Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Disparities in Infant Health Among American Indians and Alaska Natives in US Metropolitan Areas(2002) Grossman, D. C.; Baldwin, L.-M.; Casey, S.; Nixon, B.; Hollow, W.; Hart, L. G.Abstract available at publisher's website.Item Preventing diabetes and obesity in American Indian communities: the potential of environmental interventions(2011) Gittelsohn, J.; Rowan, M.Obesity, diabetes, and other diet-related chronic diseases persist in American Indians at rates that are significantly higher than those in other ethnic minority populations. Environmental interventions to improve diet and increase physical activity have the potential to improve these health outcomes, but relatively little work has taken place in American Indian communities. We reviewed the experiences and findings of the following 3 case studies of intervention trials in American Indian communities: the Pathways trial, which was a school-based trial that focused on children; the Apache Healthy Stores program, which was a food-store program that focused on food preparers and shoppers; and the Zhiwaapenewin Akino'maagewin trial, which was a multiinstitutional trial for First Nations adults that worked with food stores, elementary schools, and health and social services agencies. All 3 trials showed mixed success. Important lessons were learned, including the need to focus on supply and demand, institutional and multilevel approaches, and the identification of institutional bases to sustain programs.Item Changing Numbers, Changing Needs: American Indian Demography and Public Health(National Academies Press, 1996) Sandefur, Gary D.; Rindfuss, Ronald R.; Cohen, BarneyThe reported population of American Indians and Alaska Natives has grown rapidly over the past 20 years. These changes raise questions for the Indian Health Service and other agencies responsible for serving the American Indian population. How big is the population? What are its health care and insurance needs? This volume presents an up-to-date summary of what is known about the demography of American Indian and Alaska Native population--their age and geographic distributions, household structure, employment, and disability and disease patterns. This information is critical for health care planners who must determine the eligible population for Indian health services and the costs of providing them. The volume will also be of interest to researchers and policymakers concerned about the future characteristics and needs of the American Indian population.Item Barriers to providing effective mental health services to American Indians.(2001) Johnson, J L; Cameron, M CLike most indigenous populations throughout the world who have undergone innumerable cultural changes, the mental health care needs of American Indians are great. Some surveys conducted by the Indian Health Service show high rates of suicide, mortality, depression and substance abuse. Little is known about effective mental health care among American Indians due, in part, to the lack of culturally appropriate models of mental health in American Indians. This article presents a cultural framework in order to understand the mental health care needs of American Indians and discusses barriers to providing effective mental health services to American Indians.Item Practicing participatory research in American Indian communities.(1999) Davis, S M; Reid, RThe purpose of this article is to explore the historical issues that affect research in American Indian communities and examine the implications of these issues as they relate to culturally sensitive, respectful, and appropriate research with this population. Methods include review and analysis of the literature and examination of our collective experience and that of our colleagues. Recommendations are given for conducting culturally sensitive, participatory research. We conclude that research efforts must build on the establishment of partnerships between investigators and American Indian communities to ensure accurate findings and analyses and to implement culturally relevant benefits.Item Beginning a discussion of nutrition and health disparities(2011) Lancaster, K. J.; Bermudez, O. I.In 2005, the American Society for Nutrition (ASN) created a Minority Affairs Committee (MAC). The goal of the committee is to enhance the participation of scientists from minority groups in the activities of the ASN. Because of the marked disparities in health conditions between white Americans and ethnic minority groups, the MAC also aims to promote scholarly interaction in the area of nutrition in health disparities. To that end, in 2010, the MAC held its first symposium at Experimental Biology. The goal of the symposium was to begin a discussion within the ASN of the role of nutrition in disparities...Item Involving American Indians and medically underserved rural populations in cancer clinical trials(2009) Guadagnolo, B A; Petereit, D. G; Helbig, P.; Koop, D.; Kussman, P.; Fox Dunn, E.; Patnaik, A.PURPOSE: To assess cancer clinical trial recruitment and reasons for nonaccrual among a rural, medically underserved population served by a community-based cancer care center. METHODS: We prospectively tracked clinical trial enrollment incidence among all new patients presenting at the Rapid City Regional Cancer Care Institute. Evaluating physicians completed questionnaires for each patient regarding clinical trial enrollment status and primary reasons for nonenrollment. Patients who identified as American Indian