Tribal Public Health Broadcast
October 05, 2017
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Public Health News





Public Health News

CDC Releases the 2016 Sexually Transmitted Disease (STD) Surveillance  Report

The Centers for Disease Control and Prevention (CDC) released the  annual  report  Sexually Transmitted Disease (STD) Surveillance 2016 This report indicated a high number of cases of chlamydia, gonorrhea, and syphilis across all races/ethnicities in the United States.  Rates of all three diseases increased  from 2015, and are currently at a  record high.  

Specific data on the rates of of STD's in American Indian/Alaska Native (AI/AN) communities is included in the report, which can be accessed HERE

According to CDC guidelines, STD screening and treatment should be included in routine medical care. Learn about the IHS National STD program HERE.

United Nations Dialogue with Indigenous People & Climate Change in Poor, Rural Communities

Indigenous people at UN meeting. [ Image source]

Earlier this year, international nonprofit  All Together in Dignity (ATD) Fourth World organized a dialogue between the United Nations and indigenous groups of the world. This conversation was part of the "Leave No One Behind" dialogue series.

Around the world, high numbers of indigenous people live in poverty, and often more extreme poverty than other groups experience. During the dialogue, topics discussed included: the importance of including indigenous people in decision-making and the wisdom they can contribute to the 2030 Agenda.  "Indigenous groups [...] are working towards creative solutions. Unfortunately, they are very often seen as criminals and have to fight against discrimination. Indigenous peoples have a profound knowledge of nature, and they understand the connection between lands, languages, cultures and many forms of well-being," the ATD Fourth World Article states. Other issues discussed include  discrimination, poverty and discrimination, and issues that indigenous people are currently facing. Indigenous people identified some of their most pressing problems as mining, electric plants, certain types of industry, and climate change. 

Climate change is of particular concern in environments like the Arctic and the Amazon. "Indigenous people have contributed very little to the depletion of resources," the article says. "Yet, they are most affected by environmental degradation. They are also very aware of the inability and lack of preparation of most governments to deal with health and other issues that result from harm to the environment." A representative of the Hutukara Yanomami Association in Brazil acknowledged that his people have representation on paper, but he emphasized that they also must be acknowledged "in living words and in action."  In the Arctic, temperatures are rising double the speed of the rest of the world [ source ]. This impacts Alaska Native communities in profound ways. Look for more information soon about an NIHB climate project in northern Alaska. 

The International Fund for Agricultural Development (IFAD) is an agency at the United Nations. Watch an IFAD video  HERE about people living traditional lifestyles in Mongolia and learn how climate change is dramatically affecting people's lives.  "Over the next century, climate change will exact the highest price from the world's poorest rural people," the video opens.

Read the ATD Fourth World article about the meeting  HERE

Learn more about climate change on the NIHB climate hub HERE and check back for updates coming soon!  Learn more about climate impacts on health from CDC HERE

Navajo Nation Example: Successful Response to Disease Outbreak

Centers for Disease Control and Prevention (CDC) Emergency Partners recently published an article entitled "Words of Wisdom: Successful Responses Start Locally" about Tribal champions and effective local partnership in disease response.  Though the article will be archived  HERE, it is currently unavailable online and has been copied below with minor formatting changes and some images removed. 

Disease outbreak response and prevention requires more than just science. A successful health intervention needs to be led by who we are caring for. Understanding culture-what makes a population unique, how they understand illness, and how they live-is critical to stopping disease spread.

Navajo Nation
The Navajo people (Diné) have lived in the Four Corners area, covering parts of Arizona, New Mexico, and Utah, since long before U.S. colonization. According to Navajo culture, the Diné arrived on Navajoland by emerging through four levels of worlds, and they live as they were taught, in a tradition that maintains balance and harmony with Mother Earth, Father Sky, and the elements of life such as people, animals, plants, and insects. 

[Source: CDC email] 

Some Diné people who practice traditional religion live in the Hogan, or "sacred dwelling," to conduct traditional healing ceremonies for mental, spiritual, and physical wellbeing. Each Hogan has an opening on the east side to bring in harmony of the sun, a conical roof for harmony with the sky, and walls and floor made of branches, bark, grass, and earth. After the Hogan is constructed, the Medicine man blesses the house.

