health care

Interview with Dr. Stephanie Carroll about New Research on COVID-19 Spread in Indian Country

Producer
Native Nations Institute
Year

Listen to public health researcher Stephanie Carroll, co-author of “American Indian Reservations and COVID-19: Correlates of Early Infection Rates in the Pandemic.” Hear about this new research showing which factors, like household plumbing and language barriers, correlate with a higher spread of the virus, and policy recommendations to address these factors.

Native Nations
Resource Type
Citation

Native Nations Institute. "Interview with Dr. Stephanie Carroll about New Research on COVID-19 Spread in Indian Country." May 1, 2020. (https://www.youtube.com/watch?v=m26M9O_KUYE, accessed July 25, 2023)

Honoring Nations All-Stars Profile: Tohono O’odham Nursing Care Authority

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For many years, due to the Tohono O’odham Nation’s location in the Sonoran Desert of Arizona and the sparse population, Nation members did not have ac-cess to reservation-based long-term or post-hospital care services. This was particularly true for O’odham elders. Elders admitted to the Sells Area Indian Health Service Hospital for acute care who subsequently required follow up long-term skilled nursing care or a place for post-hospital recovery were discharged to nursing home facilities in the Tucson, Arizona area. For most O’odham families, a visit to elder family members required a drive of ninety minutes or more—if trans-portation was available at all. Language and cultural barriers in these urban settings also became a major concern. The facility caregivers could not speak to these residents in the O’odham language, and O’odham residents were not offered traditional foods to eat, could not easily seek the assistance of medicine people, and were not able to spend their remaining days in the desert environment to which they were accustomed. While statistics are not readily available, it is not hard to conclude that placing an ill and frail O’odham elder in a foreign and isolating facility hastens further debilitation and death.Seeking change, the Tohono O’odham community members asked their government to find a way to provide good, culturally appropriate, and local care so that they could bring their elders home

Native Nations
Resource Type
Citation

Stout, Francis and Judith Dworkin. Honoring Nations All-Stars Profile: Tohono O’odham Nursing Care Authority. Harvard Project on American Indian Economic Development, John F. Kennedy School of Government, Harvard University. Cambridge, Massachusetts. 2013.

Policy Brief: Proposal for a Fair and Feasible Formula for the Allocation of CARES Act COVID‐19 Relief Funds to American Indian and Alaska Native Tribal Governments

Year

Title V of the CARES Act requires that the Act’s funds earmarked for tribal governments be released immediately and that they be used for actions taken to respond to the COVID‐19 pandemic. These may include costs incurred by tribal governments to respond directly to the crisis, such as medical or public health expenditures by tribal health departments. Eligible costs may also include burdens associated with what the U.S. Treasury Department calls “second‐order effects,”2 such as having to provide economic support to those suffering from employment or business interruptions due to pandemic‐driven business closures. Determining eligible costs is problematic. Title V of the CARES Act instructs that the costs to be covered are those incurred between March 1, 2020 and December 30, 2020. Not only does this create the need for some means of approximating expenditures that are not yet incurred or known, but the Act’s emphasis on the rapid release of funds to tribes also makes it imperative that a fair and feasible formula be devised to allocate the funds across 574 tribes without imposing undue delay and costs on either the federal government or the tribes.

Citation

Akee, Randall K.Q., Eric C. Henson, Miriam R. Jorgensen, Joseph P. Kalt. May 18, 2020. Policy Brief: Proposal for a Fair and Feasible Formula for the Allocation of CARES Act COVID‐19 Relief Funds to American Indian and Alaska Native Tribal Governments. Cambridge and Tucson: Harvard Project for American Indian Economic Development and Native Nations Institute.

Broken Promises: Continuing Federal Funding Shortfall for Native Americans: Briefing Report

Year

Since our nation’s founding, the United States and Native Americans have committed to and sustained a special trust relationship, which obligates the federal government to promote tribalself-government, support the general wellbeing of Native American tribes and villages, and to protect their lands and resources. In exchange for the surrender and reduction of tribal lands andremoval and resettlement of approximately one-fifth of Native American tribes from their original lands, the United States signed 375 treaties, passed laws, and instituted policies that shape and define the special government-to-government relationship between federal and tribal governments. Yet the U.S. government forced many Native Americans to give up their culture and did not provide adequate assistance to support their interconnected infrastructure, self-governance, housing, education, health, and economic development needs.

Resource Type
Citation

The U.S. Commission on Civil Rights. Broken Promises: Continuing Federal Funding Shortfall for Native Americans. Briefing Report. (December 2018). The U.S. Commission on Civil Rights: Washington, DC. https://www.usccr.gov/pubs/2018/12-20-Broken-Promises.pdf

Genomic Research Through an Indigenous Lens: Understanding the Expectations

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Indigenous scholars are leading initiatives to improve access to genetic and genomic research and health care based on their unique cultural contexts and within sovereign-based governance models created and accepted by their peoples. In the past, Indigenous peoples’ engagement with genomic research was hampered by a lack of standardized guidelines and institutional partnerships, resulting in group harms. This article provides a comparative analysis of research guidelines from Canada, New Zealand, Australia, and the United States that pertain to Indigenous peoples. The goals of the analysis are to identify areas that need attention, support Indigenous-led governance, and promote the development of a model research policy framework for genomic research and health care that has international relevance for Indigenous peoples.

