and the American College of Obstetricians and Gynecologists Committee on American Indian/Alaska Native Women's Health.