Indian Health Service (IHS) Director's Corner Bloghttps://www.ihs.gov/newsroom/directorsblog/IHS updates on important issues affecting the Indian Health Service.en-usApril is STD Awareness Monthhttps://www.ihs.gov/newsroom/ihs-blog/april2017/april-is-std-awareness-monthhttps://www.ihs.gov/newsroom/ihs-blog/april2017/april-is-std-awareness-monthTuesday, April 25, 2017 ]]>April is recognized as Sexually Transmitted Disease (STD) Awareness Month and brings attention to the nearly 20 million new STDs that occur in the United States each year. While STDs affect all racial and ethnic groups, American Indian/Alaska Native (AI/AN) populations are affected at a higher rate.

In November 2016, the Centers for Disease Control and Prevention (CDC) released its latest Sexually Transmitted Diseases Surveillance Report Exit Disclaimer: You Are Leaving www.ihs.gov, showing the highest rates of STDs in 20 years. The report identifies that in 2015, AI/ANs had the second highest rates for both chlamydia and gonorrhea infections, and AI/AN women had the second highest primary and secondary syphilis rates among all race groups. Reports of congenital syphilis (CS), a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy, is particularly concerning among AI/ANs.

Raising Awareness

The IHS National STD program is committed to continue raising awareness of STDs as a high priority health issue and supporting partnerships, collaborations, policies and education that help reduce the impact of sexually transmitted diseases in Indian Country. The consistent use of clinical reminders in the Electronic Health Record (EHR), and patient and provider education are important and proven interventions for improving STD screening rates and disease prevention. In an effort to stem the rising rates of STDs in Indian Country, the IHS National STD Program, in collaboration with CDC, has developed additional STD educational and technical assistance resources that can be used as-is or adapted by individuals and clinicians to guide local STD screening and treatment efforts. These resources include sample policies and protocols that are available to sites to adopt or adapt based on sites’ needs and local epidemiology. National EHR reminders prompting STD screenings for targeted patient groups are available for deployment at local sites to improve chlamydia and other STD screening rates.

What you can do

STDs, like chlamydia and gonorrhea, can be asymptomatic. Untreated STDs can lead to pelvic inflammatory disease (PID) and infertility. STD infections also increase the likelihood of contracting and transmitting human immunodeficiency virus (HIV).  Although readily preventable when detected during early pregnancy, unrecognized and untreated CS can cause severe illness, miscarriage, stillbirth and early infant death.

STD screening is important for early detection and treatment. National recommendations advise for an annual chlamydia screening for all women between 16-24 years of age. In addition, other high risk groups such as pregnant women and Men who have Sex with Men (MSM) should be also be screened. All pregnant women should be screened at their first prenatal visit and women at high risk should be rescreened early in their third trimester and again at delivery.

Knowing your STD status is a critical step to stopping STD transmission. If you know you are infected you can take steps to protect yourself and your partner. Be sure to ask your healthcare provider to test you for STDs. Many STDs can be diagnosed and treated.

Andria Apostolou, PhD, MPH, is an epidemiologist with the Division of Epidemiology and Disease Prevention and leads the IHS National STD Program. She serves as a subject matter expert for IHS on STD and infectious disease issues that impact American Indian and Alaska Native communities.

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April is National Child Abuse Prevention Monthhttps://www.ihs.gov/newsroom/ihs-blog/april2017/april-is-national-child-abuse-prevention-monthhttps://www.ihs.gov/newsroom/ihs-blog/april2017/april-is-national-child-abuse-prevention-monthMonday, April 24, 2017 ]]>As we observe National Child Abuse Prevention Month, the Indian Health Service has an important role in improving the lives of Native youth. We recently hosted training provided by the Johns Hopkins University in Albuquerque, New Mexico, where 26 community health representatives were trained in an early intervention home visiting program called Family Spirit. Family Spirit Exit Disclaimer: You Are Leaving www.ihs.gov focuses on young children up to three years of age and their families. It is evidence-based, culturally tailored, and shown to improve outcomes for children with the help of front line community health representatives.

