American Indians and Alaskan Natives bear what experts call a “disproportionate disease burden.” Here’s how that euphemistic term translates to real life:
They’re at higher risk of heart disease than the general population and more than twice as likely to develop diabetes. They’re also more likely to die from diabetes, chronic liver disease and cirrhosis, cancer, stroke, kidney disease, suicide, assault and drug-related causes.
These tragic gaps aren’t a new medical challenge, but they remain a particularly stubborn and shameful one. That’s why a new initiative from the University of Minnesota’s School of Public Health is timely and needed.
In Minnesota and across the nation, there is growing acknowledgment of the value of having caregivers who are not only aware of American Indians’ unique health needs and but familiar with their cultural values. This foundation can strengthen the caregiver-patient relationship, which in turn can serve as a foundation for improved medical outcomes.
At the same time, there is a shortage of health care providers and staff with the cultural knowledge needed to strengthen care in Indian communities. The new School of Public Health program, which was announced in June, aims to help meet this workforce demand.
The school is now offering its graduate students a chance to minor in American Indian health. The pathway is believed to be the first of its kind in the nation. It also complements the work done at the University of Minnesota Medical School’s Center of American Indian and Minority Health.
There’s no need to be American Indian to enroll. Subjects will include Indian culture and provide an in-depth look at tribal law, the federally run Indian Health Service and the complicated interaction between Indian nations and the federal government.
The knowledge will augment traditional public health graduate majors, which include biostatistics, community health promotion, epidemiology, environmental health, and public health administration and policy.
Those who complete the minor will be better prepared to work “within the unique world of tribal public health and wellness,’’ said Linda Frizzell, an assistant professor and nationally recognized expert on Indian health care policy and administration.
Dr. Mary Owen, the director of the University of Minnesota Medical School’s Center of American Indian and Minority Health, applauded the program’s debut. Building a culturally aware workforce can improve outcomes in many ways, she told an editorial writer. It can strengthen one-on-one patient interactions. It can also help lay the foundation for large-scale community-based interventions tailored to the community’s needs.
Owen said an example of a program like this is the American Indian Special Diabetes Program, which is credited with decreasing the rate of kidney failure from type 2 diabetes in Native Americans by 54% from 1996 to 2013.
“So, yes, Native American specific programming within the School of Public Health is critical, both to increase the pool of culturally aware health care workers but also to expand awareness of the existing and successful public health programming that has long been integral to Native American health care.”
It reflects well on Minnesota that its flagship university is taking a smart, practical approach — better workforce training — to address health disparities. Academic institutions elsewhere should follow its lead.