scholarly journals American Indian/Alaska Native community infrastructure limitations amid the COVID-19 threat

2021 ◽  
Vol 11 (8) ◽  
pp. 62
Author(s):  
Christine Samuel-Nakamura ◽  
Felicia Schanche Hodge
Keyword(s):  
Health Education ◽  
American Indian ◽  
Alaska Native ◽  
Preventive Measures ◽  
Community Education ◽  
The United States ◽  
Telecommunication Networks ◽  
Contact Tracing ◽  
Ecological Approach ◽  
Social Distancing

Objective: The recent SARS-CoV-2 (COVID-19) pandemic that is spreading throughout the nation is a particular threat to American Indian and Alaska Native (AI/AN) communities. The use of recommended methods to prevent or mitigate the spread of the virus, such as hand washing, social distancing, masks, contact tracing and community education is highly problematic at many of these sites. The objective of this paper is to identify and examine structural or cultural barriers to implementing COVID-19 recommendations on select reservation sites.Methods: A qualitative approach that collected and analyzed data from existing sources including newsletter articles, relevant policies and other published reports was instituted in the Spring of 2020. The Centers for Disease Control and Prevention (CDC) policies regarding COVID-19 recommendations to halt the spread of the virus were selected as the standard for COVID-19 prevention, surveillance and mitigation. News articles between March 1, 2020 and December 1, 2020 were identified using various search engines and tribal websites. Information from news resources, including literature reviews, newsletter articles, social media reports, and tribal policy announcements, were gathered and reviewed. Two U.S. southwestern communities are used as examples for the review.Results: Data collected from various sources paint a picture of American Indian communities that lack adequate community infrastructures, and have problems of residential isolation, close living quarters, and contaminated and scarce water supplies. Unsafe or limited water restricts handwashing. Limited informational tools, such as telephone, internet, computer and newsletters, restricted adequate notification of the novel coronavirus to American Indian reservation communities. Often, the lack of a physical home address can create barriers to healthcare accessibility and surveillance, as it limits the identification and access to households. In addition, many traditional cultures of AI/ANs emphasize the interrelatedness of all in nature and thus require an ecological approach to health education and preventive measures, identified as a limitation for COVID-19 surveillance and mitigation.Conclusions: AI/AN communities face a serious threat of contracting COVID-19. Four key infrastructure limitations to effective COVID-19 prevention, surveillance and mitigation were identified: limited access to safe water, deficient telecommunication networks (telephone, internet, and television), housing isolation and shortages, and inadequate medical services – are experienced by many AI/AN communities. Although there are 574 federally recognized tribes in the United States, the two identified in this study subscribe to an ecological approach to health education and preventive measures in that they believe in the interrelatedness of all things in nature. Surveillance questions may be misunderstood or seem invasive and prevention measures (masks, social distancing, and handwashing) may seem to be extreme measures to groups so close to the environment. Together, these present serious barriers to prevention and mitigation of the COVID-19 virus in this underserved population.

scholarly journals A Confluence of Policy Inequality: Health Disparities in Old Age Among American Indian and Alaska Native Populations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Sadie Giles
Keyword(s):  
United States ◽  
Health Disparities ◽  
Life Course ◽  
American Indian ◽  
Old Age ◽  
Alaska Native ◽  
Political History ◽  
The United States ◽  
The Political ◽  
The Life Course

Abstract Racial health disparities in old age are well established, and new conceptualizations and methodologies continue to advance our understanding of health inequality across the life course. One group that is overlooked in many of these analyses, however, is the aging American Indian/Native Alaskan (AI/NA) population. While scholars have attended to the unique health inequities faced by the AI/NA population as a whole due to its discordant political history with the US government, little attention has been paid to unique patterns of disparity that might exist in old age. I propose to draw critical gerontology into the conversation in order to establish a framework through which we can uncover barriers to health, both from the political context of the AI/NA people as well as the political history of old age policy in the United States. Health disparities in old age are often described through a cumulative (dis)advantage framework that offers the benefit of appreciating that different groups enter old age with different resources and health statuses as a result of cumulative inequalities across the life course. Adding a framework of age relations, appreciating age as a system of inequality where people also gain or lose access to resources and status upon entering old age offers a path for understanding the intersection of race and old age. This paper will show how policy history for this group in particular as well as old age policy in the United States all create a unique and unequal circumstance for the aging AI/NA population.

scholarly journals Envisioning health equity for American Indian/Alaska Natives: a unique HIT opportunity