In March, IHS announced ten pilot sites in our Pediatric Integrated Care Collaborative Exit Disclaimer: You Are Leaving www.ihs.gov, or PICC, to improve the capacity of primary care to serve children and families experiencing trauma and chronic stress. The project is a result of a partnership between IHS and the Johns Hopkins University Center for Mental Health Services in Pediatric Primary Care. Under the guidance of Johns Hopkins faculty, pilot sites will work toward increasing the quality of child trauma services by integrating behavioral and physical health services for families with young children.

In February, IHS announced a new service of the Indian Children’s Program which offers pediatric neuropsychology consultations to provide expert opinion, clarify diagnoses, and provides behavioral health treatment recommendations. The Indian Children’s Program also offers training for healthcare providers on important clinical topics, such as autism.

The IHS also provides child sexual abuse examiner and clinical skills training for health care providers through a partnership with the International Association of Forensic Nurses called the Tribal Forensic Healthcare Training Project. The training allows medical professionals to acquire and maintain the knowledge, skills, and competency to provide clinical services in response to child sexual abuse. The next web-based course on pediatric sexual assault examiner opened on April 19. It is a self-paced course and runs through June 30. For more information, please visit http://www.tribalforensichealthcare.org/ Exit Disclaimer: You Are Leaving www.ihs.gov.

In honor of National Child Abuse Prevention Month, I encourage you to join us in our efforts of early intervention, screening, assessment, training, and community-based programming to build resiliency among children and youth and promoting family engagement.

Beverly Cotton, DNP, an enrolled member of the Mississippi Band of Choctaw Indians, is a graduate of Vanderbilt University and a primary care pediatric nurse practitioner.

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Family Spirit Program is Aimed at Assisting New Parents

National Social Work Month


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Earth Day: Healthy Planet, Healthy Populationshttps://www.ihs.gov/newsroom/ihs-blog/april2017/earth-day-healthy-planet-healthy-populationshttps://www.ihs.gov/newsroom/ihs-blog/april2017/earth-day-healthy-planet-healthy-populationsFriday, April 21, 2017 ]]>Last year on Earth Day I encouraged everyone to make every day Earth Day. What did we do at IHS during the past year to accomplish that?

We have increased employee participation of telework to reduce greenhouse gas emissions from 26,832 telework days to 29,198 telework days annually. The construction of a new Fort Yuma Health Center is well under way and is expected to receive the Leadership in Energy and Environmental Design (LEED), Gold Certification. LEED is the most widely used green building certification and rating system internationally.

The IHS Desert Sage Youth Wellness Center in Hemet, Calif., include xeriscaping to minimize water use by planting indigenous species that are compatible with the local climate to reduce or eliminate the need for irrigation. This is one of many IHS efforts to reduce our impact on the environment.
The IHS Desert Sage Youth Wellness Center in Hemet, Calif., include xeriscaping to minimize water use by planting indigenous species that are compatible with the local climate to reduce or eliminate the need for irrigation. This is one of many IHS efforts to reduce our impact on the environment.

Funding has been approved to implement energy conservation measures such as lighting replacements at Northern Valley Indian Health Exit Disclaimer: You Are Leaving www.ihs.gov in Chico, CA; the Healing Lodge of the Seven Nations Exit Disclaimer: You Are Leaving www.ihs.gov in Spokane, WA; and Fort Belknap Service Unit facilities in Montana.

IHS efforts also include xeriscaping Exit Disclaimer: You Are Leaving www.ihs.gov projects, which minimize water use by planting indigenous species that are compatible with the local climate to reduce or eliminate the need for irrigation. This is being implemented at three health care centers in Montana, at the Riverside/San Bernardino County Indian Health Center Exit Disclaimer: You Are Leaving www.ihs.gov in Banning, CA, and Fort Washakie Health Center in Wyoming.  These are only a few examples of our efforts.

We are proud of these improvements and will continue to work hard on reducing our resource use and our impact on the environment.

The focus of this year’s Earth Day campaign is Environmental and Climate Literacy.  Environmental and climate literacy Exit Disclaimer: You Are Leaving www.ihs.gov is the engine not only for advancing environmental and climate laws and policies but also for accelerating green technologies and jobs. A healthy planet is the basis for healthy populations, which contributes to the IHS Mission: to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level.

