Tribal Epi Center (TEC) Newsletter Oct-Dec2015

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T R I B A L

E P I D E M I O L O G Y

C E N T E R

NEWSLETTER OCTOBER/NOVEMBER/DECEMBER 2015

MISS INDIAN WORLD

Cheyenne Brady

INSPIRING CULTURAL PRIDE, PROMOTING HIGHER EDUCATION, & ENCOURAGING HEALTHY LIFESTYLES

Oklahoma City Veterans Affairs Health Care System NAVIGATION FOR AMERICAN INDIAN VETERANS

SEPTEMBER IS NATIONAL SUICIDE AWARENESS MONTH ■ ■

OCTOBER IS HEALTH LITERACY MONTH

NOVEMBER IS NATIVE AMERICAN HERITAGE MONTH


Contents

05 09 13 17 2 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

INTERVIEW WITH CHEYENNE BRADY Q & A with Miss Indian World 2015, Cheyenne Brady. In a candid interview, she shares her journey to winning the title, her role models, and the health issues concerning our Tribal communities.

OKC VETERANS AFFAIRS HEALTH CARE SYSTEM: NAVIGATION FOR AMERICAN INDIAN VETERANS Candy Klumpp, RN, Native American Nurse Navigator at Oklahoma City VA Health Care System, shares her story of looking at health through the eyes of American Indian Veterans and the areas affected in their lives.

A LOOK INTO SUICIDE AWARENESS We look at the harsh realities of suicide on families, the story of one survivor, and suicide prevention.

THE NATIONAL INDIAN HEALTH BOARD (NIHB) 5TH ANNUAL AWARDS GALA The Awards Gala honoring and recognizing outstanding individuals who have dedicated their time to advancing the delivery of health care to tribal communities.


SEPTEMBER IS NATIONAL SUICIDE AWARENESS MONTH

OCTOBER IS HEALTH LITERACY MONTH

NOVEMBER IS NATIVE AMERICAN HERITAGE MONTH

Be smoke free.

In this issue: Contents 2–3 Interview with Cheyenne Brady Spotlight on Kansas Tribal Health Summit A Look into Veterans Affairs

4–8 8 9–10

Caring Van Spotlight

11–12

A Look into Suicide Awareness

13–15

The Power of Prayer in the Work Environment

For yourself. For your family.

16

Reducing the Risk of Illness by Packing a Safe School Lunch 16 National Indian Health Board 5th Annual Awards Gala

17

The Importance of Health Literacy

18–19

Immunizations for Children 7–18

20–21

OCAITHB/ OK TEC Board Member Directory

22

OCAITHB/ OK TEC Staff Member Directory

23

Not smoking will help you live a longer, healthier life. Having a home without tobacco smoke is best for your family. Produced by the IHS Division of Diabetes Treatment and Prevention, www.diabetes.ihs.gov

OCTOBER/NOVEMBER/DECEMBER 2015 | 3


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WRITTEN BY: ALEX E. SMITH • OCAITHB CREATIVE DIRECTOR

INTERVIEW BY: ALEX E. SMITH, JENIFER SHIELDCHIEF GOVER, TOM ANDERSON, AMBER ANDERSON, RD DICKENS, LOREN TONEMAH, AND KARLA IRON

Q&A INTERVIEW

Cheyenne Brady

MISS INDIAN WORLD

INSPIRING CULTURAL PRIDE, PROMOTING HIGHER EDUCATION, & ENCOURAGING HEALTHY LIFESTYLES

That moment—your palms get sweaty, your heart is beating out of your chest, and you inch to the edge of your seat with anticipation. The booming voice of the announcer echoes through the University of New Mexico’s 15,000-seat arena “The Pit” and says, “With 2,675 points, representing the Sac & Fox Nation, from Newtown, North Dakota...CHEYENNE BRADY! Your Miss Indian World 2015!” Cheers erupt like an earthquake. That moment was pure glee and jubilation for me as her uncle. I literally jumped out of my seat in the stands and sprinted down to celebrate with Cheyenne. I could only imagine the exhilaration she felt when she heard her name called. In a candid interview with our staff, Cheyenne shares that moment with us, the role models who impacted her platform, and the power of education and living a healthy lifestyle. You’ve probably heard this question many times, but can you share what it was like in that moment you heard your name called as Miss Indian World 2015?

too excited because that’s how my heart was broken the first time I ran. When they announced my name, my little knees buckled and I put my hand over my mouth and I instantly started telling myself, “do not cry, do not Ever since I was a little girl, I can remember going to cry.” I pulled myself together and just allowed myself to Gathering of Nations enjoy the moment. I was and seeing the girls super happy as it was one being crowned as Miss of those unexplainable WHEN THEY ANNOUNCED MY NAME, Indian World. As soon moments which you MY LITTLE KNEES BUCKLED AND I PUT MY as I turned 18 years old always dreamed would in 2011, I was too ready happen and finally did. It HAND OVER MY MOUTH AND I INSTANTLY and I ran, but didn’t win. was special. STARTED TELLING MYSELF, So, I tried it again this year in 2015 because I Who are the dominant DO NOT CRY, DO NOT CRY. thought the timing was role models in your life? good and I would be How do they have an finished with school. Before announcing the Miss Indian impact on your platform? World winner, they announced I had won two awards I have three main role models: my mom, my grandma, for Best Essay and Best Dance as I did the first time in and Jodi Gillette. My family is really close-knit and I was 2011 when I ran. Honestly in that moment, I didn’t get very close to both my mom and my grandma. Even at OCTOBER/NOVEMBER/DECEMBER 2015 | 5


of our Native youth are still struggling and are still lost. There’s this big gap between the youth and the grandparents. Also, my parents have always taught us to be proud of who you are and where you come from. These are the things that have provoked me to have the platform that I have now—to encourage, inspire, and motivate youth to be proud of who they are and where they come from. In your Generation Indigenous speech at the White House, you encouraged youth to adopt more healthy lifestyles. Nowadays when people think of native food, they think of Powwow food, i.e. frybread, Indian tacos. These types of foods without a doubt contribute to high rates of diabetes in tribal communities. How can we get back to eating healthier, traditional foods? That’s really hard because everyone is stuck in their ways. I think it goes back to educating our people. If they don’t know what real traditional foods are, how are they going to be able to incorporate them into their daily lifestyle? We also need to be educated on the negative effects of cooking with grease and fat in our “traditional” foods like frybread. We are very