2019 ◽  
Vol 26 (8-9) ◽  
pp. 891-894 ◽  
Author(s):  
Theresa Cullen ◽  
Jan Flowers ◽  
Thomas D Sequist ◽  
Howard Hays ◽  
Paul Biondich ◽  
...  
Keyword(s):  
United States ◽  
American Indian ◽  
Health Information ◽  
Health Equity ◽  
Alaska Native ◽  
Management System ◽  
Information Needs ◽  
Patient Management ◽  
The United States ◽  
Core Mission

Abstract The Indian Health Service provides care to remote and under-resourced communities in the United States. American Indian/Alaska Native patients have some of the highest morbidity and mortality among any ethnic group in the United States. Starting in the 1980s, the IHS implemented the Resource and Patient Management System health information technology (HIT) platform to improve efficiency and quality to address these disparities. The IHS is currently assessing the Resource and Patient Management System to ensure that changing health information needs are met. HIT assessments have traditionally focused on cost, reimbursement opportunities, infrastructure, required or desired functionality, and the ability to meet provider needs. Little information exists on frameworks that assess HIT legacy systems to determine solutions for an integrated rural healthcare system whose end goal is health equity. This search for a next-generation HIT solution for a historically underserved population presents a unique opportunity to envision and redefine HIT that supports health equity as its core mission.

scholarly journals Drawing from justice theories to support targets of online harassment

2020 ◽  
pp. 146144482091312
Author(s):  
Sarita Schoenebeck ◽  
Oliver L Haimson ◽  
Lisa Nakamura
Keyword(s):  
United States ◽  
Social Media ◽  
Criminal Justice ◽  
American Indian ◽  
Alaska Native ◽  
Online Survey ◽  
The United States ◽  
Online Harassment ◽  
Justice Theories

Most content moderation approaches in the United States rely on criminal justice models that sanction offenders via content removal or user bans. However, these models write the online harassment targets out of the justice-seeking process. Via an online survey with US participants ( N = 573), this research draws from justice theories to investigate approaches for supporting targets of online harassment. We uncover preferences for banning offenders, removing content, and apologies, but aversion to mediation and adjusting targets’ audiences. Preferences vary by identities (e.g. transgender participants on average find more exposure to be undesirable; American Indian or Alaska Native participants on average find payment to be unfair) and by social media behaviors (e.g. Instagram users report payment as just and fair). Our results suggest that a one-size-fits-all approach will fail some users while privileging others. We propose a broader theoretical and empirical landscape for supporting online harassment targets.

scholarly journals Resilience in American Indian and Alaska Native Public Health: An Underexplored Framework

2016 ◽  
Vol 32 (2) ◽  
pp. 274-281 ◽  
Author(s):  
Nicolette I. Teufel-Shone ◽  
Julie A. Tippens ◽  
Hilary C. McCrary ◽  
John E. Ehiri ◽  
Priscilla R. Sanderson
Keyword(s):  
United States ◽  
Health Promotion ◽  
American Indian ◽  
Alaska Native ◽  
Data Extraction ◽  
Target Population ◽  
The United States ◽  
Original Research ◽  
Data Synthesis ◽  
Collective Resilience

Objective: To conduct a systematic literature review to assess the conceptualization, application, and measurement of resilience in American Indian and Alaska Native (AIAN) health promotion. Data Sources: We searched 9 literature databases to document how resilience is discussed, fostered, and evaluated in studies of AIAN health promotion in the United States. Study Inclusion and Exclusion Criteria: The article had to (1) be in English; (2) peer reviewed, published from January 1, 1980, to July 31, 2015; (3) identify the target population as predominantly AIANs in the United States; (4) describe a nonclinical intervention or original research that identified resilience as an outcome or resource; and (5) discuss resilience as related to cultural, social, and/or collective strengths. Data Extraction: Sixty full texts were retrieved and assessed for inclusion by 3 reviewers. Data were extracted by 2 reviewers and verified for relevance to inclusion criteria by the third reviewer. Data Synthesis: Attributes of resilience that appeared repeatedly in the literature were identified. Findings were categorized across the lifespan (age group of participants), divided by attributes, and further defined by specific domains within each attribute. Results: Nine articles (8 studies) met the criteria. Currently, resilience research in AIAN populations is limited to the identification of attributes and pilot interventions focused on individual resilience. Resilience models are not used to guide health promotion programming; collective resilience is not explored. Conclusion: Attributes of AIAN resilience should be considered in the development of health interventions. Attention to collective resilience is recommended to leverage existing assets in AIAN communities.

scholarly journals Survival Among Minority Populations with Chronic Myeloid Leukemia: A Surveillance Epidemiology and End Results Database Analysis