Gary J. Hartz, P.E. is the IHS chief sustainability officer. He leads IHS efforts to provide functional, well maintained health care facilities and staff quarters, technical and financial assistance to tribes on safe water and wastewater systems and a broad range of environmental health and injury prevention activities.

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Let's make every day Earth Day


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IHS Strives to Address Alcohol Misusehttps://www.ihs.gov/newsroom/ihs-blog/april2017/ihs-strives-to-address-alcohol-misusehttps://www.ihs.gov/newsroom/ihs-blog/april2017/ihs-strives-to-address-alcohol-misuseWednesday, April 5, 2017 ]]>Alcohol use can have long term and sometimes devastating effects on individuals, families and communities. Unfortunately, Indian Country is not always immune to these effects. Alcohol Awareness Month provides an opportunity to strengthen awareness, reduce stigma, and encourage communities to promote wellness. The Indian Health Service (IHS) is committed to developing support strategies to assist American Indian and Alaska Native communities to address alcohol and substance misuse.

According to the National Council on Alcoholism and Drug Dependence (NCADD), alcohol is the most commonly used addictive substance in the United States with 17.6 million people (one in every 12 adults) suffering from alcohol misuse or dependence and several million engaging in risky, binge drinking patters that may lead to alcohol issues.

IHS alcohol and substance abuse expert Marcy Ronyak, Ph.D., speaks about common myths of alcoholism during Alcohol Awareness Month.
MSPI Program Focus is Native Youth

In response, IHS expanded the national Methamphetamine Suicide Prevention Initiative (MSPI) to provide substance use and suicide prevention and intervention resources and approaches that are culturally appropriate for use by tribal communities. IHS currently funds 159 projects totaling more than $22.3 million. One of our primary focus areas within MSPI is Native youth. Purpose Area 3 focuses on substance use disorder prevention, treatment and aftercare. There are currently 19 projects providing over $2 million dollars to tribal and urban programs. The goals of this focus area are to encourage programs to build direct service to address substance use disorder through collaboration and innovation to meet the unique needs of their communities.

The national goal of MSPI Generation Indigenous (Gen-I) is to promote early intervention strategies and implement positive youth programming aimed at reducing risk factors for suicidal behavior and substance misuse. IHS funds 91 Gen-I projects for a total of $13.9 million. Projects address objectives that aim to build resiliency, promote positive development, and increase self-sufficiency behaviors among Native youth, engage families, increase access to prevention activities that address substance use and suicidal behaviors, and increase the number of behavioral health providers who specialize in treating children and adolescents. This collaborative process allows IHS and Tribes to identify and share best practices throughout tribal communities in addressing substance use issues.

TAP Provides Resources to Tribes

IHS collaborates with other federal agencies to support tribes in addressing substance issues from a strategic perspective through Tribal Action Plan (TAP) development. IHS serves as the chair of the TAP work group that assists tribes in developing plans that best meets their needs through trainings, reviews, resource access, and technical assistance.  Tribes are able to develop a systemic action plan that identifies multiple opportunities to address alcohol and substance misuse. Over time, excessive alcohol use, both in the form of heavy drinking or binge drinking, can lead to numerous health problems, chronic diseases, neurological impairments and social problems, which may be addressed by the development of a TAP unique to the tribal community.

Research shows that addressing alcohol use in early stages is one of the most effect ways to reduce misuse.  IHS is working with direct service sites to incorporate Screening, Brief Intervention, and Referral to Treatment into their intake process. By identifying potential alcohol issues early on, it allows practitioners to intervene which has shown higher favorable outcomes with alcohol use reduction.

IHS continues to look for ways to reduce harmful alcohol and substance use within tribal communities by raising the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

Walter Castle, LCSW, MCAP, is a senior public health advisor and alcohol and substance abuse lead in the Division of Behavioral Health at the Indian Health Service.

