Tuesday, September 24, 2013
An Update
Hello,
It has been a productively busy and exciting last few months. Here are some of the recent activities that I have been involved in:
The Inter Tribal Council of Arizona, Inc. (ITCA) American Indian Research Center for Health (AIRCH) in collaboration with the Dental Prevention Clinical Support Center (DPCSC) hosted the 2013 AIRCH Health Research Conference on August 15-16, 2013 at the Wild Horse Pass Hotel & Casino. This year’s theme was “Addressing Tribal Health Priorities through a Community-Based Translational Research Framework.” The conference focused on translational research which is scientific research that helps to make findings from basic science useful for practical applications that enhance human health and well-being. Translational research links the discoveries of the research bench to the development of better diagnostic methods, therapeutic products and preventive processes that improve healthcare outcomes.
This conference examined tribal health priorities and translational research to help build tribal health and oral health research capacity for the present and into the future. This conference provided ongoing dialogue among tribal leaders, health officials, researchers, students and other key stakeholders regarding current and future translational research in American Indian communities.
Dr. Donald Warne, director of North Dakota State University's Master of Public Health Program, said a portion of the Affordable Care Act would set up scholarship and grant programs for physicians who wish to work in underserved rural areas and reservations. However, if the law is not fully funded, those resources would not be available.
"It would be bad for us if it's not funded," he said.
Warne and others suggested one of the most important ways to get medical personnel onto reservations is to get more tribal members to go into medical careers and come home to work.
September 6: Presented at Higher Education Resource Organization for Students (HEROS) conference in Bismarck on American Indian Public Health as an Academic Discipline. http://und.edu/orgs/higher-education-resource-organization-for-students/conference.cfm
It has been a productively busy and exciting last few months. Here are some of the recent activities that I have been involved in:
August 13-14: I attended a board of directors meeting for the American Cancer Society. I am on the National Board. The Society’s Board of Directors is composed of 11 officers, 24 directors (12 medical professionals and 12 lay persons), and eight directors-at-large (four medical and four lay). Directors are elected for a two-year term and can serve a maximum of three two-year terms.
The Board of Directors utilizes a self-perpetuating board model and is responsible for the nominating process, the election of the Board members and Officers, and the election of the Nominating Committee.
The Board is the sole governing and fiduciary body for the American Cancer Society, and as such it sets policy, develops and approves an enterprise-wide strategic plan and related resource allocation, and is responsible for the performance of the organization as a whole.
The Board of Directors utilizes a self-perpetuating board model and is responsible for the nominating process, the election of the Board members and Officers, and the election of the Nominating Committee.
The Board is the sole governing and fiduciary body for the American Cancer Society, and as such it sets policy, develops and approves an enterprise-wide strategic plan and related resource allocation, and is responsible for the performance of the organization as a whole.
August 15: I presented the opening keynote address at the Inter Tribal
Council of Arizona Research Conference in Phoenix, AZ.
with John Molina, MD—CEO of Phoenix Indian Medical Center
This conference examined tribal health priorities and translational research to help build tribal health and oral health research capacity for the present and into the future. This conference provided ongoing dialogue among tribal leaders, health officials, researchers, students and other key stakeholders regarding current and future translational research in American Indian communities.
August 29: I met with members of the Rosebud Sioux Tribe in follow up to the Novo
Nordisk Diabetes Project.
Native News Network Photo Credit
ROSEBUD, SOUTH DAKOTA – Addressing one of the biggest health problems facing Native American communities everywhere, the Rosebud Sioux Tribe unveiled a new wellness center and a first of its kind mobile diabetes medical unit. These resources will allow the Rosebud Sioux Tribe Diabetes Prevention Program to improve screening and intervention in children, as well as promote healthy lifestyles for people of all ages on the reservation.
“This program has several important components to addressing diabetes in Indian country,”said Donald K. Warne, MD, MPH, professor at North Dakota State University and advisor to the project.