Resource Type
Citation
Garrison, N. A., Hudson, M., Ballantyne, L. L., Garba, I., Martinez, A., Taualii, M., . . . Rainie, S. C. (2019). Genomic Research Through an Indigenous Lens: Understanding the Expectations. Annual Review of Genomics and Human Genetics, 20(1). doi:10.1146/annurev-genom-083118-015434

Navajo's Pine Hill Health Center

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In the Ramah Chapter of the Navajo Nation–as in many parts of Indian Country–late detection of breast cancer leads to disproportionally high rates of breast cancer mortality. Ramah Navajo’s Pine Hill Health Center devised a creative response: it launched a series of "Mammo Days," educational and social outings designed to encourage Navajo women to get regular breast cancer exams. Highly popular, Mammo Days meet a critical need in a culturally sensitive and medically effective way.

Native Nations
Resource Type
Citation

"Pine Hill Health Center." Honoring Nations: 2008 Honoree. Harvard Project on American Indian Economic Development, John F. Kennedy School of Government, Harvard University. Cambridge, Massachusetts. 2009. Report.

Permissions

This Honoring Nations report is featured on the Indigenous Governance Database with the permission of the Harvard Project on American Indian Economic Development.

Puyallup's Institutionalized Quality Improvement Program

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Following a major tribally-initiated restructuring in the early 1980s that created a quality improvement committee and a flatter organizational structure, the PTHA has increased patient access for urgent care visits, reduced "no show" rates, created clinical objectives, increased dental treatments, and incorporated the use of traditional healers into health care delivery. The Puyallup Tribe's Quality Improvement Program has enabled the PTHA to effectively address many of the health care needs of the community that were previously unmet under the Indian Health Service's management. With six full time physicians and a staff of 210, the PTHA has become a model for other Indian nations seeking to create and sustain health systems that meet the highest standard of excellence.

Native Nations
Resource Type
Citation

 "Institutionalized Quality Improvement Program". Honoring Nations: 1999 Honoree. The Harvard Project on American Indian Economic Development, John F. Kennedy School of Government, Harvard University. Cambridge, Massachusetts. 2000. Report.

Permissions

This Honoring Nations report is featured on the Indigenous Governance Database with the permission of the Harvard Project on American Indian Economic Development. 

Choctaw Community Injury Prevention Program

Year

Responding to alarming rates of preventable accidents on its reservation, the Mississippi Band of Choctaw created a comprehensive community injury prevention program in 2001. Through seat belt and child safety seat campaigns, strict enforcement of motor vehicle laws, and community-wide education initiatives, the program is successfully changing behaviors, saving lives, reducing injuries and disabilities, and lowering health care costs.

Resource Type
Citation

"Choctaw Community Injury Prevention Program". Honoring Nations: 2003 Honoree. The Harvard Project on American Indian Economic Development, John F. Kennedy School of Government, Harvard University. Cambridge, Massachusetts. 2004. Report.  

Permissions

This Honoring Nations report is featured on the Indigenous Governance Database with the permission of the Harvard Project on American Indian Economic Development. 

Choctaw Health Center

Year

After transferring all health care decisions from Indian Health Services to tribal control over a ten-year period, the Band significantly improved its health care delivery system. Its state-of-the-art Health Center provides health and dental care, behavioral health care and community health promotion, education and prevention programs, and the first-ever on-reservation disability clinic. In addition, the Tribe has implemented an efficient billing and records system that has reduced the "red-tape" typically associated with third party billing. By taking a more active role in its reservation health care, the tribally controlled Choctaw Health Center is improving community health and meeting the specific health care needs of its citizens. In 1997, the Choctaw Band's Disability Clinic received the Vice President's prestigious Hammer Award for the Clinic's effective disability determination process.

Resource Type
Citation

"Choctaw Health Center". Honoring Nations: 1999 Honoree. The Harvard Project on American Indian Economic Development, John F. Kennedy School of Government, Harvard University. Cambridge, Massachusetts. 2000. Report. 

Permissions

This Honoring Nations report is featured on the Indigenous Governance Database with the permission of the Harvard Project on American Indian Economic Development. 

Northwest Portland Area Indian Health Board

Year

Serving tribes in Oregon, Washington, and Idaho, the Northwest Portland Area Indian Health Board (NPAIHB) was created in 1972 to increase tribes’ ability to exercise control over the design and development of tribal health care delivery systems. Governed by tribal government delegates, NPAIHB facilitates intertribal coordination and promotes intergovernmental consultation. A leader in data collection and advocacy, NPAIHB also administers the first and largest tribal epidemiology center.

Resource Type
Citation

"Northwest Portland Area Indian Health Board". Honoring Nations: 2003 Honoree. The Harvard Project on American Indian Economic Development, John F. Kennedy School of Government, Harvard University. Cambridge, Massachusetts. 2004. Report.

Permissions

This Honoring Nations report is featured on the Indigenous Governance Database with the permission of the Harvard Project on American Indian Economic Development.