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Bemidji Area hosts alcohol and drug abuse prevention conference


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Family Spirit Program is Aimed at Assisting New Parentshttps://www.ihs.gov/newsroom/ihs-blog/april2017/family-spirit-program-is-aimed-at-assisting-new-parentshttps://www.ihs.gov/newsroom/ihs-blog/april2017/family-spirit-program-is-aimed-at-assisting-new-parentsTuesday, April 4, 2017 ]]>The Family Spirit Program Exit Disclaimer: You Are Leaving www.ihs.gov is an evidence-based, culturally tailored home-visit intervention delivered by Community Health Representatives (CHRs) as a core strategy to support young Native families who have infants and children ages 0 to 3 years old. Parents gain knowledge and skills to promote healthy development of their preschool-aged children.

The CHR program is a community-based outreach program, staffed by a cadre of well-trained, medically-guided, tribal and Native community people who provide a variety of health services within American Indian/Alaska Native communities. IHS hosted a five-day Family Spirit Program certification training session for CHRs from March 27 to 31 in Albuquerque, New Mexico.

The Family Spirit Program focuses on:

  • Increasing parenting knowledge and skills
  • Addressing maternal psychosocial risks that could interfere with positive child-rearing, including drug and alcohol use; depression; education and employment; and domestic violence
  • Promoting optimal physical, cognitive social and emotional development
  • Preparing children for early school success
  • Ensuring children get recommended well-child visits and health care
  • Linking families to community services to address specific needs
  • Promoting parents’ and children’s life skills and behavioral outcomes across the lifespan

The Family Spirit Program has been rigorously evaluated by the Johns Hopkins Center for American Indian Health in partnership with the Navajo Nation, White Mountain Apache and San Carlos Apache tribal communities. The Family Spirit is the largest, most rigorous and only evidence-based early childhood home visiting program designed specifically for American Indian communities.

Family Spirit CHR Class of 2017, after 5-day training session in Albuquerque, New Mexico.
Family Spirit CHR Class of 2017, after 5-day training session in Albuquerque, New Mexico.

Evidence from randomized controlled trials showed the following outcomes:

Parenting

  • Increased maternal knowledge
  • Increased parent self-efficacy
  • Reduced parent stress
  • Improved home safety attitudes

Maternal Outcomes

  • Decreased maternal depression
  • Decreased substance use
  • Fewer behavior problems in mothers

Child Outcomes

  • Fewer behavior problems in children through age three
    • Predicts lower risk of substance use and behavioral health problems over the life course

Georgianna Old Elk is the acting program coordinator for CHRs and public health advisor in the IHS Division of Behavioral Health. She is an enrolled member of the Ft. Peck Assiniboine and Sioux tribes of Montana.

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Celebrating Successes in Diabetes Prevention for Native Americans and Continuing the Workhttps://www.ihs.gov/newsroom/ihs-blog/march2017/celebrating-successes-in-diabetes-prevention-for-native-americans-and-continuing-the-workhttps://www.ihs.gov/newsroom/ihs-blog/march2017/celebrating-successes-in-diabetes-prevention-for-native-americans-and-continuing-the-workWednesday, March 29, 2017 ]]>Today, I was honored to testify before the United States Senate Committee on Indian Affairs at the Oversight Hearing on Native Youth: Promoting Diabetes Prevention Through Healthy Living Exit Disclaimer: You Are Leaving www.ihs.gov.

Diabetes is an important topic for Indian Country, for our families and communities, and for the Indian Health Service. It’s a complex, costly and chronic disease. Diabetes can cause many complications, including kidney damage. Many of us have relatives or friends who require dialysis for diabetes-related, end-stage kidney disease and must travel long distances to a dialysis center several times a week.

Diabetes is leveling off among adults in Indian Country
RADM Chris Buchanan with witnesses and Members of Congress after the U.S. Senate Committee on Indian Affairs hearing.
RADM Chris Buchanan with witnesses and Members of Congress after the U.S. Senate Committee on Indian Affairs hearing.

As I testified, the latest data show a leveling off of diabetes in Native America. The proportion of American Indian adults who have diabetes is no longer increasing, and we are seeing big changes in treatment of complications of diabetes, too. According to the January 2017 Centers for Disease Control and Prevention Vital Signs report Exit Disclaimer: You Are Leaving www.ihs.gov, new cases of diabetes-related kidney failure decreased dramatically -- 54 percent -- among American Indian and Alaska Native adults from 1996 to 2013, a much larger decline than in any other racial group in the United States.

