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The best known system of measuring health in the U.S. is Healthy People 2010 (Healthy People 2020 is to be released soon), which contains a total of 467 separate indicators on 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.
For all of the focus areas listed below you can find Evidence Based Practices, Promising Practices, Local Efforts, Policies and resources through what is called the Online Submission, Consultation and Reporting (OSCAR) system. Additional information can be found on the websites linked to under each focus area.
Access To Healthcare
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. Just as important is the personal, “high-talk, low-tech” approach that CHRs provide to patients to ensure that outreach, case-finding, monitoring, and follow-up outside the four walls of the clinic are done to facilitate patients’ access to health care services and resources across the spectrum of service settings.
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. In 1998, Congress established the Special Diabetes Program for Indians (SDPI), a planned partnership between IHS and Tribes with the goal of improving diabetes prevention and treatment resources and outcomes for American Indian and Alaska Native people.
For more information see the Division of Diabetes Treatment & Prevention website.
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.
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. Using 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.
What people eat has a powerful impact on their health. Nutrition 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.
For more information on obesity prevention see our Healthy Weight for Life website.
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.
Physical Activity and Exercise
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.
For more information visit the IHS Physical Activity Kit.
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.
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.
Learn about IHS Tobacco Projects.
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.