PRIMARY PREVENTION FOCUS AREAS
:: TOBACCO CESSATION
Background
The best known system of measuring health in the U.S. is Healthy People 2010, which contains a total of 467 separate indicators of the health of the country. A small subset of indicators, called Primary Prevention Focus Areas, can serve as the roadmap American Indian and Alaskan Native (AI/AN) communities need for assessing current health status, designing and implementing programs to improve health, and evaluating the effectiveness of these programs.
Criteria for selection of the Primary Prevention Focus Areas:
Relevance and importance to all communities.
Preventive health can be implemented by individuals and communities.
The intervention is measurable to allow for evaluation of effectiveness.
The IHS Director's Prevention Initiative is currently working with tribes, tribal organizations, IHS staff, and health consultants to develop a systematic and comprehensive way to focus prevention activities on these areas.
Primary Prevention Focus Areas
ASTHMA
Asthma is a chronic lung disease that affects 14-15 million people in the United States. People with asthma have almost half a million hospitalizations annually, and 5000 die each year of the disease.
In 1979 Congress established the IHS National Diabetes Program in response to the epidemic of type 2 diabetes occurring in Indian communities.The mission of the Indian Health Service (IHS) National Diabetes Program (NDP) is to develop, document, and sustain a public health effort to prevent and control diabetes in AI/AN peoples.
What people eat has a powerful impact on their health. Nutition plays an integral part in many of our most prevalent diseases, including diabetes mellitus, heart disease, stroke, obesity, hyperlipidemia, hypertension, certain cancers (breast and colon, e.g.), and osteoporosis. The Indian Health Service is working both to improve the health of patients with nutrition related diseases, and to prevent these illnesses in future generations through interventions in schools, community health programs and hospital and clinic based services.
One in five children are overweight among the general population compared with two in five children among AI/ANs. Indian Health Service is working to engage IHS Areas, local health facilities, and tribal communities in developing long-range, culturally competent, multidisciplinary, effective overweight and obesity treatments and preventative interventions for the diverse AI/AN population.
Regular physical activity, fitness, and exercise are critically important for the health and well being of people of all ages. Research has demonstrated that virtually all individuals can benefit from regular physical activity, whether they participate in vigorous exercise or some type of moderate health-enhancing physical activity.
Commercial tobacco use is one of the leading causes of Preventable Death nationwide. IHS recognizes that tobacco use is a major issue in AI/AN communities.
AI/ANs face multiple challenges in accessing care, including lack of fiscal resources, transportation and remoteness of communities. AI/AN communities and IHS are working to meet these challenges in ways such as telemedicine and mobile mammography.
The incidence rates of Cardiovascular Disease in AI/ANs appear to be increasing significantly despite a fall in the general U.S. population mortality rates, quickly reaching incidence rates almost twice that of the general U.S. population. The age adjusted death rates for cerebrovascular disease are declining more rapidly in the general U.S. population than in AI/ANs, with AI/AN rates now approximately 5% greater than the general U.S. population. In addition, in the face of an epidemic of type 2 diabetes, increasing rates of hypertension and coronary artery disease, there is a concern that we may see an actual increase in stroke rates over the next several decades. Although secondary and tertiary preventative activities have clearly been shown to be extremely beneficial and require significant expansion and increased scope, primary prevention activities related to these and other chronic diseases should be primarily focused on lifestyle modification within AI/AN communities, with a strong focus on AI/AN youth.
Environmental quality refers to the quality of those items that make up the natural environment: air, water, land. Environmental health refers to those aspects of human disease and injury that are determined or influenced by factors in the environment. The Office of Environmental Health and Engineering (OEHE), as a public health program, improves the environmental quality of the AI/AN people through injury and disease prevention. OEHE program include the Sanitation Facilities Construction Program, which supports safe water, wastewater, and solid waste systems, and related support facilities, and the Environmental Health Services Program, which seeks to enhance AI/AN community capacity to develop and manage comprehensive environmental health programs at the local level.
Immunizations are one of the most effective disease- prevention tools available today. Thanks to the routine immunization of children, the U.S. has seen a dramatic decrease in a number of vaccine-preventable diseases that used to cause significant illness and even death.
To raise the health status of American Indians and Alaska Natives to the highest possible level by decreasing the incidence of severe injuries and death to the lowest possible level and increasing the ability of tribes to address their injury problems.
Positive mental and emotional health is crucial for the well being of AI/AN individuals and their communities. The Indian Health Service work with AI/AN communities to provide clinical and preventive services that address the full range of mental health and social problems present in individuals to communities, including depression; suicide; traumatic life circumstances including child abuse, neglect and domestic violence; and co-occurring disorders including the interplay among physical disorders, addiction, and behavioral health. MUsing the latest tools in clinical practice and traditional approaches that span the generations, the mental health programs of IHS are dedicated to providing culturally innovative healing and prevention services to AI/AM communities.
Oral diseases continue to be a significant health problem in the American Indian and Alaska Native population. The three greatest oral health problems facing the Indian Health Service (IHS) and the people it serves are high dental disease rates, poor access to dental care, and severe dental health workforce shortages.
The Indian Health Service is called upon to provide or arrange for prevention and treatment of sexually transmitted diseases. Unlike many serious diseases, simple measures can prevent sexually transmitted diseases.
The Alcoholism and Substance Abuse Program (ASAP) activities are part of an integrated Behavioral Health Team that works collaboratively to eliminate the diseases of alcoholism and other drug dependencies, as well as the associated pain they bring to individuals of all ages, families, villages, communities, and tribes. The ASAP primary goal is to reduce the prevalence and incidence of alcoholism and other drug dependencies. It provides support and resources for American Indians and Alaska Natives (AI/AN) communities to achieve excellence in holistic alcohol and other drug dependency treatments, rehabilitation, and prevention services for individuals and their families.
Traditional Medicine Initiative emphasizes the alliance of traditional and western medical practices between community traditional healers and Indian Health Services (IHS) health care providers. Through this initiative, the agency seeks to foster formal relationships between local service units and traditional healers so that cultural values, beliefs, and traditional healing practices are respected and affirmed by the IHS as an integral component of the healing process.
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