American Indian youth and diabetes

There is good news for the health of youth, as well. Although the proportion of American Indian youth ages 10 to 19 who have type 2 diabetes is higher than in other racial/ethnic groups, the prevalence for American Indian youth in this age group did not increase from 2001 to 2009. Obesity among youth, an important risk factor for diabetes, also seems to be leveling off.

Partnerships to address diabetes in Indian Country

Our partnerships with Tribes, Tribal organizations and Urban Indian Health Programs are central to our mission. If we’re all pulling in the same direction, we will make more progress.

Several key partnerships contributed to this significant and ongoing progress, including the Special Diabetes Program for Indians, or SDPI. The IHS also funds obesity prevention at Boys & Girls Clubs in Indian Country through a cooperative agreement with the National Congress of American Indians. And, IHS has a Memorandum of Understanding with Johns Hopkins University’s Center for American Indian Health to promote implementation of their evidence-based Family Spirit home visiting intervention. The IHS Division of Diabetes Treatment and Prevention develops, documents and sustains the IHS clinical and public health efforts to treat and prevent diabetes in American Indians and Alaska Natives.

Although it takes many years to turn around an epidemic like diabetes, this is happening in American Indian communities, with significant improvements in childhood obesity, diabetes prevalence, and diabetes-related kidney failure. I look forward to continuing to work with partners and communities to ensure the health of our Native youth and families.

RADM Chris Buchanan, an enrolled member of the Seminole Nation of Oklahoma and a graduate of the University of North Carolina at Chapel Hill, serves as Acting Director of the Indian Health Service.

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Meet Phoenix Area Chef Adam Mulletthttps://www.ihs.gov/newsroom/ihs-blog/march2017/meet-phoenix-area-chef-adam-mulletthttps://www.ihs.gov/newsroom/ihs-blog/march2017/meet-phoenix-area-chef-adam-mullettWednesday, March 22, 2017 ]]>One day, Adam Mullett (Navajo) sat in the cafeteria at the Phoenix Indian Medical Center waiting for his dad’s shift to end. Jeff Parrish, who is the food service director, asked Adam what he did for employment. Adam told him he was in high school and the manager at a fast food restaurant. Jeff then shared that a temporary position was opening soon. Adam jumped at the opportunity.

Chef Adam Mullett encourages patients, staff and visitors to the Phoenix Indian Medical Center to eat healthy.
Chef Adam Mullett encourages patients, staff and visitors to the Phoenix Indian Medical Center to eat healthy.

Adam spent the next two months as a dishwasher in Novaki Dining Hall. Jeff noticed that Adam demonstrated he was a motivated worker from day one. Adam did everything from sweeping, mopping, and delivering trays, to serving as cashier. A year later, Jeff encouraged Adam to consider culinary school. Despite never having seen himself as a chef, Adam accepted the challenge and spent nights and days off studying for courses such as Purchasing, Menu Planning, International Cuisine, Principles and Skills, and more.

When Adam reflects on the experience, he recalls that his supervisors at IHS really rooted for him. Culinary school was an amazing experience for him. He had fun and enjoyed that it was a hands-on learning environment.

Jeff describes Adam and his department as customer-service oriented. Their customers include patients, visitors, staff and even other departments. As the epitome of good customer service, Adam jumps in and helps if there is a disabled customer coming through the lunch line without being told. He worked his way up through the system from dishwasher to chef. He’s a great example for other young people who are trying to figure out what IHS career track they want to take.

Adam shared that what he likes most about his job is the chaos and pressure of the fast-paced kitchen. He truly has a blast and loves his job. In honor of National Nutrition Month, Adam and I want to remind you that healthy food can be absolutely delicious. Additionally, he wants to encourage everyone to eat healthy, live a great lifestyle, and have a great time doing it!

RADM Michael Weahkee (Zuni) is the CEO of the Phoenix Indian Medical Center, leading the largest federally operated IHS hospital in the nation.

