felicia schanche hodge, dr.ph
DESCRIPTION
Felicia Schanche Hodge, Dr.PH. Center for American Indian Research & Education. American Indian/Alaskan Native Population. 1996 U.S. Bureau of Census Population Estimates. 2.3 million. 1996 IHS service population. 1.4 million. More than 550 Federally recognized tribes in the U.S. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/1.jpg)
Felicia Schanche Hodge, Dr.PH
C RE
Center for American Indian
Research & Education
![Page 2: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/2.jpg)
American Indian/Alaskan Native Population
1996 U.S. Bureau of CensusPopulation Estimates
1996 IHS service population
2.3 million
1.4 million
C RE
More than 550 Federally recognized tribes in the U.S.
![Page 3: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/3.jpg)
American Indian/Alaskan Native Health Services
IHS Service Area - 12 Area Offices
C RE
Service area consists of counties on and near federal Indian reservations
•37 hospitals •64 healthcenters• 5 school health centers•50 health stations•34 urban Indian health projects
![Page 4: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/4.jpg)
• 12 hospitals• 116 health centers• 3 school health centers • 56 health stations• 167 Alaska village clinics
Tribally operated health services
C RE
American Indian/Alaskan Native Health Services(cont.)
![Page 5: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/5.jpg)
• 50% or more reside in urban areas
C RE
• Non - IHS eligible population falling through the cracks
![Page 6: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/6.jpg)
• hard to reach populations
C RE
![Page 7: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/7.jpg)
• acute chronic
C RE
![Page 8: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/8.jpg)
Leading Causes of DeathIHS Service Area 1991-1993
• Diseases of the Heart 116.1
• Malignant neoplasms 80.6
• Accidents 78.0
• Diabetes Mellitus 25.0
• Chronic Liver disease and cirrhosis 23.6
• Cerebrovascular diseases 23.3
(Deaths per 100,000)
![Page 9: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/9.jpg)
Leading Causes of DeathIHS Service Area 1991-1993 (cont.)
• Pneumonia and influenza 19.5
• Suicide 15.2
• Homicide and legal intervention 14.0
• Chronic obstructive pulmonary diseases and allied conditions 12.8
![Page 10: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/10.jpg)
Causes of DeathIHS Service Area 1991-1993
Compared to rates for the U.S. Population,death rates among American Indians are:
465% higher due to alcoholism (703%)*425% higher due to tuberculosis (525%)*184% higher due to accidents (282%)*166% higher due to diabetes (248%)* 46% higher due to suicides ( 89%)*
*excluding 3 areas with problems underreporting death rates for Indians
![Page 11: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/11.jpg)
C RE
• Culture
• Public awareness
• Missed opportunities
• Recruitment strategies
![Page 12: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/12.jpg)
C RE
• Culture
![Page 13: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/13.jpg)
C RE
• fatalism
• fear
• white man’s disease
• introduction of foreign matter
![Page 14: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/14.jpg)
C RE
• Public Awareness
![Page 15: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/15.jpg)
C RE
• Threat is on-going
• Where to obtain health care
• For yourself and your community
![Page 16: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/16.jpg)
C RE
Culturally Competent Outreach
• Culturally sensitive programs
• Utilize community resources
• Educate via Indian way
![Page 17: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/17.jpg)
C RE
• Demographic Barriers
- written materials inappropriate
- not culturally appropriate
![Page 18: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/18.jpg)
C RE
• Social Barriers
- caretakers
- childhood disease
![Page 19: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/19.jpg)
C RE
• Institutional Barrier
- lack of access
- patient / provider communication
![Page 20: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/20.jpg)
C RE
• Missed Opportunities
![Page 21: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/21.jpg)
C RE
• at IHS clinics
• at urban clinics
• at health fairs
![Page 22: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/22.jpg)
C RE
Barriers to Care
• Access to medical care
• Transportation
• Financial limitations
• Cultural barriers
![Page 23: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/23.jpg)
C RE
CAIRE Projects
Smoking Cessation Project
• Data collected from a sample of 1,369 adult Northern California Indian male/female patients at 18 Indian health clinics
![Page 24: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/24.jpg)
C RE
CAIRE Projects
Smoking Cessation Project (cont.)
• Participants completed a self-administered questionnaire designed to assess smoking rates, patterns andattitudes as well as health status
![Page 25: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/25.jpg)
C RE
Smoking and American Indians
•IHS statistics show 2 out of 5 deaths of Indians arerelated to smoking
•Ceremonial vs. Habitual Tobacco Use - Tobacco in American Indian culture
• Estimated that nationwide 50% of American Indians smoke and 41 % of Indian teens smoke
![Page 26: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/26.jpg)
C RE
Smoking and American Indians (cont.)
• Combined chronic alcohol consumption and tobacco use substantially increases the risk of cancer
• Women who smoke may be at a higher risk for developing cervical cancer
• Tobacco control policies
![Page 27: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/27.jpg)
C RE
CAIRE Projects
Cervical Cancer Project
• Data collected from a sample of 413 adult California Indian patients at 8 Indian health clinic sites
• Participants completed a self-administered questionnaire designed to assess cancer screening, knowledge, attitudes and behavior and health status
![Page 28: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/28.jpg)
C RE
CAIRE Projects
Nutrition Project
• Data collected from a sample of 440 adult female heads of households at 8 Indian health clinic sites
• Participants completed a self-reported questionnaire designed to assess patterns of dietary habits, nutrition KAB, and anthropometric measures
![Page 29: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/29.jpg)
CES-D Caseness Rates
Smoking CessationStudy
16cutoff
28cutoff
Nutrition Study 36.2% 13.6%
42.3% 14.7%
Original Study 19% 5%
Cervical CancerStudy 43.0% 15.8%
![Page 30: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/30.jpg)
Depression: CES-D Scale
0
10
20
30
40
50
score score
OriginalStudy
(Radloff)
SmokingCessation
Study
CervicalCancerStudy
NutritionStudy
16 28
![Page 31: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/31.jpg)
Recruitment Strategies
C RE
• Identify gatekeepers
• Utilize Community Health Representatives (CHRs)
• Work from “Inside” not “Outside”
• Utilize community resources
![Page 32: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/32.jpg)
Education Strategies
C RE
• Talking Circles
• Community newsletters
• Community clinics
• Fully explain participation
• Answer all questions
![Page 33: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/33.jpg)
Communication Strategies
C RE
• Body language
• Organization of speech
• Less direct / more generalized
• Talk slower - pauses
• Minimize complaints
![Page 34: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/34.jpg)
Barriers
C RE
• Understand fears
• Address concerns
• Extend family needs
• Money, childcare, transportation
![Page 35: Felicia Schanche Hodge, Dr.PH](https://reader036.vdocuments.site/reader036/viewer/2022062314/56813e5b550346895da856f6/html5/thumbnails/35.jpg)
Cultural Considerations
C RE
• Loss of body parts
• Illness beliefs
• Healing ceremonies