a young age, I watched them how they worked with people. They were genuinely caring and were always trying to have a positive attitude. My grandma worked in Indian education so she was always involved with I FEEL LIKE WHATEVER WAYS ARE IN PLACE the youth and doing something for the youth. That really impacted my views that I have now. Jodi Gillette NOW ARE NOT WORKING BECAUSE WE‘RE is another big role model for me. She’s a very positive STILL FRYING EVERYTHING AND OUR person and into her culture, and was President Barack Obama’s special assistant for Native American affairs— FAMILIES STILL STRUGGLE WITH that’s so awesome! She’s also from North Dakota and HIGH RATES OF DIABETES. I’ve known her since I was a little girl growing up around the Powwow circuit. She’s always had time for me and even wrote recommendation’s for me to go to Miss hands-on kind of people, so if we go out into the Indian World and to get into grad school. Her having communities and teach them in fun interactive ways that time for me makes me feel good and allows me to rather than preaching at them, maybe it would stick. I have that same mindset when other young girls want to feel like whatever ways are in place now are not working talk to me. I have to make time for them. because we’re still frying everything and our families still struggle with high rates of diabetes. Trying to find new All three did have an influence on me and my platform, ways to educate everyone is key and I am continually but what really made me choose was growing up trying to learn and figure it out so I can be helpful. in Native communities and seeing what was all going on around me. I grew up in Pawnee and then my sophomore year, I came to Newtown, ND Even though there were different dynamics within Native communities from the South to the North, overall, all

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Now that you’re in the Public Health arena, do you have a mentor? What do you look for in a mentor? I’m still getting my feet wet in Public Health, but a lot of


people have really been open to my asking questions so I’m appreciative of those people. As far as Public Health and being fairly new, I don’t have one exact mentor. I will say that Dr. Donald Warne at NDSU is amazing! He’s the Director of the Master of Public Health Program and now he’s teaching the class Leading and Management. He really opens the doors for educating people on Native Americans. He tells the truth of what happened in the past and what the government did to our people, and he tells it in a way history was, in a truthful, honest way, but also non-offensive and sensitive to everyone. Dr. Warne is a very good role model for me because I want to be able to do what he does and make people aware while being honest with everyone. As far as your generation, the Millenials, where do you see Indian Public Health being now and where it’s going in the future? I want to say its broadened. In Fort Berthold, we don’t have anyone who is an information officer and there’s a lot of reservations who have people, even though highly valued by their efforts, that are thrown into Public Health who do not have that education in Public Health. I hope that with our generation, we can become more educated because there are so many different things that go into Public Health. Along with being more educated, I’d urge the youth in my generation to find a passion for our people, because we get into that “don’t care attitude” sometimes. We have to make a difference and that begins with education and having passion. How do you plan to create positive change with what you are learning in school? I really want to work for the underserved Native American population. I want to be a part of the change, the shift and the rising up of our people because I think we’re close to returning to who we once were and being what we used to be, but in contemporary society. My plan is to use all the knowledge I obtain in school and go out into the community and educate people. I want to be hands-on, out in the community bringing all these people together and making it fun because you have to develop that community bond so they feel supported. You have an amazing platform to speak from to educate Native communities about poor health care

I WANT TO BE A PART OF THE CHANGE, THE SHIFT, AND THE RISING UP OF OUR PEOPLE BECAUSE I THINK WE‘RE CLOSE TO RETURNING TO WHO WE ONCE WERE AND BEING WHAT WE USED TO BE.

statistics from high rates of diabetes to youth suicide. We too, as a Tribal Health Board, have a responsibility to educate and improve American Indian Health. What issues in Indian Country can we bring more awareness to? Diabetes is a big one, but I think depression, mental health, and domestic violence. There’s no light shed on these issues and we have a tendency to keep them hush-hush, but we shouldn’t be like that. We want to make all this positive change within our communities, but how are we going to educate when we don’t have the courage to bring light to them? Those are really big issues and we can’t keep sweeping them under the rug. We want to get your thoughts on an issue that doesn’t get talked about enough in American Indian Public Health and that is communication within our families. Actually, we feel it is at the very root and cause of a lot of mental health problems throughout Tribal communities nationwide. Why do you think we have a problem with simple communication in our families?

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Honestly, communication or the lack of it, happens everywhere. On my travels across the country, I realized all Native American families have that common problem and we all sweep stuff under the rug and that way of thinking is passed from generation to generation. Maybe it’s an effect of boarding school for some, maybe others are scared of people judging them. Again, people aren’t educated on how much communication can make a difference. These small fights within families lead up to these huge divisions within larger families because we can’t talk things out. That does have an effect on Public Health—an argument turns into depression, which can turn into not eating, and so on. This snowball of negatives all starts from a simple lack of communication within our families.