But this way of life, maintaining such closeness to earth, may increase the risk of hantavirus, a disease carried in rodents that live in the area. Navajo Nation's Department of Health, with the help of CDC, has found some ways to address this risk communication challenge.

A Mysterious Illness
In 1993, a mysterious deadly illness causing respiratory issues was spreading in Navajoland. Local reporters began calling the unidentified illness "Navajo Disease." Worse still, reporters and disease investigators overwhelmed the people, often without invitation, and in ways disrespectful to Navajo culture. The outbreak investigation concluded that the illnesses were caused by a newly identified type of hantavirus, Sin Nombre hantavirus (SNV).

A Message from the Medicine Man
Then, two years ago, another person died of hantavirus, and three others became ill on Navajoland, bringing back the memories of stigma and fear. Del Yazzie, the Acting Director of Navajo Nation's Tribal Epidemiology Center, reached out to CDC's hantavirus experts and told them that the greatest need was to educate the Diné about this disease and its prevention in the Navajo language. It was important to make people aware of the symptoms and how to prevent mice from getting into their homes.  

Less than a week later, Craig Manning, a CDC Health Communication Specialist, was at the Tribal Epidemiology Center in Window Rock, Arizona, working with Yazzie and his team to develop messages and a community education plan.

When Manning first met with Navajo Department of Health officials, they told him that the best way to reach the most people was through radio. From families at home to sheepherders in mountains, many Navajo Nation community members get their news from radio. Yazzie and Manning approached KTNN, a radio station heard across the Nation, to create Public Service Announcements (PSAs), and a live, call-in program on hantavirus. Experts from Navajo Nation and CDC, as well as Navajo Nation President Russell Begaye and Vice President Jonathan Nez, brought together public health science and prevention information spoken in Navajo through revered trusted officials on the first call-in radio talk show in 2016.

More recently the medicine man of the Navajo Department of Health worked with Yazzie and Manning to record a PSA giving guidance on prevention, transmission, symptoms, and treatment of hantavirus. A medicine man is "the holder of truth" about the Navajo way of life and is considered a superior being; a healer, religious leader, and historian able to reach out to spiritual Gods through chants to bring people back into balance, especially when they are ill.

While these PSAs played two times per day for a month, Yazzie received many positive follow-up calls and emails and questions from listeners showing that people were now aware and interested in learning how to prevent hantavirus.

"The stigma caused in the 1990's outbreak naturally subsided with more community education and outreach. People became informed and took it upon themselves to do things to prevent the disease," says Yazzie. "The evaluation of our communication efforts is lacking, but I really believe it [the use of radio] is working to prevent disease."

This partnership resulted in a new way to reach out to the Diné with health information and established a system to reach the most people quickly in an emergency. Navajo Nation's Diné College invites Manning to return each spring to teach students in the Principles of Public Health course how to develop video PSAs.

Local Partnerships
When fighting a disease outbreak, it's important not to lose sight of the goal: to protect the people at risk. Understanding the culture and people affected by an outbreak is just as important as understanding the disease behind it. Identifying hantavirus as the cause of the rash of illnesses and deaths in the 1990's without fully understanding and working with the local population only addressed part of the problem. With Diné national and spiritual leaders determining the best ways to reach their communities, more people in Navajo Nation have the information they need to protect their health.

View past newsletter archives or sign up for CDC Emergency Partners Newsletters  HERE

Tribes are eligible to apply.  The US Dept. of Housing and Urban Development's (HUD) Choice Neighborhoods program leverages significant public and private dollars to support locally driven strategies that address struggling neighborhoods with distressed public or HUD assisted housing through a comprehensive approach to neighborhood transformation. Local leaders, residents, and stakeholders, such as public housing authorities, cities, schools, police, business owners, nonprofits, and private developers, come together to create and implement a plan that revitalizes distressed HUD housing and addresses the challenges in the surrounding neighborhood. The program helps communities transform neighborhoods by revitalizing severely distressed public and/or assisted housing and catalyzing critical improvements in the neighborhood, including vacant property, housing, businesses, services and schools.   More information

Research and Intervention Research to Improve Native American Health - National Institutes of Health 
Due May 14, 2018 (or 2019, 2020)

The National Institutes of Health (NIH) has announced two funding opportunities to improve the health of American Indians, Alaska Natives, and Native Hawaiians. 