September 4: I presented at ND Behavioral Health Conference on American
Indian Behavioral Health Disparities in Bismarck, ND. http://www.dce.ndsu.nodak.edu/conferences/ndbhc/
"It would be bad for us if it's not funded," he said.
Warne and others suggested one of the most important ways to get medical personnel onto reservations is to get more tribal members to go into medical careers and come home to work.
September 6: Presented at Higher Education Resource Organization for Students (HEROS) conference in Bismarck on American Indian Public Health as an Academic Discipline. http://und.edu/orgs/higher-education-resource-organization-for-students/conference.cfm
September 13: Presented at the 33rd Annual Symposium on Perinatal Medicine
& Women's Health Care in Minot on American Indian Maternal and Child Health
Disparities.
The goal of this two-day symposium is to provide the most up-to-date
information on current issues and hot topics in perinatal medicine and women's
health. National and local experts presented practical approaches to
challenging problems and gave the newest diagnostic and therapeutic
techniques.
with Reba Mathern Jacobson, MSW, Director of Program Services, March of Dimes
September 13: Presented on the Affordable Care Act at the Mandan, Hidatsa, and
Arikara Nation in New Town, ND.
September 16: Presented at Blackfeet Community College Issksiniip Project Career Pathway Health Conference in Great Falls, MT.
with: Gayle Dine’ Chacon, MD—former
Surgeon General of Navajo Nation, me, Billie Jo Kipp, PhD—President of
Blackfeet Community College
Thursday, September 12, 2013
Dr. Don Warne nominated as a White House Champion of Change for Public Health!
From http://www.whitehouse.gov/champions
Congratulations Dr. Warne!
The best ideas come from the American people. Everyone has a
story to tell, everyone has a part to play.
All across the country, ordinary Americans are doing
extraordinary things in their communities to out-innovate, out-educate, and
out-build the rest of the world. Every week, we will invite these Champions of
Change to the White House to share their ideas to win the future.
The blog of Champions can be viewed here: http://www.whitehouse.gov/champions/blog
Sunday, September 1, 2013
Argus Leader- Insulin maker to fight diabetes on reservation
I worked on this project with Novo Nordisk and the
Rosebud Sioux Tribe. The full article can be found here.
Article written by Steve Young:
August 25, 2013
The dark patches on their skin tell a troubling tale of life and poverty on the Rosebud Indian Reservation.
Doctors call them acanthosis nigricans, and they mark hundreds of Lakota children from places such as Rosebud and Milk’s Camp and Two Strike whose bodies are resisting insulin and teetering on the edge of diabetes.
Left untreated, many of those children could become part of a startling statistic — death from Type 2 diabetes on the reservation is five to six times the national average and worse than anyplace else in America.
But a Denmark-based company called Novo Nordisk is working to reverse that possibility with a $3 million gift to the Rosebud Sioux. The money is paying for a 13,000-square-foot wellness center, for a mobile clinic to bring health care to the most desolate corners of the reservation and for diabetes education.
“I applaud them,” said Dr. Donald Warne, former head of Sanford Health’s Office of Native American Health and now director of North Dakota State University’s master of public health program. “No other private sector entities have stepped forward onto the reservations to try to do something like this in a positive direction.”
The pharmaceutical giant Novo Nordisk is the world’s largest producer of insulin. It’s also heavily involved in nonprofit work, reaching out internationally to underserved communities.
Visit to the reservation
It happened upon Rosebud after one of its medical leaders visited western South Dakota in 2010.
Curt Oltmans, general counsel for Novo Nordisk, grew up in Norfolk, Neb., and would drive across the reservation in a meat delivery truck 30 years ago. He’s seen the challenges of life there, and now knowing the interest within the company for helping this reservation, he moved into a project leadership role.
Initially, the company met with the tribe’s diabetes prevention staff and gathered data about the prevalence of the disease on the reservation and the needs. Then they talked with tribal council members about administration and financing.