CHEYENNE BRADY

MISS INDIAN WORLD 2015

Spotlight on 2015 Kansas Tribal Health Summit WRITTEN BY: SUSAN GAY • OKTEC PUBLIC HEALTH COORDINATOR

The 2015 Kansas Tribal Health Summit took place on August 18 through August 19, 2015 at the Prairie Band Casino and Resort in Mayetta, Kansas. The two-day event commenced with an opening ceremony which included prayer and the presentation and retiring of Colors by the Iowa Tribal Ceremonial Honor Guard. Attendees were warmly welcomed by Dr. DeeAnn DeRoin, Bill Thorne Jr., and Tim Rhodd, Chairman of The Iowa Tribe of Kansas and Nebraska. On day one of the health summit, the four Kansas tribes (The Prairie Band Potawatomi Nation, The Sac and Fox Nation of Missouri in Kansas and Nebraska, The Iowa Tribe in Kansas, and The Kickapoo Tribe in Kansas,) conducted work sessions on Community Health Assessments and Tribal Health Improvement Plans. At the conclusion of the work sessions, each tribe reported on the Tribal Health Improvement Plan. Other highlights from the first day included a presentation by Greg Crawford of the Kansas Department of Health and Environment on the sharing of American Indian mortality data, a “Data into Action” discussion, and the

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evening dinner address by Dr. Jeffrey Henderson of the Black Hills Center for American Indian Health. On day two, Dr. Jeffrey Henderson gave the morning plenary address, and President Marshall Gover, former president of Pawnee Nation, gave the lunchtime plenary address. There were ten breakout sessions covering topics such as tribal health sovereignty, tribal veteran’s issues, partnering with philanthropies for enhanced tribal health, Historical Trauma, tribal dental health therapy, and traditional foods. The overall health summit evaluations were positive, with the majority of respondents rating the event as excellent. The directors and staff of the Oklahoma City Inter-Tribal Health Board (OCAITHB) and the Oklahoma Area Tribal Epidemiology Center (OATEC) were in attendance both days to provide assistance and to give support to the Kansas tribes. Sincere thanks to the organizers, hosts, sponsors, presenters, attendees, and everyone else who contributed to making the event successful.


A LOOK

INTO VETERANS AFFAIRS

Oklahoma City Veterans Affairs Health Care System: WRITTEN BY: CANDY KLUMP, RN NATIVE AMERICAN NURSE NAVIGATOR AT OKLAHOMA CITY VA HEALTH CARE SYSTEM

NAVIGATION FOR AMERICAN INDIAN VETERANS

LOOKING AT HEALTH THROUGH THE EYES OF THE NATIVE AMERICAN, IT IS ACKNOWLEDGED THAT THE BEST WAY TO BE HEALTHY IS THROUGH BALANCE- PHYSICALLY, MENTALLY, EMOTIONALLY AND SPIRITUALLY.

On November 18, 2014, “Calvin” (not his real name), Vietnam Veteran, contacted Candy Klumpp, RN, Native American Nurse Navigator at Oklahoma City VA Health Care System. He reported that he was currently living on $312.90 a month plus occasional assistance from his tribe. He was having difficulty paying his bills. In fact, he would be homeless if his ex-wife had not allowed him to move in with her. As the veteran talked about his past, Ms. Klumpp recognized that this veteran might be suffering from a very familiar condition. She asked the veteran a few questions: Do you have trouble sleeping? Nightmares? Substance abuse? Difficulty controlling anger? Calvin had already admitted that he was a recovering alcoholic. He appeared surprised that the nurse seemed to know so much about him. He did indeed have difficulty sleeping, and nightmares were a common occurrence. His difficulty with anger had

OCTOBER/NOVEMBER/DECEMBER 2015 | 9


affected his life for years, and was probably the reason for the demise of his marriage. Calvin suffers from post-traumatic stress disorder (PTSD). PTSD is defined as an anxiety disorder that is triggered by one or more traumatic events (in Calvin’s case, events that he experienced during combat). Although his outside medical history documented this clearly, Calvin had never sought treatment for his condition. In addition, Calvin was unaware that PTSD was a service-connected disability for which he could be compensated. Calvin was offered treatment for his PTSD through VA Mental Health Service. Ms. Klumpp contacted VA Veterans Benefits Administration (VBA), who assisted Calvin with his application for disability benefits. Calvin’s immediate needs continued to be an issue. Since he was on the verge of homelessness, he was referred to Christine Cleary and Kevin Acer with the VA Homeless program. They provided assistance and referrals to assist the veteran through this tough time. He applied for housing with his tribe, and was placed on a waiting list. In June 2015, Calvin received a letter from VBA, notifying him that he had been approved for 70% service-connected disability for PTSD and tinnitus (ringing in the ears resulting from exposure to gunfire). On June 30, the veteran received his first check, with “back pay” from the date of his initial application. Calvin was very happy. Currently, he is moving forward in his life. Since he has a stable income, he wants to look at the possibility of permanent housing. As a result of his inquiry, VA and his tribe are currently looking at a Memorandum of Understanding (MOU) which would allow any veteran who owns trust land to apply for a Native American Direct Loan from the VA. Once that MOU is completed,

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Calvin intends to apply for a home loan through this program. He continues to visit the Native American Nurse Navigator, who has become a resource for him. There are a few things we can learn from Calvin’s story. Looking at health through the eyes of the Native American, it is acknowledged that the best way to be healthy is through balance- physically, mentally, emotionally and spiritually. Ms. Klumpp recognizes that all areas of life affect our veterans’ health. Calvin’s most urgent problem was financial. Without a steady income, he could not address the other areas of need in his life. Although the VA cannot solve all of life’s problems for every veteran, one of Ms. Klumpp’s responsibilities is to use her nursing skills to evaluate the situation and address any issues that she finds. In the process, she may reach out to sources within the VA, as well as Indian Health Service, Tribal health programs, or community resources. If you know a veteran with needs that are not being addressed, feel free to contact Candy Klumpp, RN, Native American Nurse Navigator at 405-456-3808.


Caring Van Spotlight

WRITTEN BY: SUSAN GAY • OKTEC PUBLIC HEALTH COORDINATOR

Caring Van Travels September 15, 2015 – VA Warriors Resource Enrollment Fair

Caring Van Travels to Norman WRITTEN BY: JANICE BLACK • CARING VAN COORDINATOR

Tuesday from 9am to 3pm at the Holdenville Indian Community Center in Holdenville, OK. Counseling for Veterans. September 24, 2015 – Iowa Tribe “Journey to Wellness” Health Event

The Caring Van and Oklahoma City Area Inter-Tribal Health Board staff traveled to the Absentee Shawnee Tribal Health System’s “Health Awareness for All Generations 2015” event. This is their 2nd Annual health event which took place on July 31st at the Little Axe Health Center in Norman, Oklahoma.

