Efforts to monitor and improve the health of American Indian and Alaska Native (AIAN) populations face unique challenges, including racial misclassification and underrepresentation in health research. The role of the Tribal Epidemiology Centers (TECs) in improving the public health infrastructure for the AIAN population is highlighted in a special September supplement to the Journal of Public Health Management and Practice. The journal is published in the Lippincott portfolio by Wolters Kluwer.
The supplement papers "demonstrate the diversity of public health work conducted by TECs to support tribal and urban Indian communities across the country," according to an introductory editorial by Vannesscia L. Cresci, MSW, MPA, of the California Rural Indian Health Board, Roseville; and Rosalina D. James, PhD, of the Urban Indian Health Institute, Seattle. Dr. James is one of the Guest Editors of the special issue, along with Kevin English, DrPH, RPh, of the Albuquerque Area (N.M.) Southwest TEC; Jamie Ritchey, PhD, MPH, of the Inter Tribal Council of Arizona TEC, Phoenix; and Victoria Warren-Mears, PhD, RDN, FAND, of the Northwest TEC, Portland, Ore.
Tribal Epidemiology Centers work to improve public health in AIAN Communities
The TECs were created in 1996, with the goal of improving disease surveillance and other public health functions for the AIAN population. Today there are 12 Tribal Epidemiology Centers 11 serving Indian Health Service (IHS) administrative areas and one, Urban Indian Health Institute, supporting urban Indian organizations nationwide.
Through a wide range of programs and approaches, the TECs seek to improve the health of AIAN communities "by identification and understanding of health risks and inequities, strengthening public health capacity, and assisting in disease prevention and control," according to the TEC website. Ms. Cresci and Dr. James add: "TECs now play a pivotal role in working with tribal communities, urban Indian organizations, governmental agencies, and academic institutions in efforts to reduce AIAN disparities."
The supplement includes 17 papers presenting new research and perspectives from the TECs highlighting their contributions to monitoring and improving the health of AIAN populations. Topics addressed by the special issue papers include:
- Partnerships with federal and state governments to improve the health of AIAN communities. One paper describes the development of "Healthy Alaskans 2020," an innovative tribal-state partnership to develop a statewide health improvement plan.
- Public health issues of special concern to AIAN groups. Topics include cigarette use in different AIAN populations, the high burden of accidental deaths in AIAN communities in the Midwest, colorectal cancer risk factors and diagnosis, and the "forgotten danger" of deaths due to influenza.
- The special challenges of collecting public health data in AIAN populations including the longstanding problem of racial misclassification. Two studies look at approaches using linkage to Tribal health records to improve identification of AIAN individuals in state death certificate data. Other papers evaluate approaches to performing effective health surveys in AIAN communities.
- Technology and advanced research methods to address AIAN health concerns. One paper evaluates a hepatitis C virus telehealth program serving tribal communities. Other studies use spatial or spatiotemporal evaluation techniques to examine access to healthy food or use of tobacco helplines.
Along with the JPHMP Editors, the Guest Editors hope the supplement will provide an update on essential research efforts and programs to understand and respond to issues affecting the health of AIAN communities across the United States. Ms. Cresci and Dr. James conclude: "This body of work demonstrates the critical role of TECs in providing culturally and scientifically rigorous data services to make visible the public health and wellness needs of the AIAN population."
About Journal of Public Health Management and Practice
Journal of Public Health Management and Practice publishes articles which focus on evidence-based public health practice and research. The journal is a bi-monthly peer-reviewed publication guided by a multidisciplinary editorial board of administrators, practitioners and scientists. Journal of Public Health Management and Practice publishes in a wide range of population health topics including research to practice; emergency preparedness; bioterrorism; infectious disease surveillance; environmental health; community health assessment; chronic disease prevention and health promotion; and academic-practice linkages.