National Resource Center on Native American Aging

1. National Resource Center on Native American Aging Collette Adamsen, PhD Director, NRCNAA Turtle Mountain Band of Chippewa Indians

2. Twenty-five years serving tribes, Alaska villages, and Hawaiian homesteads. Located at the University of North Dakota, School of Medicine & Health Sciences, Center for Rural Health. Funded by the Administration for Community Living (ACL). Two sister centers in Alaska and Hawaii. National Resource Center on Native American Aging (NRCNAA)

3. Mission: identify and increase awareness of evolving Native elder health and social issues. Vision: is to empower Native people to develop community based solutions while honoring and helping to maintain cultural values. Mission and Vision

4. History • Pre-colonization • Free of chronic and infectious diseases • Health Disparities • Historical trauma • “AI/ANs experience the worst health disparities in the nation” (Espey et al. 2014; Warne & Lajimodiere, 2015). • Loss of land, cultural devastation, and inadequate health care access are associated with high rates of health disparities” (Walters et al., 2011). • Cultural Trauma • High rates of diseases • Decline in health

5. Culture and Resiliency • Culture, “is the representations of past and present experiences of shared history, language, and psychological lineage among people that expands across many generations of AI/AN people,” (Fialkowski, Okoror & Boushey, 2012, p. 298). • Strength and resilience of AI/AN people. • Culture serves a fundamental role in managing good health and wellness. • Primary vehicle to delivering healing.

6. Balance and Harmony • Medicine Wheel • Balance between four realms (mental, spiritual, emotion and physical) (Czyzewski, 2011). • Increase in chronic diseases • “At the root of health disparities” (Satterfield et al., 2016).

7. Identifying our Needs: A Survey of Elders • Document and assess needs • Chronic conditions, emotional health, engagement in cultural practices • 3 year cycles • Title VI grants • Native elders • Provides information on health and social need trends. • Partnership with tribes • Tribal members data collectors • Tribes own their data

8. Cycle VI Participation • 16,683 Native elders age 55 years and older • 164 sites representing 267 tribes, villages, and homesteads

9. Cultural Participation

10. Results

11. Results

12. Results

13. Results

14. Results

15. Results

16. Results

17. Discussion • American Indian/Alaska Native/Native Hawaiian elders who participated their cultural practices experienced lower rates of diabetes, arthritis, and depression. • Participation in cultural practices also led to better emotional health. • Results show AI/AN culture serve as a protective factor against certain chronic conditions and increase rates of positive emotional health. • Culture is medicine

18. Culturally tailor programs for tribes • WELL Balanced program • Falls prevention and chronic disease management program • Pilot test with Native elders • Developed in a culturally appropriate manner • Native Elder Caregiver Curriculum • Training curriculum for Native elder caregivers • Developed in conjunction with feedback from Native elders, tribal community, and the university. • Curriculum designed to be flexible for tribal communities to make it fit for their needs. • Evidence-based programs based on AI/AN/NH protocols • Deem evidence based not on Westernized research protocols, but taking into account AI/AN/NH people. • Train providers to be more culturally sensitive and/or appropriate when treating AI/AN/NH elder populations. • Diversity of tribes • “If you’ve seen one tribe, you’ve seen one tribe.” Implications for Practice

19. The NRCNAA Team Collette Adamsen, PhD Research Assistant Professor Director Cole Ward, MA Project Coordinator Courtney Souvannasacd Outreach Coordinator Temp Robin Besse, PhD Research Analyst ND Health Workforce Development Team Jordan Dionne Project Coordinator Temp

20. Contact Information For more information contact: National Resource Center on Native American Aging Center for Rural Health School of Medicine and Health Sciences Grand Forks, ND 58202-9037 Tel: 800-896-7628 Fax: (701) 777-6779 http://www.nrcnaa.org

21. References Bassett, D. & Tsosie, U. (2012). “Our Culture is Medicine”: Perspectives of Native Healers on Posttrauma Recovery Among American Indian and Alaska Native Patients. The Permanente Journal, 16(1): 19-27. Czyzweski, K. (2011). Colonialism as a Broader Social Determinant of Health. The International Indigenous Policy Journal, 2 (1). Retrieved from: http://ir.lib.uwo.ca/iipj/vol2/iss1/5. DOI: 10.18584/iipj.2011.2.1.5 Espey, D.K., Jim, M.A., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 14(S3), S303-S311. Fialkowski, M.K., Okoror, T.A., & Boushey, C.J. (2012). The Relevancy of Community-Based Methods: Using Diet within Native American and Alaska Native Adult Populations as an Example. Clinical and Translational Science, 5, 295-300. Satterfield, D., DeBruyn, L., Santos, M., Alonso, L., & Frank, M. (2016). Health Promotion and Diabetes Prevention in American Indian and Alaska Native Communities—Traditional Foods Project, 2008-2014. Morbidity and Mortality Weekly Report, 65(1): 4-10 Walters, K.L., Mohammed, S.A., Evans-Campbell, T., Beltran, R.E., Chae, D.H., & Duran, B. (2011). Bodies Don’t Just Tell Stories, They Tell Histories: Embodiment of Historical Trauma among American Indians and Alaska Natives. Du Bois Review, 8 (1), 179-189. Warne, D., & Lajimodiere, D. (2015). American Indian health disparities: psychosocial influences. Social and Personality Psychology Compass, 9/10, 567-579. doi: 10.1111/spc3.12198