Friday from 10am to 3pm at Iowa Tribe of Oklahoma in Perkins, OK. Provided flu vaccinations.

The Caring Van along with LPN’s from the clinic offered Head Lice checks for all ages. Education and overthe-counter recommendations were provided for the patients. Special thanks to Stephanie Davis LPN, Brenda Newcomb LPN and Amber Barnes LPN for their nursing assistance on the van.

Saturday from 9am to Noon, Bricktown Chevy Event Center Oklahoma City. Diabetic Foot Checks.

OUR GOAL IS TO CONTINUE TO PROVIDE PREVENTATIVE HEALTH SCREENINGS THROUGHOUT THE STATE OF OKLAHOMA AND TO SERVE AS MANY PEOPLE AS WE CAN.

Upcoming Events October 3, 2015 - Integris Men’s Health University

October 16, 2015 - VA Cheyenne & Arapaho Intertribal Stand Down Friday from 9am to 3pm at the Clinton Community Hall Clinton, OK. Counseling for Veterans. October 17, 2015 American Heart Associations “The Beat of Life” Health Fair Saturday from 8:00am to 3:00pm at the Firelake Arena in Shawnee, OK. Providing Health Screenings (TBD)

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Caring Van Spotlight

PICTURED FROM LEFT TO RIGHT: BARNEY MITCHELL AND CHRIS POWELL, VETERANS AND MEMBERS OF THE SEMINOLE COLOR GUARD WHO VISITED THE CARING VAN.

Caring Van at the VA Warriors Resource Enrollment Fair WRITTEN BY: YONAVEA HAWKINS • OKTEC PROJECT MANAGER

The Oklahoma City Intertribal Health Board staff attended the “VA Warriors Resource Enrollment Fair” at Holdenville, Oklahoma. The Enrollment Fair was held at the Holdenville Creek Community Center and offered veterans and widows of veterans the opportunity to sign up for services with Veteran Affairs. Wewoka IHS and tribal programs from the Creek and Seminole nations were at the Enrollment Fair to give assistance to veterans. The Caring Van was there to help with the overflow for veterans needing one-on-one counseling with the doctors. As the Caring Van was set up outside the community center with the VA mobile unit, the Caring Van had visitors that were driving by and stopping to see the it. The Caring Van had a great opportunity to help veterans and provide outreach to the Native community in Holdenville.

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A LOOK

INTO

SUICIDE AWARENESS

New figures on the Impact of Suicide SOURCE BY: QPR INSTITUTE

Based on just-released research by Dr. Julie Cerel, the new estimated number of loss survivors impacted by a single death by suicide is not the earlier estimated 6 to 1, but 25 to 1. A “loss survivor” is defined as someone who experiences a “major life disruption” in the aftermath of a completed suicide. “Exposure to suicide” is anyone who “knew someone who died by suicide.”

Therefore, the following numbers apply to the American population. For each suicide death each year:

At the current rate of suicide of 41,419 deaths in 2013, more than one million Americans will be seriously impacted. This means that since 1989 through 2013, the number of loss survivors is 20.65 million, or 1 in every 15 Americans, which further means that you should expect to have a loss survivor in pretty much every class you teach, and in some communities, e.g., Native American or Alaskan Indian, in every class you teach. So, be prepared, have your grief counseling resources ready, and spread the compassion we all feel for those impacted by suicide.

• 115 people are exposed to suicide (4.7 million) • Of these, 25 people are loss survivors and experience a devastating effect and major life disruption (1 million plus) • If someone dies by suicide every 12.8 minutes, there are 25 new loss survivors every 12.8 minutes

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Out of the Darkness Community Walks HONORING MY BROTHERS MEMORY

WRITTEN BY: MELANIE JOHNSON • OKTEC SPF-TIG GRANT LEAD

I have honored my brother’s memory by donating to 34th birthday. The impact that his death has had on me his favorite charities and by attending the “Out of the and my family has been traumatic. Exposure to suicide Darkness” walk held at Lake Hefner on Sept 5, 2015. is most definitely considered a Post Traumatic Stress September is also known as National Suicide Prevention Disorder. I hope to grieve in a way that honors my late Awareness Month which brother. In order to heal, helps promote resources one must dig deep to find and awareness around “ their way of healing”. I HOPE TO GRIEVE IN A WAY THAT HONORS the issues of suicide MY LATE BROTHER. IN ORDER TO HEAL, Being aware of those prevention, how you can around you whether it be ONE MUST DIG DEEP TO FIND help others and how to in the home, work, or just talk about suicide without “ THEIR WAY OF HEALING”. a casual acquaintance can increasing the risk of influence how you interact harm. However, exposure with anybody that might to suicide is also something that needs to be addressed be experiencing any type of suicidal ideology. within our native communities. I have been a “loss survivor” for a year now. I lost my brother to suicide in August of 2014, a week after his

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Awareness can make a difference.


line e f i L e h T , is FREE and , l a i t n e confid e. l b a l i a v a September always is National Suicide LP Awareness Month HE e, n o d e v a lo , d n e i r f a Death by suicide is a very difficult thing to talk about, lf. to but we cannot afford to miss a single opportunity e s r u o y r bring awareness too prevention efforts.

SOURCE BY: THE OFFICE OF JUSTICE SERVICES (OJS) AT THE BUREAU OF INDIAN AFFAIRS AND THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

centers s i s i r c nity Commu e calls. n i l e f i L answer

The BIA Office of Justice Services has partnered with the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide pocket sized VICES AN SER UMhand suicide prevention cards for OJS employees to ND H tration EALTH A ervices Adminis H F O T S EN lth M ea T H R l · A ta P en National Suicide U.S. DE features and M out. The card prominently the ce Abuse Substan hsa.gov am .s w w w Prevention Lifeline 1-800-273-TALK (8255). d 2011 suicidal ideations We know that people who having printe • Reare nted 2005 26 ri P will often times exhibit signs; either through -01 Pwarning CMHS-SV what they say or what they do. We believe the more information people have regarding signs to watch for; the more people will get the help that they need.

e h t n r a e L g n i n r a W Signs. The Lifeline is FREE, confidential, and always available. HELP a loved one, a friend, or yourself.

