Native Strong Visiting & Learning Grantee Conference

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1 Native Strong Visiting & Learning Grantee Conference Susan V. Karol, M.D. Chief Medical Officer Indian Health Service May 13,

2 A Quick Look at the Indian Health Service Provides a comprehensive health service delivery system for approximately 2.2 million American Indians and Alaska Natives. Serves members of 566 federally recognized Tribes. FY 2014 budget is approximately $4.4 billion. Indian Health Service total staff consists of about 15,630 employees, which includes approximately 2,590 nurses, 790 physicians, 660 pharmacists, 670 engineers/sanitarians, 330 physician assistants/nurse practitioners, and 290 dentists. Approximately 69 percent of IHS staff are American Indians and Alaska Natives. 2

3 Diabetes in Tribal Communities Ø American Indians and Alaska Natives are 2.3 times more likely to be diagnosed with diabetes compared to non-hispanic whites. Ø American Indian and Alaska Native youth aged are 9 times more likely to be diagnosed with type 2 diabetes compared to non-hispanic whites. Ø There has been a 110 percent increase in diagnosed diabetes from 1990 to 2009 in American Indian and Alaska Native youth aged years. Ø Death rate due to diabetes for American Indians and Alaska Natives is 2.8 times higher than the general U.S. population. 3

4 Indian Health Diabetes Best Practices Healthy Weight for Life Initiative Special Diabetes Program for Indians - Best Practices: Designed for the Special Diabetes Program for Indians community directed programs but can be used by anyone in clinical and community settings. Downloadable from the IHS Division of Diabetes Treatment and Prevention website. Updated in 2011 and cover 20 diabetes treatment and prevention topics. Based on findings from the latest scientific research, outcomes studies, and successful experiences of diabetes programs. Designed to help diabetes care teams assess what works and does not work. 4

5 Youth-Oriented Best Practices Test for pre-diabetes and diabetes in at-risk youth. Use healthy eating and physical activity guidelines for youth. Implement an education and prevention/treatment plan for youth who are overweight, obese, have pre-diabetes, and/or have diabetes. Engage families in the planning and implementation of the youth and type 2 diabetes prevention and treatment program. Improve the school environment to support health-enhancing behaviors. Provide diabetes disease management in the school setting through a multidisciplinary school health team. 5

6 Breastfeeding Support Best Practices Breastfeeding has been proven to reduce diabetes in mothers and children. Here are some examples from recent studies. Ø Gila River Indian Community members who had been breastfed for two months or longer experienced a 40 percent reduced diabetes prevalence when they were years of age. Ø Native Canadians who were breastfed in the first year of life significantly reduced their risk of diabetes by age eighteen. Ø Every year a woman breastfeeds reduces her risk of developing diabetes by 15 percent. Ø The Centers for Disease Control and Prevention estimate that for every month a child is breastfed, his or her risk for childhood obesity decreases by 4 percent, reaching a plateau at eight months for a risk reduction of approximately one-third. 6

7 T.R.A.I.L. Program The On the T.R.A.I.L (Together Raising Awareness for Indian Life) to Diabetes Prevention program is designed to help reduce the onset of diabetes in children. Started in 2003, the program is funded by IHS and has served nearly 12,000 youth ages 8 to 10 in 83 tribal communities. The program offers a combination of physical, educational, and nutritional activities. The T.R.A.I.L. program is a partnership between the IHS, the National Congress of American Indians, the Boys & Girls Clubs of America, and Nike, Inc. 7

8 Let s Move! in Indian Country The Let s Move! in Indian Country initiative seeks to reduce the rates of childhood obesity in American Indian and Alaska Native children. In 2013, program coordination transitioned from the Department of the Interior to the IHS. Program goals include: Ø Creating a healthy start on life; Ø Developing healthy learning communities; Ø Increasing opportunities for physical activity; and Ø Ensuring families have access to healthy, affordable foods. 8

9 Let s Move! in Indian Country Moving Forward IHS LMIC initiatives include: Ø working to certify all 13 IHS obstetric hospitals as Baby- Friendly, Ø convening a monthly best practices webinar, and Ø a partnership and MOU with NB3F. Current goals include: Ø Developing more collaborative efforts with other Let s Move! sub-initiatives Ø Engaging tribal leaders in obesity prevention, and Ø Updating the Let s Move! in Indian Country website, toolkit, and best practices. 9

10 Questions? 10

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