CENTER FOR NATIVE ORAL HEALTH RESEARCH

1. CENTER FOR NATIVE ORAL HEALTH RESEARCH Judith E. Albino, PhD, PI Spero Manson, PhD, Co-I Funded by: NIH-NIDCR-U54-DE019259

2. CENTER FOR NATIVE ORAL HEALTH RESEARCH (CNOHR) VISION To become the premier national center working with AI/AN communities to generate and sustain research, training, information dissemination, and technical assistance needed to address AI/AN oral health disparities. TheMissionof CNOHR is to work with AI/AN communities to conduct, facilitate, and disseminate the next generation of AI/AN oral health intervention research, with an initial focus on oral infections and their complications.

3. CNOHR Executive Committee Ruth Nowjack-Raymer, J. Albino, S. Manson, W. Henderson CENTER FOR NATIVE ORAL HEALTH RESEARCHJudith E. Albino, PISpero Manson, Co-I Community Advisory Committee CNOHR Asst. Administrator Judy Sandoval RPAC Judith Albino, PI S&DCC William Henderson, PI Training and Career Development Terry Batliner, DDS Statistics & Sampling Luohua Jiang CNOHR Multi-methods Team Community Liaison and Dissemination Core Spero Manson, PhD Clinical, Community, Economic, Epidemiologic Ethnographic, etc. Developmental Research Programs Judith Albino, PhD RC1: Promoting Behavioral Change for OH in MI Mothers & Children Terry Batliner, PI RC2: Preventing Caries in Preschoolers: Delivery Model in AI Head Start Centers David Quissell, PI

4. University of Colorado Denver/Boulder/Colorado Springs UCD Anschutz Medical Campus Colorado School of Public Health School of Dental Medicine Centers for American Indian/Alaska Native Health AI/AN Head Start Research School of Medicine Native Elder Research Faculty in Other CU Schools & Colleges Center for Native AmericanTelehealth & Tele-Education Urban Indian Heart Health Center for Native Oral Health Research (CNOHR) School of Pharmacy AI/AN Mental Health Research Public Health Faculty at CSU and UNC Special Diabetes Program for Indians Export/Minority Health & Disparities Circles of Care Colorado Clinical and Translational Science Institute

5. Professions and Disciplines of Individuals Who Have Contributed to CNOHR • Anthropology • Biostatistics • Business Administration • Communications • Clinical Psychology • Community Psychology • Demography • Dental Hygiene • Developmental Psychology • Diabetology • Economics • Epidemiology • General Dentistry • Health Psychology • Medicine • Microbiology • Pediatric Dentistry • Pediatric Medicine • Periodontics • Psychology • Psychiatry • Public Health • Social Psychology • Sociology

6. Why Study AI/AN Oral Health Issues? • The population is small, but …the disparities are great.

7. Demographics • Census 2000 – 4.1 million individuals identified as AI/AN (1.5% of the US population). • AI/AN live predominantly in the West (43%) and South (31%). • Approximately 35% of AI/ANs live on reservations or in AN villages. • 560 AI/AN tribes and communities recognized by US Government. Tribes are legally sovereign nations. • AI/AN groups reflect great cultural diversity, with differences in language, culture and customs. .

8. More Demographics • Median age is 29 compared to 35 for the US as a whole • Approximately 33% are under 18 (26% of overall US population) • Only 6% are 65 or older (12% for US) • Only 71% of AI/ANs have at least a high school education and 11% at least a baccalaureate degree, compared to 80% and 24%, respectively • 2006, the overall poverty rate for AI/ANs was 26%, compared to 12% of the US generally. .

9. AI/AN Health Disparities • Life expectancy is 6 years less than for the US population • Infant mortality rate is 21% higher • Injuries 3.4 times higher ; tuberculosis 4.4 times higher; • alcoholism 7.5 times higher; diabetes almost 4 times higher; CHD 2 times higher • CVD rates are rising, and CVD appears to be more fatal • Higher mortality from all cancers than other groups • Higher risks: Obesity in AI/AN WIC children is 2 times higher (20% vs 13%); smoking is more prevalent (36% vs 23%); adults more likely not to exercise (50% vs 37%) • In 2005, per-capita spending for Medicare was almost $6800; for Medicaid, $4300+; and for IHS, just $2130.

10. Oral Health Disparities in the AI/AN Population • The greatest group disparities in oral health are found among American Indians/ Alaska Natives. • Results from IHS Oral Health Surveys show ECC in AI/ANs continues to increase. • Compared to other children ages 2-5, AI/ANs are 3+ times more likely to have untreated decay (68% vs 19%). • AI/AN adults have significantly more periodontal disease. • Nearly 25% of AI/ANs over 65 are completely edentulous.

12. Major Research Components Two studies focused on prevention of ECC RC1: Promoting Behavioral Change for Oral Health in American Indian Mothers and Children • adapt, demonstrate, and test a preventive intervention strategy (MI) for ECC targeted to newborns (600 mothers and 600 controls) RC2: Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in AI Head Start Programs - develop and test a prevention program, including FV, and provided by AI community workers in 26 HS Centers (26 control Centers)

13. Affiliated and Developmental Projects • “Denver Children’s Oral Health Project,” J. O’Connell, PI, & J. Albino, Denver AI Focus Schools. Funded by the Colorado Trust, 2006- • “A Motivational Approach to Improve Prevention of ECC in AI Children,” T. Batliner, PI, & J. Albino, Southern Ute, Ignacio, CO, for Project Export (S. Manson, PI). Funded by NCMHD 63085479, 2008- • “Training Community Members for Prevention of ECC in AI Children,” J. Albino, PI, & D. Quissell, for Native American Research Centers for Health, G. Belcourt, Montana-Wyoming Tribal Leaders Council, PI. Funded by DHHS-IHS, NOT GM-08-115, 2009- • “Periodontal Disease Prevention and Control in AI Adolescents and Young Adults,” E. Morrato, PI, Denver Indian Health and Family Services Center, developmental project concept to be presented Tuesday.

14. CNOHR’s Student Investigators • NOT-OD-09-060 Administrative Supplement: Providing Summer Research Experiences for Students and Science Educators • Amanda Campbell is AI/AN, from the Cherokee and Yup’ik tribes, Amanda is a first year student at the SoDM. She graduated Cum Laude with a BS in Biology from California Lutheran University and then completed the Post-Baccalaureate program at UC Denver’s SoDM. • Kendra Velasquez is Hispanic and grew up in Los Lunas, NM. Kendra graduated with honors, earning a BS in Biology from the New Mexico Institute of Mining and Technology on an academic scholarship. She is the first in her family to earn a degree and pursue graduate/professional studies. • Copies of their final presentation to faculty can be found at the front table.