From September 1st - 30th, OJS Director Darren Cruzan participated in “No Shave (No Shame) September” to help raise suicide prevention awareness. You are all invited join him. Please let us know if there are other suicide prevention awareness activities happening in your community.

Community crisis centers answer Lifeline calls. ·

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration www.samhsa.gov

Printed 2005 • Reprinted 2011 CMHS-SVP-0126

OCTOBER/NOVEMBER/DECEMBER 2015 | 15

Le W S


OCAITHB Staff Prayer Breakfast WRITTEN BY: JENIFER SHIELDCHIEF GOVER OCAITHB EXECUTIVE DIRECTOR

The Oklahoma City Area Inter-Tribal Health Board is dedicated to their employees’ physical and mental health, as well as encouraging a positive work environment and culture. We believe the Creator has given us all many ways to praise him, and they are all good. For this reason, we have started a quarterly pot-luck Prayer Breakfast where staff come together to uplift each other, our leadership, and our individual families. Our staff has gone through many challenges with family matters, as well as work. We want to always be thankful for our staff, leadership, and our families, as they all give us the strength and encouragement to fight at the front lines for Tribal Public Health and health care on a daily basis

Reduce the Risk of Illness by Packing a Safe School Lunch WRITTEN BY: PATRICIA YARHOLAR

OKTEC PUBLIC HEALTH COORDINATOR

Packing a healthy school lunch is just one of the many

things on the minds of parents as the new school year

begins. During the morning rush, the safety of that packed lunch can easily be overlooked. Public health officials at

the Oklahoma State Department of Health (OSDH) want to remind parents that it’s important to practice food safety when preparing a lunch to send to school.

The good news is there are many healthy choices to pack in a lunch which usually are safe choices, too. Most fruits and vegetables do not spoil at room temperature and low-fat

milk is available in boxes that don’t need refrigeration until opened.

“For the safety of our kids, it’s important to remember

these basic steps in the rush of the morning,” said OSDH Interim Consumer Health Director Lynnette Jordan. “You

can even prepare the night before by setting out the nonrefrigerated foods so you can focus on packing the safest

lunch in the morning. Remember to start clean, keep cold foods cold and hot foods hot through the lunch period.”

OSDH recommends the following tips to keep your healthy lunch a safe lunch:

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• Keep everything clean when packing the lunch. • Use an insulated lunch box with freezer gel packs to help keep cold foods cold.

• Use a thermos to keep soup, chili and stew hot. Use an insulated bottle stored in an insulated lunch box.

• Pack shelf-stable foods, such as crackers, peanut butter sandwiches, canned meats, packaged pudding, and

canned fruits and juices, especially if you have a brown paper bag lunch.

• Rinse fresh fruits and vegetables under running tap

water and blot dry with a paper towel before packing,

including those with skins and rinds that are not eaten. • Keep your lunch in the coolest place possible. Lunch

kept in the refrigerator is best, but if one is not available keep it out of the sun and away from heat.

• Throw away perishable leftovers, or food that can spoil, after lunch. Pack non-perishable food items for an afternoon snack.

• Wash your hands. Make sure kids wash their hands

with soap and water or an alcohol-based hand sanitizer before eating lunch.

For more information about food safety, visit the OSDH

website at www.health.ok.gov and type the words “food safety” in the search box


National Indian Health Board (NIHB) 5th Annual Awards Gala The National Indian Health Board (NIHB) had their 5th Annual Awards Gala on September 23, 2015 in Washington, DC, their 32nd Annual Consumer Conference. The purpose of this Gala was to honor and recognize outstanding individuals who have dedicated their time to advancing the delivery of the health care to tribal communities. On behalf of the Oklahoma City Inter-Tribal Health Board, we would like to congratulate the following award recipients:

LOCAL IMPACT AWARD

ACKNOWLEDGES AN INDIVIDUAL OR ORGANIZATION WHOSE WORK HAS AFFECTED CHANGE OR IMPACTED HEALTH CARE ON THE LOCAL AND OR TRIBAL LEVEL.

TOM ANDERSON, Cherokee Nation, Director, Oklahoma Area Tribal Epidemiology Center, Oklahoma City Area Inter-Tribal Health Board. Director Anderson is receiving the Local Impact award for his commitment to tribal health care and resource development, his work on behalf the Oklahoma City Area Health Board is proof of his willingness to be engaged and informed. VICKI TALL CHIEF, PhD Professor, University of Oklahoma Health Sciences Center – College of Public Health. Dr. Vicki Tall chief is receiving the Local Impact Award for her leadership and extensive involvement in providing training, technical support, and, education on behalf of Indian country.

AREA/REGIONAL IMPACT AWARD

PAYS TRIBUTE TO AN INDIVIDUAL OR ORGANIZATION WHOSE WORK HAS CONTRIBUTED TO IMPROVING AMERICAN INDIAN/ALASKA NATIVE HEALTH CARE OR AFFECTED CHANGE ON AN AREA OR REGIONAL BASIS.

URBAN INTER-TRIBAL CENTER OF TEXAS DALLAS, TEXAS The Urban Inter-Tribal Center of Texas is receiving the Area/Regional Impact Award for going to great lengths to bring affordable health care to uninsured American Indians and Alaskan Natives throughout the Dallas Region.

NATIONAL IMPACT AWARD

HONORS AN INDIVIDUAL OR ORGANIZATION WHOSE WORK HAS MADE AN IMPACT ON AMERICAN INDIAN/ALASKA NATIVE HEALTH CARE ON A NATIONAL LEVEL

CONGRESSMAN TOM COLE, CHICKASAW United States Congress Congressman Cole is receiving the National Impact Award for his continued advocacy on behalf of Indian country and the advancement of the Tribes improved health care resources. RHONDA BUTCHER, Citizen Potawatomi Nation Self-Governance Director, Citizen Potawatomi Nation Rhonda is receiving the National Impact Award for all of her dedication and tireless work in the advancement of health policy affecting all American Indian and Alaska Natives.