The council bought in during spring 2011. Before that, Novo Nordisk set up a $3 million trust it called the Native American Health Initiative. From that money, it was decided to spend a little more than $2 million on a new and expanded wellness center, and another $400,000 on a mobile unit that eventually could provide billable health care services relating to diabetes treatment.
'Only for diabetes prevention'
“The only thing we’ve asked the tribe to do is use this wellness center and mobile unit only for diabetes prevention and education. Those are the only strings attached,” Oltmans said.
The dedication of the wellness center near the Indian Health Service hospital in Rosebud was Friday. The possibilities for this expanded space are immense, said Connie Brushbreaker, director of the tribe’s diabetes
Fitness classes now can be held in the wellness building where space was too tight before, she said. There is dedicated education space, a kitchen to teach more healthful cooking, classroom space and Internet connectivity that will allow for distance learning, and office space.
“There will be three or four very basic exam rooms,” Oltmans said. “It’s hard for people to get physicals through Indian Health Service. We’re trying to get physicians into the center periodically to do that.”
More than a one-time thing
Mobile units that roamed the reservation in the past were there mostly to screen for heart disease, cancer and other ailments, but offered no real primary care or medical services, Warne said.
“With all the other units that came through the reservation, it was a one-time thing,” Brushbreaker said. “I heard a lot of complaints about no follow-up,” Brushbreaker said. “With our diabetes mobile unit, we’ll be able to go out continually, meet with patients and continue education. We’re not going to a community one time and that will be it.”
This unit will do X-rays, screenings and provide other services. If the program can gain recognition from external bodies such as the American Association of Diabetes Educators, it “can charge back for time, services and help them generate some income,” Oltmans said.
Beyond its capital investments, Novo Nordisk will cover operating costs for a while, Oltmans said. But getting the program to the point where it can bill Medicaid, Medicare and other insurance for services is critical.
Tribe to play key role in staffing
So is the tribe’s participation. So, for example, while Novo Nordisk will start out paying for the maintenance and insurance on the mobile unit, the tribe will provide staffing for it and the wellness center.
The effort’s third leg is the training and certification of diabetes education and prevention specialists to work with tribal members, Oltmans said. Their jobs will be convincing the people that Type 2 diabetes is preventable and that a diagnosis does not have to be a death sentence.
At 90 percent completion, the wellness center should be fully operational by mid-October, Brushbreaker said. “And the mobile unit,” she said, “will hopefully be operating much sooner than that.”
Oltmans said his company will “be very disappointed” if people aren’t going to the wellness center and the reservation’s diabetes numbers don’t drop dramatically.
Warne and Brushbreaker don’t believe that will be a problem.
“Their existing wellness center already does a very good job of tracking the number of people using their services and a good job of tracking health measures as far as managing or preventing diabetes,” Warne said. “My sense of it is they will see a dramatic increase in wellness center utilization because they have more capacity. Because of that, more physical activity should translate into less diabetes and less complications.”
Article written by Steve Young:
August 25, 2013
The dark patches on their skin tell a troubling tale of life and poverty on the Rosebud Indian Reservation.
Doctors call them acanthosis nigricans, and they mark hundreds of Lakota children from places such as Rosebud and Milk’s Camp and Two Strike whose bodies are resisting insulin and teetering on the edge of diabetes.
Left untreated, many of those children could become part of a startling statistic — death from Type 2 diabetes on the reservation is five to six times the national average and worse than anyplace else in America.
But a Denmark-based company called Novo Nordisk is working to reverse that possibility with a $3 million gift to the Rosebud Sioux. The money is paying for a 13,000-square-foot wellness center, for a mobile clinic to bring health care to the most desolate corners of the reservation and for diabetes education.
“I applaud them,” said Dr. Donald Warne, former head of Sanford Health’s Office of Native American Health and now director of North Dakota State University’s master of public health program. “No other private sector entities have stepped forward onto the reservations to try to do something like this in a positive direction.”