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Celebrate National Nutrition Month with IHS in March


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IHS Environmental Health and Engineering Leaders Recognizedhttps://www.ihs.gov/newsroom/ihs-blog/march2017/ihs-environmental-health-and-engineering-leaders-recognizedhttps://www.ihs.gov/newsroom/ihs-blog/march2017/ihs-environmental-health-and-engineering-leaders-recognizedTuesday, March 21, 2017 ]]>Did you know that environmental health is an important part of the IHS mission? IHS is tasked with identifying the need for sanitation facilities, prioritizing projects to match available appropriated funding, and constructing those facilities and other disease prevention infrastructure such as potable water and waste disposal facilities for American Indian and Alaska Native communities.

The IHS Office of Environmental Health and Engineering recently announced two awardees, IHS employees who went above and beyond to serve American Indian communities. CDR Mike Reed is Environmental Health Specialist of 2016 and LCDR Ryan Clapp is the Engineer of 2016.

Annually the Division of Environmental Health Services recognizes the Environmental Health Specialist of the Year and the Division of Sanitation Facility Construction recognizes the Engineer of the Year.

Presentation of DEHS Environmental Health Specialist of 2016 (L-R: CAPT David McMahon, CDR Mike Reed and RADM Chris Buchanan.)
Presentation of DEHS Environmental Health Specialist of 2016 (L-R: CAPT David McMahon, CDR Mike Reed and RADM Chris Buchanan.)

CDR Mike Reed, District Environmental Health Officer, Sioux City District Office, is the Environmental Health Specialist of 2016.

The Division of Environmental Health Services has recognized an outstanding Environmental Health Specialist of the Year annually since 1993. The award is given to the Environmental Health Specialist representing the DEHS with distinction and, through superior performance, positively impacting the health outcomes of American Indians and Alaskan Natives. Commissioned Corps Officers, Civil Service, tribal employees serving in IHS funded positions, or IHS staff on detail to a tribal organization are eligible.

A few examples of how CDR Reed applied expertise and innovative solutions to prevent health problems in 2016 include:

CDR Reed collaborated with tribal, state, and Service Unit partners to assure mission needs were met and is viewed as a trusted professional by his peers and the population he unselfishly serves.

LCDR Ryan Clapp is the SFC Engineer of 2016.

SFC 2016 Engineer of the Year: Presentation of the Sanitation Facilities Construction Program 2016 Engineer Award (L-R: Roger Slape, Navajo Area SFC Director, LCDR Ryan Clap, Navajo Area Senior Environmental Engineer and RADM Mark Calkins DSFC Director)
SFC 2016 Engineer of the Year: Presentation of the Sanitation Facilities Construction Program 2016 Engineer Award (L-R: Roger Slape, Navajo Area SFC Director, LCDR Ryan Clap, Navajo Area Senior Environmental Engineer and RADM Mark Calkins DSFC Director)

This award, established in 1990, recognizes SFC engineers in the early stages of their career that have demonstrated exemplary work, as evidenced by specific engineering accomplishments.

LCDR Clapp received this award in recognition of his technical expertise, his cooperative attitude, and his continued service to the people of the Navajo Nation by providing access to sanitation facilities that improve quality of life and protect public health. In 2016, LCDR Clapp completed work on six major construction projects that helped provide or maintain access to safe drinking water at over 890 Nation homes. He was a leader for the Navajo Area’s development of electronic as-built construction drawings that improved work efficiency and communication with Nation officials.

In addition, when key staff members transferred out of the Area, LCDR Clapp volunteered to temporarily accept responsibility for office management and supervision of five engineering technicians and one administrative assistant. Despite these personnel challenges, he was able to accelerate construction expenditures for the office while continuing to effectively manage his own construction project workload.

Gary J. Hartz, P.E. leads IHS efforts to provide functional, well maintained health care facilities and staff housing, technical and financial assistance to Tribes on safe water and wastewater systems and a broad range of environmental health and injury prevention activities.

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National Social Work Monthhttps://www.ihs.gov/newsroom/ihs-blog/march2017/national-social-work-monthhttps://www.ihs.gov/newsroom/ihs-blog/march2017/national-social-work-monthTuesday, March 14, 2017 ]]>Jessica Johnson, a clinical social worker at the IHS Western Oregon Service Unit, provides direct service counseling and prevention services to students at the Bureau of Indian Education, Chemawa Indian Boarding School, and coordinates trauma-informed care efforts within the service unit. Jessica and approximately 177 other social workers across IHS are working with health care providers throughout Indian Country and are making a difference in the lives of American Indians and Alaska Natives (AI/ANs).

