Preventing Health Disparities on the Coeur d’Alene Reservation
Monday, June 22, 2015
by Marquette Hendrickx
Clinic Services Director
Benewah Medical and Wellness Center
American Indian/Alaska Native (AIAN) populations across the United States are plagued by health disparities that include disproportional death rates attributed to cerebrovascular disease and diabetes when compared with the general population.
AIAN mortality rates for these two diseases are 2.7 times that of the general population (National Stakeholder Strategy for Achieving Health Equity, 2011). High poverty rates contribute to these disparities. Though the AIAN population makes up approximately 1% of the U.S. population, it represents approximately 2% of recipients of the Supplemental Nutrition Assessment Program (SNAP).
Lack of familiarity with the historical and societal issues that may impact AIAN communities’ participation in prevention programs is a barrier for providers working in Indian Country.
Over the last twenty years, the Coeur d’Alene Tribe has made continual strides in promoting a healthy, active community. In 1987, after years of inadequate health care services, the Coeur d’Alene Tribe and the City of Plummer formed a collaboration to become the first ever health center to serve both Native American and non-Native residents on the Reservation and in the surrounding region, establishing the Benewah Medical Center.
In 1998, the Tribe expanded its prevention services, building the state-of-the-art Wellness Center to encourage physical activity in the community. Today the Tribe is providing high quality health and prevention services to the community through many programs in both the Medical &and Wellness Centers.
Among the many Community Health Programs are the Diabetes Treatment program and the Diabetes Prevention Program (Native Lifestyle Balance). The diabetes treatment team works closely with the medical providers to help patients manage their disease and meet their personal wellness goals.
They also host a quarterly “Diabetes Talk About,” with guest speakers on various diabetes related topics, a healthy meal and time to know peers. The diabetes team most recently started hosting a weekly “Balancing your Life and Diabetes” class.
The Diabetes Prevention Program offers a 16-week class on healthy eating, activity and lifestyle for those with pre-diabetes. The team recruits participants by receiving referrals from our medical staff or screening community members at various events. The American Diabetes Association Type 2 Diabetes Risk test and a random blood glucose test are used to screen community members for diabetes.
Staff will recruit those who fit into the Diabetes Prevention Program criteria or refer to other Community Health Programs. The DP program hosts a quarterly fun run to promote physical activity and a few hands-on cooking classes a year to encourage participants to cook at home.
To continue to expand prevention services the Tribe successfully applied for the Centers for Disease Control’s Community Transformation Grant for Small Communities in 2011, establishing the “Preventing Health Issues Through Transformation” (PHITT) Program, and creating a Community Leadership Team.
The PHITT Leadership Team is a coalition of representatives that includes Benewah Medical Center community health staff, providers, human resources representatives from the Coeur d’Alene Tribe, the Casino and medical center, the Chief Executive Officer of the Tribe’s Development Corporation (which includes the Tribe’s grocery store), the Tribal police chief, the school superintendents, Tribal Planning, University of Idaho Extension, University of Idaho researchers and stakeholders from various Tribal departments.
Together, they have established the hnqhesnet (Coeur d’Alene language for, “It is Our Wellbeing”) program. The goals of the hnqhestnet program are to increase access to physical activity opportunities and healthy eating in the community. This two-year grant allowed the hnqhesnet leadership team to build many important relationships and build capacity to make change in the community.
In 2014, the Tribe successfully applied for the Centers for Disease Control’s Racial and Ethnic Approaches to Community Health (REACH) Programs, to continue its hnqhesnet projects. The hnqhesnet projects under the REACH grant will focus on the cultural strengths of the Coeur d’Alene Tribe to provide a basis for community strategies that will promote active living and healthy eating.
Gardening, root digging and canoe building are examples of traditional strategies used to promote healthy lifestyles in the community. The program has also started a series of PSA's called "the qhest life" translated from the Coeur d'Alene language meaning a good, healthy and traditional way of life.
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