The pharmaceutical giant Novo Nordisk is the world’s largest producer of insulin. It’s also heavily involved in nonprofit work, reaching out internationally to underserved communities.
Visit to the reservation
It happened upon Rosebud after one of its medical leaders visited western South Dakota in 2010.
Curt Oltmans, general counsel for Novo Nordisk, grew up in Norfolk, Neb., and would drive across the reservation in a meat delivery truck 30 years ago. He’s seen the challenges of life there, and now knowing the interest within the company for helping this reservation, he moved into a project leadership role.
Initially, the company met with the tribe’s diabetes prevention staff and gathered data about the prevalence of the disease on the reservation and the needs. Then they talked with tribal council members about administration and financing.
The council bought in during spring 2011. Before that, Novo Nordisk set up a $3 million trust it called the Native American Health Initiative. From that money, it was decided to spend a little more than $2 million on a new and expanded wellness center, and another $400,000 on a mobile unit that eventually could provide billable health care services relating to diabetes treatment.
'Only for diabetes prevention'
“The only thing we’ve asked the tribe to do is use this wellness center and mobile unit only for diabetes prevention and education. Those are the only strings attached,” Oltmans said.
The dedication of the wellness center near the Indian Health Service hospital in Rosebud was Friday. The possibilities for this expanded space are immense, said Connie Brushbreaker, director of the tribe’s diabetes
Fitness classes now can be held in the wellness building where space was too tight before, she said. There is dedicated education space, a kitchen to teach more healthful cooking, classroom space and Internet connectivity that will allow for distance learning, and office space.
“There will be three or four very basic exam rooms,” Oltmans said. “It’s hard for people to get physicals through Indian Health Service. We’re trying to get physicians into the center periodically to do that.”
More than a one-time thing
Mobile units that roamed the reservation in the past were there mostly to screen for heart disease, cancer and other ailments, but offered no real primary care or medical services, Warne said.
“With all the other units that came through the reservation, it was a one-time thing,” Brushbreaker said. “I heard a lot of complaints about no follow-up,” Brushbreaker said. “With our diabetes mobile unit, we’ll be able to go out continually, meet with patients and continue education. We’re not going to a community one time and that will be it.”
This unit will do X-rays, screenings and provide other services. If the program can gain recognition from external bodies such as the American Association of Diabetes Educators, it “can charge back for time, services and help them generate some income,” Oltmans said.
Beyond its capital investments, Novo Nordisk will cover operating costs for a while, Oltmans said. But getting the program to the point where it can bill Medicaid, Medicare and other insurance for services is critical.
Tribe to play key role in staffing
So is the tribe’s participation. So, for example, while Novo Nordisk will start out paying for the maintenance and insurance on the mobile unit, the tribe will provide staffing for it and the wellness center.
The effort’s third leg is the training and certification of diabetes education and prevention specialists to work with tribal members, Oltmans said. Their jobs will be convincing the people that Type 2 diabetes is preventable and that a diagnosis does not have to be a death sentence.
At 90 percent completion, the wellness center should be fully operational by mid-October, Brushbreaker said. “And the mobile unit,” she said, “will hopefully be operating much sooner than that.”
Oltmans said his company will “be very disappointed” if people aren’t going to the wellness center and the reservation’s diabetes numbers don’t drop dramatically.
Warne and Brushbreaker don’t believe that will be a problem.
“Their existing wellness center already does a very good job of tracking the number of people using their services and a good job of tracking health measures as far as managing or preventing diabetes,” Warne said. “My sense of it is they will see a dramatic increase in wellness center utilization because they have more capacity. Because of that, more physical activity should translate into less diabetes and less complications.”
MPH Student at Health Board
Impromptu training by MPH student Nicki Cain for students at the
Health Board meeting in Aberdeen.
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