July 2008

Grant Results

SUMMARY

Project staff from the Northwest Portland (Ore.) Area Indian Health Board worked with local Native American health leaders to revise and pilot test a newly created Indian Community Health Profile, which local tribes can use to assess the health status of the tribal community and monitor its progress over time.

The health board is a nonprofit tribal organization that assists the 41 federally recognized tribes of Idaho, Oregon and Washington on health-related matters.

Key Results
The Indian Community Health Profile project:

  • Established a process for tribal communities to develop their own community health profile, using local site coordinators and tribal resources.
  • Developed templates for individual health indicators that other communities can use.
  • Disseminated information about the profile to a wide range of tribal, regional and national audiences.

Funding
The Robert Wood Johnson Foundation (RWJF) provided the health board with a grant of $171,185 between 2000 and 2003 in support of this work.

 See Grant Detail & Contact Information
 Back to the Table of Contents


THE PROBLEM

Vast disparities in health status persist between Native Americans and Alaskan Natives and white Americans, despite efforts by the federal government to narrow the gap, including establishment of the Indian Health Service.

A major barrier to improving health outcomes among Native Americans is that public health authorities typically assess population health status and monitor its progress using data collected at regional and national levels, while health status is determined by conditions and interventions at the community or tribal level.

Indeed, existing public health indicators are suitable for populations of 10,000 or more, whereas tribal communities are typically small, with populations between 1,000 and 5,000.

With Indian Health Service funding, the Northwest Portland Area Indian Health Board's Northwest Tribal Epidemiology Center convened a work group in 1999 to develop a set of health indicators that tribes could use to assess overall tribal health status and monitor its progress.

The result became known as the Indian Community Health Profile. It includes 15 medical, mental, dental, educational and social health indicators, which function as a proxy for the overall health status of the community. Examples of these indicators include prevalence of diabetes, rate of high school graduation and prevalence of adolescent alcohol and other drug use.

The profile is flexible and can be customized to individual community needs. For information about the profile, see the Indian Community Health Profile Web site.

 Back to the Table of Contents


THE PROJECT

Support from RWJF enabled the health board to refine the Indian Community Health Profile and to pilot test it in three tribal communities. Criteria for pilot site selection included:

  1. Broad community support
  2. Population between 1,000 and 5,000
  3. Defined geographic area
  4. Willingness to use community resources
  5. Available data.

Thirty-three sites expressed interest in the project. Project staff visited the eight sites that met project criteria, of which three became the pilot sites: Port Gamble S'Klallam Tribe in Northwest Washington, Coeur d'Alene Tribe in Western Idaho and Fort Peck Tribe in Northeastern Montana.

The health board staff provided technical assistance to the pilot sites through 16 site visits, initial training sessions, data analysis training and an evaluation session for each site. A local site coordinator worked with broad-based groups in each community to identify data sources and develop indicators useful to each community.

Coordinators gathered data from community sources, including surveys of adults and youth adapted from surveys developed by the federal Centers for Disease Control and Prevention and the state of Washington Department of Health. Profile results remain in the community for use in creating interventions and monitoring progress.

 Back to the Table of Contents


RESULTS

The Indian Community Health Profile project accomplished the following:

  • Established a process for tribal communities to develop their own community health profile, using local site coordinators and tribal resources. This process serves as a model for other tribal communities.
  • Developed templates for individual health indicators that other communities can use.
  • Disseminated information about the profile to a wide range of tribal, regional and national audiences.
  • Introduced the Indian Community Health Profile Newsletter in May 2002.

Communications

Health board staff made 29 presentations on the profile to audiences that included tribal nations; the American Public Health Association; chief medical officers, clinical directors and other groups of the Indian Health Service; the U.S. Secretary of Health and Human Service's Health Summit to Reduce Racial and Ethnic Disparities; and others. Project staff distributed 300 copies of the first issue of The Indian Community Health Profile Newsletter in May 2002.

 Back to the Table of Contents


AFTER THE GRANT

In an internal evaluation of the implementation system, the health board suggested that the Community Health Profile project had a positive effect on community health and noted that tribal health systems now possess community-specific data that has improved their ability to plan appropriate health services and regulations. The investigators recommended that health centers of non-participating tribes take steps to implement the profile in their own communities.

The Indian Health Service provided $200,000 to the health board to develop a toolkit to assist new sites in conducting and using their own community health profile. Available online, the 120-page toolkit offers survey templates, analysis instructions, and recommendations for policy changes.

 Back to the Table of Contents


GRANT DETAILS & CONTACT INFORMATION

Project

Developing and Implementing Indian Community Health Profile Guidelines

Grantee

Northwest Portland Area Indian Health Board (Portland,  OR)

  • Amount: $ 171,185
    Dates: September 2000 to April 2003
    ID#:  039203

Contact

Tam Lutz, M.P.H., M.H.A.
(503) 228-4185
tlutz@npaihb.org

Web Site

http://www.npaihb.org/epi/ichp/ichp.html

 Back to the Table of Contents


BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Articles

Perry L. "Tribes to Gather Health Data to Meet Local Needs." Wotanin Wowapi, 31(May 3): 1–12, 2001.

Perry L. "Local Agencies Train to Design Fort Peck's Health Profile." Wotanin Wowapi, 32(August 23): 6, 2001.

Reports

"Indian Community Health Profile Project Toolkit." Northwest Tribal Epidemiology Center, June 2005. Available online.

Lutz T. Indian Community Health Profile Project. Portland, Ore.: Northwest Portland Area Indian Health Board, 2000.

Lutz T. Indian Community Health Profile Project Quarterly Reports. Portland, Ore.: Northwest Portland Area Indian Health Board, 2000.

Lutz T. Indian Community Health Profile Project Quarterly Reports. Portland, Ore.: Northwest Portland Area Indian Health Board, 2002.

Lutz T. Indian Community Health Profile Project Newsletter. Portland, Ore.: Northwest Portland Area Indian Health Board, May 2002. 300 copies mailed. Available online.

"2001 Behavioral Risk Factor Surveillance System (BRFSS) Interviewer Training Manual." Indian Community Health Profile Project, May 2001.

Presentations and Testimony

Tam Lutz, "Indian Community Health Profile Project," at the Annual Meeting of the American Public Health Association, November 15, 2000, Boston.

Tam Lutz, "Indian Community Health Profile Project," at the U.S. Secretary of Health and Human Service's Health Summit to Reduce Racial and Ethnic Health Disparities, July 12, 2002, Washington.

 Back to the Table of Contents


Report prepared by: Mary B. Geisz
Reviewed by: Richard Camer
Reviewed by: Molly McKaughan
Program Officer: M. Katherine Kraft

Most Requested