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WHAT IS HEALTH LITERACY? The Patient Protection and Affordable Care Act of 2010, Title V defines health literacy as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions.” Health literacy should not be confused with literacy. Health literacy is not necessarily related to years of education or general reading ability. However, low literacy skills can make reading and understanding basic health information more difficult. Health literacy requires skills such as listening, reading, processing, finding, analyzing, decision-making, and the ability to apply these skills to health situations. Such skills are necessary when filling out medical forms, reading health information, taking medication correctly, and shopping for or enrolling in medical insurance.

WHO NEEDS HEALTH LITERACY SKILLS?

The Importance of Health Literacy OCTOBER IS HEALTH LITERACY MONTH WRITTEN BY: SUSAN GAY • OKTEC PUBLIC HEALTH COORDINATOR

18 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

According to the Centers for Disease Control and Prevention (CDC), most health information is presented in ways that are not understood by most Americans. It is important for everyone to be aware of health literacy because it affects everyone. Anyone who needs health information and services also needs health literacy skills. At some point, everyone will need to find, understand, and use health information, products, and services. In addition, anyone who provides health information and services to others also needs health literacy skills, e.g. doctor, pharmacist, community health worker, health educator, etc. People need information and services they can understand and use. Therefore, it is crucial that health professionals and organizations provide health information and services that can be understood and used by everyone. When people or organizations create or give information to others that is difficult to understand, they create a health literacy problem.


When people are expected to figure out health services that are unfamiliar, confusing, or complex, a health literacy problem is created. The Indian Health Service White Paper on Health Literacy reveals that although low health literacy affects all people, vulnerable populations such as American Indians /Alaska Natives are disproportionately affected.

WHAT CAN BE DONE TO IMPROVE HEALTH LITERACY? Health professionals and health organizations are mostly responsible for improving health literacy since they are at the forefront of creating and providing health information, products, and services. Health professionals should write and speak using plain language. Plain language is language that is easy to read, process, understand, and use. Health professionals can build their own health literacy skills by becoming familiar with health literacy, and the most effective ways to create, provide, and communicate health information and services. The health information and services they offer should also be accurate, accessible, and actionable (information that can be put into action). Knowledge and application of health literacy help prevent or manage health problems and protect our health. Consider this a call to action to promote the importance of health literacy!

For information regarding health literacy training and information, please visit: http://www.cdc.gov/healthliteracy/gettraining.html http://www.ihs.gov/healthcommunications/index. cfm?module=dsp_hc_health_literacy

EXAMPLES OF PLAIN LANGUAGE Instead of: • • • • •

benign conclude dehydrated chronic contagious

Use: • • • • •

harmless end or finish need water long lasting can be spread from one person to another

OCTOBER/NOVEMBER/DECEMBER 2015 | 19


20 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER 2

These shaded boxes indicate the vaccine should be given if a child is catching-up on missed vaccines.

For more information, call toll free 1-800-CDC-INFO (1-800-232-4636) or visit http://www.cdc.gov/vaccines/teens

1

MCV4 Dose 1 3

HPV

Tdap

Booster at age 16 years

13-18 YEARS

These shaded boxes indicate the vaccine is recommended for children with certain health conditions that put them at high risk for serious diseases. Note that healthy children can get the HepA series6. See vaccine-specific recommendations at www.cdc.gov/vaccines/pubs/ACIP-list.htm.

Varicella Vaccine Series

Measles, Mumps, Rubella (MMR) Vaccine Series

Inactivated Polio Vaccine (IPV) Series

Hepatitis B (HepB) Vaccine Series

Hepatitis A (HepA) Vaccine Series6

Pneumococcal Vaccine5

Influenza (Yearly)4

Meningococcal Conjugate Vaccine (MCV4) Dose 1 3

Tdap vaccine is recommended at age 11 or 12 to protect against tetanus, diphtheria and pertussis. If your child has not received any or all of the DTaP vaccine series, or if you don’t know if your child has received these shots, your child needs a single dose of Tdap when they are 7 -10 years old. Talk to your child’s health care provider to find out if they need additional catch-up vaccines. 2 All 11 or 12 year olds – both girls and boys – should receive 3 doses of HPV vaccine to protect against HPV-related disease. The full HPV vaccine series should be given as recommended for best protection. 3 Meningococcal conjugate vaccine (MCV) is recommended at age 11 or 12. A booster shot is recommended at age 16. Teens who received MCV for the first time at age 13 through 15 years will need a one-time booster dose between the ages of 16 and 18 years. If your teenager missed getting the vaccine altogether, ask their health care provider about getting it now, especially if your teenager is about to move into a college dorm or military barracks. 4 Everyone 6 months of age and older—including preteens and teens—should get a flu vaccine every year. Children under the age of 9 years may require more than one dose. Talk to your child’s health care provider to find out if they need more than one dose. 5 Pneumococcal Conjugate Vaccine (PCV13) and Pneumococcal Polysaccharide Vaccine (PPSV23) are recommended for some children 6 through 18 years old with certain medical conditions that place them at high risk. Talk to your healthcare provider about pneumococcal vaccines and what factors may place your child at high risk for pneumococcal disease. 6 Hepatitis A vaccination is recommended for older children with certain medical conditions that place them at high risk. HepA vaccine is licensed, safe, and effective for all children of all ages. Even if your child is not at high risk, you may decide you want your child protected against HepA. Talk to your healthcare provider about HepA vaccine and what factors may place your child at high risk for HepA.

FOOTNOTES

These shaded boxes indicate when the vaccine is recommended for all children unless your doctor tells you that your child cannot safely receive the vaccine.