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3546-3546
Author(s):  
Owhofasa Agbedia ◽  
Julius Ngwa ◽  
Deepika S. Darbari ◽  
Patricia Oneal
Keyword(s):  
Chronic Myeloid Leukemia ◽  
American Indian ◽  
Alaska Native ◽  
Targeted Therapies ◽  
Myeloid Leukemia ◽  
The United States ◽  
Minority Populations ◽  
Hematopoietic Stem ◽  
End Results

Abstract Introduction: Cancer affects people of all races in the U.S.; however, the burden is greater for minority populations. This is influenced by factors such as demographics, behavioral factors, and access to medical services. The disparity is well documented in some solid tumors. However, little information exists on a racial disparity in survival among minority populations diagnosed with chronic myeloid leukemia (CML) especially in the era of targeted therapies. A better understanding of the population impact of CML will drive further research into approaches to improve overall outcomes. Methods: All cases of CML diagnosed between 1973 and 2017 and with available follow-up data reported in the Surveillance, Epidemiology, and End Results database were reviewed. We performed a population-based study of CML to evaluate survival by race and calendar year of diagnosis: 1975-1989 (the era of cytotoxic therapy; busulfan and hydroxyurea), 1990-2000 (the era of Allogeneic hematopoietic stem cell transplantation or interferon-alfa ± cytarabine), and 2001-2015 (the era of targeted therapy; Tyrosine Kinase Inhibitors). Results: A total of 14572 (56.4% were females) patients diagnosed with CML were included in our analysis. The racial distribution was 83.4% white, 10% black, 0.8% American Indian/Alaska Native and 5.9% Asian or Pacific Islander. 5314 (36.5%), 3725 (25.5%) and 5544 (38%) cases of CML were diagnosed during the 1975-1989, 1990-2000 and 2001-2015 eras respectively. The median 5-year survival improved by race with each era, with the greatest improvement observed among patients diagnosed during the 2001-2015 era. Although a trend of improvement in the median 5-year survival is seen across all age categories, patients 65 years and older continue to experience only a modest survival benefit in the era of targeted therapies (Table 1). No significant differences in survival by race was observed in the era of targeted therapies (Figure 1). Conclusions: This survival analysis includes a longer follow-up duration (Diagnosis Years: 1973-2015) for patients with CML compared to prior studies. Although an overall improvement in median survival is seen across all age groups and by each era, survival benefits are lagging in certain populations (black and American Indian/ Alaska Native) older than 65. SEER database captures information from metropolitan counties in the United States and this may not truly reflect the health of the entire US population. Disclosures No relevant conflicts of interest to declare.

scholarly journals Gastric Cancer Among American Indian and Alaska Native Populations in the United States, 2005–2016

2020 ◽  
Vol 115 (12) ◽  
pp. 1989-1997
Author(s):  
Stephanie C. Melkonian ◽  
Dornell Pete ◽  
Melissa A. Jim ◽  
Donald Haverkamp ◽  
Charles L. Wiggins ◽  
...  
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
American Indian ◽  
Alaska Native ◽  
The United States ◽  
Native Populations

scholarly journals A Preliminary Estimate of the Number of People who Inject Drugs in Cherokee Nation using Capture-Recapture Methods

2021 ◽  
Author(s):  
Molly Feder ◽  
Amanda Winters ◽  
Whitney Essex ◽  
Jorge Mera
Keyword(s):  
United States ◽  
American Indian ◽  
Alaska Native ◽  
People Who Inject Drugs ◽  
The United States ◽  
Native People ◽  
Cherokee Nation ◽  
The Past ◽  
Capture Recapture ◽  
Data Source

Abstract Background: Injection drug use is an important public health issue in the United States, and estimates indicate that American Indian and Alaska Native people are disproportionately affected. Injection drug use is also the leading cause of Hepatitis C virus (HCV) infection in the United States, attributable to over half of all cases, and contributes to 44% of human immunodeficiency virus (HIV) acquisition in American Indian and Alaska Native females. Existing estimates of American Indian and Alaska Native people who inject drugs are limited. We aimed to estimate the number of people who inject drugs in Cherokee Nation.Methods: A two-sample, capture-recapture approach was used. The first data source was an abstraction of Cherokee Nation Health Services electronic medical records from February 2017 through December 2018. The second data source was an abstraction from Cherokee Nation’s HCV Elimination Program Database from August 2015 through December 2018. Individuals were included in the abstractions if they were asked if they had injected drugs in the past six months during their health visit. The indirect prevalence estimate of people who inject drugs was calculated in accordance with the UNAIDS/WHO Guidelines on Estimating the Size of Populations Most at Risk to HIV.Results: In total, 198 individuals across both data sources reported that they had injected drugs within the past six months. This included 123 unique individuals from the first source, 69 individuals from the second source, and six individuals who were included in both sources. Capture-recapture calculations indicated an estimate of 1,613 people who inject drugs (95% CI: 404, 2,821). Conclusions: This study was the first attempt at estimating the number of people who inject drugs in Cherokee Nation, and one of the few existing studies to estimate the number of American Indian/Alaska Native people who inject drugs in the United States. Gaining knowledge about the prevalence of people who inject drugs in Cherokee Nation will inform strategies to support addiction care and treatment among people who inject drugs living in Indian Country.