were referred to a program where patients were assisted in navigating the medical system by trained, culturally competent staff. RESULTS: Between September 2006 and January 2008, 891 new cancer patients were evaluated. Seventy-eight patients (9%; 95% confidence intervals, 7-11%) were enrolled on a clinical treatment trial. For 73% (95% confidence intervals, 69-75%) of patients (646 of 891) lack of relevant protocol availability or protocol inclusion criteria restrictiveness was the reason for nonenrollment. Only 45 (5%; 95% confidence intervals, 4-7%) patients refused enrollment on a trial. Of the 78 enrolled on a trial, 6 (8%; 95% confidence intervals, 3-16%) were American Indian. Three additional American Indian patients were enrolled under a nontreatment cancer control trial, bringing the total percentage enrolled of the 94 American Indians who presented to the clinic to 10% (95% confidence intervals, 5-17%). LIMITATIONS: Eligibility rates were unable to be calculated and cross validation of the number in the cohort via registries or ICD-9 codes was not performed. CONCLUSION: Clinical trial participation in this medically underserved population was low overall, but approximately 3-fold higher than reported national accrual rates. Lack of availability of protocols for common cancer sites as well as stringent protocol inclusion criteria were the primary obstacles to clinical trial enrollment. Targeted interventions using a Patient Navigation program were used to engage AI patients and may have resulted in higher clinical trial enrollment among this racial/ethnic group.Item Cultural identification and smoking among American Indian adults in an urban setting(2009) Angstman, Sarah; Harris, Kari Jo; Golbeck, Amanda; Swaney, GydaObjectives. Among American Indians (AIs), an important relationship has been theorized between cultural identification and substance abuse, including smoking. We investigated the relationship between cultural identification and smoking among AI adults. Design. Using the Orthogonal Cultural Identification Scale (OCIS), we examined the relationship between AI and White cultural identification and cigarette use in a sample of AI recruited at an urban Indian center (n=217). Results. We found that high AIs identification predicted smoker status and high White identification predicted non-smoker status when controlling for age and reservation residence. Orthogonal cultural identification status (categorized as high White/high AI, high White/low AI, low White/high AI, or low White/low AI) did not predict smoker status when controlling for age and reservation residence. OCIS item analysis revealed that positive responses to the individual OCIS items 'My family lives by the American Indian way of life,' 'I live by the American Indian way of life,' and 'I am a success in the American Indian way of life' predicted smoker status when controlling for age and reservation residence. Conclusions. Our data suggest that, among some groups of urban AIs, recreational smoking is associated with AI cultural identification.Item From Disparity to Parity in Health” Eliminating Health Disparities - Call to Action(Office of Minority Health and Health Disparities, North Carolina Department of Health and Human Services, 2002) Ngui, Emmanuel; Ngui, EmmanuelShortly after Governor Mike Easley appointed her as Secretary of the Department of Health and Human Services, Carmen Hooker Odom declared eliminating health disparities a priority for the department. The Secretary charged the Office of Minority Health and Health Disparities with lead responsibility for developing the DHHS Call to Action to Eliminate Health Disparities. A Steering Committee on the Elimination of Health Disparities was also established. The committee, which guides the work of the department in building the department’s capacity to identify and address disparities in each division, is made up of representatives from fourteen divisions and offices in DHHS. The DHHS Call to Action to Eliminate Health Disparities represents the work of the Office of Minority Health and Health Disparities and the DHHS Steering Committee of Eliminating Health Disparities. The Call to Action provides an overview of North Carolina demographics and health disparities. Although the health status of North Carolinians has continued to improve over the last decade, the health status of a large segment of North Carolinians continues to lag behind that of the general population. Recent reports from the North Carolina State Center for Health Statistics document persisting racial and ethnic disparities in health status for almost all conditions. The reports show that African Americans, American Indians and Hispanics in North Carolina are more likely to be in poorer health than the White population in the state.Item The Persistence of American Indian Health Disparities(2006) Jones, David S.Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes working to relieve them, sometimes taking advantage of the ill health of American Indians. Economic and political interests have always affected both explanations of health disparities and responses to them, influencing which explanations were emphasized and which interventions were pursued. Tensions also appear in ongoing debates about the contributions of genetic and socioeconomic forces to the pervasive health disparities. Understanding how these economic and political forces have operated historically can explain both the persistence of the health disparities and the controversies that surround them.