The funding opportunities are open to Tribes, Tribal organizations, and a variety of other agencies including nonprofits, governments, and educational institutions. 

Learn more about the opportunities  HERE and  HERE
TOOLKIT: National Breast Cancer Awareness Month

Breast cancer is the second most common kind of cancer in women.  The good news is that most women can survive breast cancer if it's found and treated early.  However, American Indian and Alaska Native women have lower screening rates than the general population.
  • If you are a woman age 40 to 49, talk with your doctor about when to start getting mammograms and how often to get them.
  • If you are a woman age 50 to 74, be sure to get a mammogram every 2 years. You may also choose to get them more often.
Talk to a doctor about your risk for breast cancer, especially if a close family member of yours had breast or ovarian cancer. Your doctor can help you decide when and how often to get mammograms.

View the breast cancer toolkit  HERE  for information about spreading the message on the importance of early detection.

Thursday, October 12, 2017

Thursday, October 12 is Children's Environmental Health Day. Learn more about the day and how you can take action on the website of Children's Environmental Health Network. The website also contains information about how climate and environmental exposure impact children's health, and contains steps for communities to protect this health. 

View the website HERE 

Thursday, October 19-Friday, October 20, 2017

The Agnese Nelms Haury Program in Environmental Justice is sponsoring a Tribal Environmental Health Forum to "address environmental health issues, to share successful resolution of community issues and to build capacity to respond to long-term and immediate environmental impacts on human health and our environment." The website describes the forum as open to Tribal members, Tribal environmental and health professionals, educators and university professionals, and students. The meeting will be used to explore and create action plans related to Tribal environmental health.  The summit will be held in Chandler, Arizona. Fees for late registration (through 10/13) cost $45 and on-site registration is $55. Financial assistance may be available for people with limited funds. 

To learn more or register, click HERE

November 4-November 8, 2017

The American Public Health Association's large annual meeting will take place next month from Saturday, November 4 through Wednesday, November 8 in Atlanta, GA. This year's theme is climate change but there are numerous sessions and poster presentations about a variety of topics. 

Some sessions are focused on American Indian/Alaska Native communities and issues. For example, presentations include: 
  • Prioritizing Native American voices to help guide the adaptation of an evidence-based HIV intervention for Native American adolescents
  • A qualitative analysis of a community health worker prenatal/early childhood program on a Native American reservation
  • A community-based pilot project to increase environmental health literacy in a Native American community
  • Changes in health indicators of communities with Alaska Native and local food-promotion initiatives
  • Native American maternal and child health burdens due to fossil-fuel contamination of sacred, treaty-protected lands: a systematic review
  • Diverse partnerships to reduce chronic diseases in Native communities
  • And others!
Learn more about the meeting or register to attend HERE

Don't Miss NB3 FIT Week! Nov. 5-11

The Notah Begay II Foundation calls upon all Tribes, communities, families, schools, and organizations to host a youth health and fitness activity in Tribal communities during NB3FIT WEEK. Its simple: plan a physical activity event for your youth, select a day during NB3FIT Week, register your event  online  and have fun!  Together, we will engage Native youth and families in physical activity, nutrition and healthy-lifeways.
Register now  and be a part of the largest national event to engage Native youth in physical activity at one time!   Native American children will know that we support and encourage their health and fitness journey.

2018 Open Forum for Quality Improvement, March 29-30 in Louisville, KY 
Abstracts Due by October 18

Save the Date: Tribal Public Health Summit 
Tuesday, May 22-Thursday, May 24, 2018

The National Indian Health Board's Tribal Public Health Summit has been announced for 2018. The Summit will take place in Prior Lake, Minnesota from May 22-24. Save the date! More information will be published soon.