scholarly journals The COVID States Project #26: Trajectory of COVID-19-related behaviors

2021 ◽  
Author(s):  
David Lazer ◽  
Mauricio Santillana ◽  
Roy H. Perlis ◽  
Alexi Quintana ◽  
Katherine Ognyanova ◽  
...  
Keyword(s):  
State Level ◽  
The United States ◽  
Contact Tracing ◽  
Upper Midwest ◽  
Social Distancing ◽  
Current State ◽  
Change Behavior ◽  
Current Prevalence ◽  
The Us ◽  
National Trends

The current state of the COVID-19 pandemic in the United States is dire, with circumstances in the Upper Midwest particularly grim. In contrast, multiple countries around the world have shown that temporary changes in human behavior and consistent precautions, such as effective testing, contact tracing, and isolation, can slow transmission of COVID-19, allowing local economies to remain open and societal activities to approach normalcy as of today. These include island countries such as New Zealand, Taiwan, Iceland and Australia, and continental countries such as Norway, Uruguay, Thailand, Finland, and South Korea. These successes demonstrate that coordinated action to change behavior can control the pandemic. In this report, we evaluate how the human behaviors that have been shown to inhibit the spread of COVID-19 have evolved across the US since April, 2020.Our report is based on surveys that the COVID States Project has been conducting approximately every month since April in all 50 US states plus the District of Columbia. We address four primary questions:1) What are the national trends in social distancing behaviors and mask wearing since April?2) What are the trends among particular population subsets?3) What are the trends across individual states plus DC?4) What is the relationship, at the state level, between social distancing behaviors and mask wearing with the current prevalence of COVID-19?

scholarly journals A path out of COVID-19 quarantine: an analysis of policy scenarios

2020 ◽  
Author(s):  
Lia Humphrey ◽  
Edward W. Thommes ◽  
Roie Fields ◽  
Naseem Hakim ◽  
Ayman Chit ◽  
...  
Keyword(s):  
Latent Infection ◽  
Average Rate ◽  
The United States ◽  
Contact Tracing ◽  
Brute Force ◽  
Social Distancing ◽  
Testing Rate ◽  
Universal Testing ◽  
The World ◽  
Brute Force Approach

In this work we present an analysis of the two major strategies currently implemented around the world in the fight against COVID-19: Social distancing & shelter-in-place measures to protect the susceptible, and testing & contact-tracing to identify, isolate and treat the infected. The majority of countries have principally relied on the former; we consider the examples of Italy, Canada and the United States. By fitting a disease transmission model to daily case report data, we infer that in each of the three countries, the current level of national shutdown is equivalent to about half the population being under quarantine. We demonstrate that in the absence of other measures, scaling back social distancing in such a way as to prevent a second wave will take prohibitively long. In contrast, South Korea, a country that has managed to control and suppress its outbreak principally through mass testing and contact tracing, and has only instated a partial shutdown. For all four countries, we estimate the level of testing which would be required to allow a complete exit from shutdown and a full lifting of social distancing measures, without a resurgence of COVID-19. We find that a “brute-force” approach of untargeted universal testing requires an average testing rate of once every 36 to 48 hours for every individual, depending on the country. If testing is combined with contact tracing, and/or if tests are able to identify latent infection, then an average rate of once every 4 to 5 days is sufficient.Significance StatementWe demonstrate how current quarantine measures can be lifted after the current pandemic wave by large-scale, frequent-testing and contact tracing on the remaining susceptible populations. We present an analysis of the two major strategies currently implemented around the world against COVID-19: Social distancing & shelter-in-place measures to protect the susceptible, and testing & contact-tracing to identify, isolate and treat the infected. We find that a “brute-force” approach of untargeted universal testing requires an average testing rate of once every 36 to 48 hours for every individual, depending on the country. If testing is combined with contact tracing, and/or if tests are able to identify latent infection, then an average rate of once every 4 to 5 days is sufficient.

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