MCV4

Tetanus, Diphtheria, Pertussis (Tdap) Vaccine

Tdap 1 Human Papillomavirus (HPV) Vaccine (3 Doses)

11-12 YEARS

7–10 YEARS

2015 Recommended Immunizations for Children from 7 Through 18 Years Old


Mumps (Can be prevented by MMR vaccine)

Pertussis (Whooping Cough) (Can be prevented by Tdap vaccine)

Mumps is an infectious disease caused by the mumps virus, which is spread in the air by a cough or sneeze from an infected person. A child can also get infected with mumps by coming in contact with a contaminated object, like a toy. The mumps virus causes fever, headaches, painful swelling of the salivary glands under the jaw, fever, muscle aches, tiredness, and loss of appetite. Severe complications for children who get mumps are uncommon, but can include meningitis (infection of the covering of the brain and spinal cord), encephalitis (inflammation of the brain), permanent hearing loss, or swelling of the testes, which rarely can lead to sterility in men.

Meningococcal disease is caused by bacteria and is a leading cause of bacterial meningitis (infection around the brain and spinal cord) in children. The bacteria are spread through the exchange of nose and throat droplets, such as when coughing, sneezing or kissing. Symptoms include nausea, vomiting, sensitivity to light, confusion and sleepiness. Meningococcal disease also causes blood infections. About one of every ten people who get the disease dies from it. Survivors of meningococcal disease may lose their arms or legs, become deaf, have problems with their nervous systems, become developmentally disabled, or suffer seizures or strokes.

Meningococcal Disease (Can be prevented by MCV vaccine)

droplets of an infected person. Measles is so contagious that just being in the same room after a person who has measles has already left can result in infection. Symptoms usually include a rash, fever, cough, and red, watery eyes. Fever can persist, rash can last for up to a week, and coughing can last about 10 days. Measles can also cause pneumonia, seizures, brain damage, or death.

Vaccine-Preventable Diseases and the Vaccines that Prevent Them Diphtheria (Can be prevented by Tdap vaccine) Diphtheria is a very contagious bacterial disease that affects the respiratory system, including the lungs. Diphtheria bacteria can be passed from person to person by direct contact with droplets from an infected person’s cough or sneeze. When people are infected, the diptheria bacteria produce a toxin (poison) in the body that can cause weakness, sore throat, low-grade fever, and swollen glands in the neck. Effects from this toxin can also lead to swelling of the heart muscle and, in some cases, heart failure. In severe cases, the illness can cause coma, paralysis, and even death.

Hepatitis A (Can be prevented by HepA vaccine) Hepatitis A is an infection in the liver caused by hepatitis A virus. The virus is spread primarily person-to-person through the fecal-oral route. In other words, the virus is taken in by mouth from contact with objects, food, or drinks contaminated by the feces (stool) of an infected person. Symptoms include fever, tiredness, loss of appetite, nausea, abdominal discomfort, dark urine, and jaundice (yellowing of the skin and eyes). An infected person may have no symptoms, may have mild illness for a week or two, or may have severe illness for several months that requires hospitalization. In the U.S., about 100 people a year die from hepatitis A.

Hepatitis B (Can be prevented by HepB vaccine) Hepatitis B is an infection of the liver caused by hepatits B virus. The virus spreads through exchange of blood or other body fluids, for example, from sharing personal items, such as razors or during sex. Hepatitis B causes a flu-like illness with loss of appetite, nausea, vomiting, rashes, joint pain, and jaundice. The virus stays in the liver of some people for the rest of their lives and can result in severe liver diseases, including fatal cancer.

Human Papillomavirus (Can be prevented by HPV vaccine)

Human papillomavirus is a common virus. HPV is most common in people in their teens and early 20s. It is the major cause of cervical cancer in women and genital warts in women and men. The strains of HPV that cause cervical cancer and genital warts are spread during sex.

Influenza (Can be prevented by annual flu vaccine)

Pertussis is caused by bacteria spread through direct contact with respiratory droplets when an infected person coughs or sneezes. In the beginning, symptoms of pertussis are similar to the common cold, including runny nose, sneezing, and cough. After 1-2 weeks, pertussis can cause spells of violent coughing and choking, making it hard to breathe, drink, or eat. This cough can last for weeks. Pertussis is most serious for babies, who can get pneumonia, have seizures, become brain damaged, or even die. About two-thirds of children under 1 year of age who get pertussis must be hospitalized.

(Can be prevented by Pneumococcal vaccine)

Pneumococcal Disease

Influenza is a highly contagious viral infection of the nose, throat, and lungs. The virus spreads easily through droplets when an infected person coughs or sneezes and can cause mild to severe illness. Typical symptoms include a sudden high fever, chills, a dry cough, headache, runny nose, sore throat, and muscle and joint pain. Extreme fatigue can last from several days to weeks. Influenza may lead to hospitalization or even death, even among previously healthy children.

Pneumonia is an infection of the lungs that can be caused by the bacteria called pneumococcus. This bacteria can cause other types of infections too, such as ear infections, sinus infections, meningitis (infection of the covering around the brain and spinal

Measles (Can be prevented by MMR vaccine)

Measles is one of the most contagious viral diseases. Measles virus is spread by direct contact with the airborne respiratory

If you have any questions about your child’s vaccines, talk to your healthcare provider.

cord), bacteremia and sepsis (blood stream infection). Sinus and ear infections are usually mild and are much more common than the more severe forms of pneumococcal disease. However, in some cases pneumococcal disease can be fatal or result in longterm problems, like brain damage, hearing loss and limb loss. Pneumococcal disease spreads when people cough or sneeze. Many people have the bacteria in their nose or throat at one time or another without being ill—this is known as being a carrier.

(Can be prevented by MMR vaccine)

Polio (Can be prevented by IPV vaccine) Polio is caused by a virus that lives in an infected person’s throat and intestines. It spreads through contact with the feces (stool) of an infected person and through droplets from a sneeze or cough. Symptoms typically include sudden fever, sore throat, headache, muscle weakness, and pain. In about 1% of cases, polio can cause paralysis. Among those who are paralyzed, up to 5% of children may die because they become unable to breathe. Rubella (German Measles)

(Can be prevented by Tdap vaccine)

Rubella is caused by a virus that is spread through coughing and sneezing. In children rubella usually causes a mild illness with fever, swollen glands, and a rash that lasts about 3 days. Rubella rarely causes serious illness or complications in children, but can be very serious to a baby in the womb. If a pregnant woman is infected, the result to the baby can be devastating, including miscarriage, serious heart defects, mental retardation and loss of hearing and eye sight.