March is National Social Work Month, and the IHS would like to recognize and thank social workers like Jessica and throughout Indian Country for the tremendous work they do.

The primary mission of the social work profession is to enhance well-being and help meet the basic needs of all people, especially the most vulnerable in society. Social workers work daily to help AI/ANs to overcome substance use disorders and mental illnesses such as depression and anxiety. Social workers provide essential services to IHS patients and strengthen the delivery of quality behavioral health care to ensure positive health outcomes. IHS recognizes social workers as an invaluable resource and supports efforts to recruit, retain and develop AI/AN social workers by partnering with leading educational institutions to provide internship opportunities to social work students. Increasing AI/AN social workers within the Indian health system strengthens the cultural sensitivity of service delivery and creates opportunity for community partnership with IHS facilities.

In recognition of the numerous contributions made by social workers throughout Indian Country, please join us in celebrating March as National Social Work Month.

Miranda Carman is a Public Health Advisor in the IHS Division of Behavioral Health and serves at the Mental Health Lead.  Miranda is a clinical social worker and a citizen of the Muscogee Creek Nation of Oklahoma.

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National Colorectal Cancer Awareness Monthhttps://www.ihs.gov/newsroom/ihs-blog/march2017/national-colorectal-cancer-awareness-monthhttps://www.ihs.gov/newsroom/ihs-blog/march2017/national-colorectal-cancer-awareness-monthThursday, March 9, 2017 ]]>March is Colorectal Cancer Awareness Month, and the Indian Health Service (IHS) is raising the awareness of colorectal cancer (CRC), a leading cause of cancer deaths among American Indian and Alaska Native (AI/AN) men and women. Over the past two decades there has been a decline in the CRC death rate for most racial and ethnic groups, but a recent study revealed that from 1990-2009 there was no decrease in the CRC death rate for AI/AN Exit Disclaimer: You Are Leaving www.ihs.gov.

Colorectal Cancer Screening

Screening is an effective way to reduce the number of deaths from CRC, since the likelihood of surviving CRC increases greatly when the cancer is detected in its earliest stages. CRC screening is recommended for all average-risk, asymptomatic, 50-75 year old women and men. Multiple CRC screening options are available, including: stool blood tests, stool DNA test, colonoscopy and CT colonography. Providers should discuss with patients the options that are available at their facility, and determine which one is preferred by each patient. The best test is the one that gets done!

The percentage of AI/ANs who are utilizing CRC screening services remains low. According to Government Performance and Results Act or GPRA data, only around 40% of the eligible IHS user population was up-to-date with CRC screening in 2016. While there are often many barriers to screening in AI/AN communities, there are also ways to make it easier for people to get screened. A recent study at three tribal health facilities, for example, demonstrated that CRC screening participation could be significantly increased, compared to usual care, by mailing FIT kits (requiring collection of only one stool sample), along with instructions, a letter from the clinic, and a stamped return envelope, directly to patients’ homes.

80% by 2018 Campaign

The National Colorectal Cancer Roundtable Exit Disclaimer: You Are Leaving www.ihs.gov is leading a national effort to have 80% of adults ages 50 and older to be screened for CRC by the year 2018. The "80% by 2018" effort is designed to educate and mobilize those who are not getting screened. AI/AN specific colorectal health resources, such as digital stories, radio PSAs, videos, brochures, flip charts, reminder postcards, and more, can be found at the Albuquerque Area Southwest Tribal Epidemiology Center's Tribal Colorectal Health Program website Exit Disclaimer: You Are Leaving www.ihs.gov and the Alaska Native Epidemiology Center's Colorectal Cancer Control Program website Exit Disclaimer: You Are Leaving www.ihs.gov.

Donald Haverkamp, MPH, CPH, is an epidemiologist with the Division of Cancer Prevention and Control at CDC. As a field assignee in New Mexico, he collaborates with the Indian Health Service Division of Epidemiology and Disease Prevention and various Tribal organizations, implementing strategies and projects designed to increase colorectal cancer screening among American Indian and Alaska Native people.


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