Cardiovascular Health Policy For Native Americans

1. Cardiovascular Health PolicyFor Native Americans Larry Murillo Dr.P.H Student University of California, Berkeley

2. Policy Issues • How do you involve the community? • Especially schools, workplace, and segments of the community most at risk? • How do you make policies that work? • Who supports the policy? • How much will implementation of policy cost?

3. Medical Support Media Advocacy Epidemiology Community Empowerment Policy Components • Employee Health • Environmental Support • Cultural Components • Ethnic Nutrition • Cultural Components

4. Environmental Support • Walking Trails • Use of Local Gyms • Use of Pool • Workout Facilities • Encourage building walkways • Dogs • Lights along walkways

5. Employee Health • Develop team oriented activities and programs such as March Into May. • Voluntary Agency Wide Program • Administrative Support • Incentives • Develop Exercise Options • Set Example for rest of community

6. Cultural Components • Promote Cultural Values • Navajo/Hopi: Wake up, pray, run towards East • Take Care of Self Instead of Physician being responsible for health. • Find Ways to Encourage dealing with: • Intergenerational PTSD • Internalized suppression • Depression • Belief in self and local community

7. Cultural Components Part II • What does history of community teach? • Impact of policy for Native Americans • Those from external groups (Boarding schools, assimilation, termination, etc.) • P.L. 94-638 and P.L. 94-437 and how they support community based action. • Decline of cultural health practices • What does this mean? How can it be changed?

8. Ethnic Nutrition • Introduction of White Man’s Food • Encourage traditional diet • High in protein, no processed foods • Understand differences of nutritional triangle. • Foods Native Americans tend to be allergic to: milk, sugar, wheat • What are underlying needs and root causes of obesity, diabetes, heart disease?

9. Medical Support • Create Metabolic clinic • Find physicians who support exercise…not just preach it. • Exercise as treatment is more reasonable approach than insulin, heart medication, surgery, or other expensive medical intervention. • Walking Diabetes Clinic instead of Walk-in • Create opportunity to promote walking while offering time to educate patients on a personal level.

10. Media Advocacy • Understanding of Four P’s of Marketing: • Placement, Price, Product, Promotion • Media Promotion • How are alcohol, tobacco, fast foods, outside values portrayed in your community. Who sponsors events in the community? Is who we say we are who we really are? • Media Literacy • Do we have our own mind?

11. Epidemiology • Professional models of health need supportive disease data. • Effective ways to communicate information to the community. • Creates support for funding efforts. • Personalizes health information for the local community.

12. Community Organizing • Change and social action creates new needs such as a new swimming pool, change in attitudes from community leaders, support from the community itself, ongoing vision, and cooperative effort. • Teach youth and elders how to spend time in a meaningful way. • Developing community oriented leaders.

13. Practical Issues for PolicyImplementation • Formal Policy • Policy interpretation AKA “Myth of what can or can’t be done.” • Informal Policy: unwritten beliefs and values of community leaders and community. • Cultural Advocacy Development • Other issues: motivation, volunteers, magnet events, research, educational materials, personnel.

14. Native American Health Concepts • Why is it important to seek support from cultural resources related to health, healing and disease? • Legitimizes approach • Community becomes involved • Learn from disease, not just treat it to escape pain. • Growth from knowledge. • Cost is minimal at time when health care cost is skyrocketing!!!!!