Government Performance and Results Act (GPRA)

A continuing emphasis on community oral health promotion/disease prevention is essential in order to address the current high prevalence, reduce the severity of oral disease and improve the oral health of American Indian/Alaska Native (AI/AN) people.

Access to dental services is a prerequisite for the control of oral disease in susceptible or high-risk populations.

The access to care measure is currently aligned with Healthy People 2020 as a percentage of patients who have visited the dentist within the previous 12 months.

Topical fluorides and dental sealants have been extensively researched and documented in the dental literature as safe and effective preventive interventions to reduce tooth decay.

Diabetes prevention and treatment efforts are important priorities to decrease the onset of diabetes and its complications.

Controlling blood pressure reduces the risk that diabetic patients will develop heart disease, stroke, and kidney failure.

Adequate control of blood sugar levels reduces the risk that patients will develop complications of diabetes, such as heart, blood vessel, eye, kidney, and nerve problems.

Nephropathy assessments help to identify patients who are at risk for kidney disease.

Retinopathy assessments help to identify diabetic patients who are at higher risk for developing blindness.

People with diabetes have an increased risk of heart disease and stroke. Medications called statins help reduce this risk.

Routine immunizations represent a cost-effective public health approach to protect individuals from preventable infectious diseases.

IHS tracked four immunizations nationally in 2018.

Two measures targeted children: combined (4:3:1:3:3:1:4) childhood series for children 19 – 35 months and an annual influenza vaccination for children 6 months to 17 years.

Two adult vaccination measures are included: annual influenza vaccination for adults 18+ and an adult composite immunization.

Prevention measures focus attention on early detection of disease (cancer screenings) and management of risk factors to prevent disease (tobacco cessation and HIV screening).

Prevention can focus on appropriate treatment of chronic conditions (cholesterol and blood pressure treatment) to avoid complications.

Prevention also focuses on healthy behaviors/lifestyles (childhood weight control and infant breastfeeding) that have been shown to prevent diseases.

High rates of alcohol and substance abuse, mental health disorders, suicide, violence, and behavior-related chronic diseases in American Indian and Alaska Native (AI/AN) communities are well documented.

Each of these serious behavioral health issues has a profound impact on the health of individuals, families, and communities.

Two measures relate to alcohol screening or identifying patients with risky or harmful alcohol use and provide them with a brief negotiated interview.

Two depression screening measures span ages 12 and older.

The intimate partner (domestic) violence (IPV/DV) measure identifies women 14 – 46 years who have been screened for IPV/DV.