Tetanus (Lockjaw)

(Can be prevented by varicella vaccine)

Tetanus is caused by bacteria found in soil. The bacteria enters the body through a wound, such as a deep cut. When people are infected, the bacteria produce a toxin (poison) in the body that causes serious, painful spasms and stiffness of all muscles in the body. This can lead to “locking” of the jaw so a person cannot open his or her mouth, swallow, or breathe. Complete recovery from tetanus can take months. Three of ten people who get tetanus die from the disease.

Varicella (Chickenpox)

Chickenpox is caused by the varicella zoster virus. Chickenpox is very contagious and spreads very easily from infected people. The virus can spread from either a cough, sneeze. It can also spread from the blisters on the skin, either by touching them or by breathing in these viral particles. Typical symptoms of chickenpox include an itchy rash with blisters, tiredness, headache and fever. Chickenpox is usually mild, but it can lead to severe skin infections, pneumonia, encephalitis (brain swelling), or even death.

Last updated on 02/02/2015 • CS254242-A

OCTOBER/NOVEMBER/DECEMBER 2015 | 21


OCAITHB Board Members NAME

TITLE

EMAIL

Tim Tallchief

Chairman

ttallchief@potawatomi.org

Seneca Smith

Vice Chairman

seneca.smith@creekhealth.org

Teresa Jackson

Treasurer

tkjackson@cnhsa.com

Nick Barton

Secretary

nbarton@c-a-tribes.org

Judy Goforth-Parker

Member

judy.parker@chickasaw.net

Billy Friend

Member

bfriend@wyandotte-nation.org

Nick Gonzales

Member

nick.gonzales@kttribe.org

Bruce Pratt

Member

bpratt@pawneenation.org

Carrie O’Toole

Member

carrie@pbpnation.org

Connie Davis

Member

connie-davis@cherokee.org

RADM Kevin Meeks

Member

kevin.meeks@ihs.gov

Lawton Service Unit

vacant

vacant

Wewoka Service Unit

John Narcomey

rep.jnarcomey@sno-nsn.gov

OKC Area Epi Center Board Members NAME

TITLE

EMAIL

Tim Tallchief

Chairman

ttallchief@potawatomi.org

Seneca Smith

Vice Chairman

seneca.smith@creekhealth.org

Teresa Jackson

Treasurer

tkjackson@cnhsa.com

Nick Barton

Secretary

nbarton@c-a-tribes.org

RADM Kevin Meeks

Member

kevin.meeks@ihs.gov

Dr. John Farris

Member

john.farris@ihs.gov

Connie Barker

Member

connie.barker@chickasaw.net

Steve Ortiz

Member

steveo@pbpnation.org

Carrie O’Toole

Member

carrie@pbpnation.org

Bonnie Stephenson

Member

bstephenson@caddonation.org

Dr. Rodney Stapp

Member

rodney.stapp@uitct.com

Dr. Larry Vark

Member

larry.vark@creekhealth.org

Tom Anderson

Member

tom.anderson@ocaithb.org

22 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER


Oklahoma City Area Inter-Tribal Health Board / Oklahoma Area TEC Staff Directory NAME

TITLE

TELEPHONE

EMAIL

Jenifer ShieldChief Gover

Executive Director

(405) 652-9201

jgover@ocaithb.org

Tom Anderson, MPH

OK Tribal Epidemiology Center Director

(405) 652-9204

tom.anderson@ocaithb.org

RD Dickens

Program Development Manager

(405) 652-9206

rd.dickens@ocaithb.org

Loren Tonemah

Project Manager

(405) 652-9207

loren.tonemah@ocaithb.org

Cuyler Snider, MPH

Assistant TEC Manager/ Epidemiologist

(405) 652- 9205

cuyler.snider@ocaithb.org

Chris Tall Bear, MLS

Clinical Trials Coordinator

(405) 652-9208

chris.tallbear@ocaithb.org

SPF-TIG Coordinator

(405) 652-9211

mjohnson@ocaithb.org

Biostatician/Epidemiologist

(405) 652-9210

stayarachakul@ocaithb.org

Patricia Yarholar

Public Health Coordinator

(405) 652-9214

pyarholar@ocaithb.org

Harvey Ross, MPH

TEC Grants Program Manager

(405) 652-9203

hross@ocaithb.org

Susan Gay, M.A.Ed., CHES

Public Health Educator

(405) 652-9202

sgay@ocaithb.org

Amber Anderson

Practice Enhancement Assistant

(405) 652-9213

aanderson@ocaithb.org

Alex E. Smith

Creative Director

(405) 652-9212

asmith@ocaithb.org

Janice Black

Caring Van Coordinator

(405) 652-9209

jblack@ocaithb.org

Tracey Prather, R.T., CVT, MHA

Good Health and Wellness Program Coordinator

(405) 652-9216

tprather@ocaithb.org

Karla Iron

OKTEC Project Manager

(405) 652-9200

kiron@ocaithb.org

Yonavea Hawkins

Public Health Training Coordinator

(405) 652-9219

yhawkins@ocaithb.org

Tyler Dougherty

Biostatistical Intern

Tracy Sexton, MBA

Grants Manager

Melanie Johnson, M.Ed. Sucharat Tayarachakul, MPH

tdougherty@ocaithb.org tsexton@ocaithb.org

For newsletter submissions, questions, or to be placed on the mailing list Email: asmith@ocaithb.org • Subject NEWSLETTER

OCTOBER/NOVEMBER/DECEMBER 2015 | 23


OKLAHOMA CITY AREA INTER-TRIBAL HEALTH BOARD ■ 9705 N. BROADWAY EXTENSION, STE. 150 ■ OKLAHOMA CITY, OK. 73114 WWW.OCAITHB.ORG ■ PHONE (405) 652-9200 ■ FAX (405) 840-7052


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