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Health News & Notes • October, 2004•

Health News & Notes

A Publication of theNorthwest Portland Area Indian Health Board

Our Mission is to assist Northwest tribes to improve the health status and quality of life of member tribes and Indianpeople in their delivery of culturally appropriate and holistic health care.

October, 2004

LtoR: LaVerne Lane-Oreiro (Lummi), Ed Fox (NPAIHB), Stella Washines(Yakama), Jim Roberts (NPAIHB) preparing for meeting on Capitol Hill to

advocate for the passage of the Indian Healthcare Improvement Act.See page 4 for IHCIA article

In This Issue

Pearl’s Report 2Executive Director’s Report 3IHCIA Update 4Washington DC Sept 2004 6Getting Water Back to Table 8

IHS Budget Update 10July 04 QBM Pictures 12July 04 QBM Pictures 13Diabetes 15IHS Energy Awards 16

Diabetes Competitive Grants 19Traditional Diet 20Upcoming Events 22New Employees 23July 2004 QBM Resolutions 24

Will Republicans Deliver On TheirPromise To Pass an IHCIA in 2004

• Northwest Portland Area Indian Health Board •

Northwest Portland AreaIndian Health Board

Executive Committee Members

Pearl Capoeman-Baller, ChairQuinualt NationBob Brisbois, Vice ChairSpokane TribeLinda Holt, Vice ChairSuquamishTribeJanice Clements, TreasurerWarm Springs TribeRod Smith, Sergeant-At-ArmsPuyallup TribeStella Washines, SecretaryYakama Nation

DelegatesBarbara Sam, Burns Paiute TribeDan Gleason, Chehalis TribeLeta Campbell, Coeur d'Alene TribeAndy Joseph, Colville TribeMark Johnston, Coos, Lower Umpqua &Siuslaw TribesVacant, Coquille TribeSharon Stanphill, Cow Creek TribeCarolee Morris, Cowlitz TribeCheryle Kennedy, Grand Ronde TribeVacant, Hoh TribeBill Riley, Jamestown S'Klallam TribeTina Nenema, Kalispel TribeNadine Hatcher, Klamath TribeJ. Raine Crowe, Kootenai TribeRosi Francis, Lower Elwha S'Klallam TribeLaVerne Lane-Oreiro, Lummi NationDebbie Wachendorf, Makah TribeJohn Daniels, Muckleshoot TribeRebecca Miles, Nez Perce NationMidred Frazier, Nisqually TribeRick George, Nooksack TribeShane Warner, NW Band of Shoshone IndiansRose Purser, Port Gamble S'Klallam TribeRod Smith, Puyallup TribeBert Black, Quileute TribePearl Capoeman-Baller, Quinault NationBillie Jo Settle, Samish TribeNorma Joseph, Sauk-Suiattle TribeMarsha Crane, Shoalwater Bay TribeBelma Colter, Shoshone-Bannock TribesJessie Davis, Siletz TribeMarie Gouley, Skokomish TribeRobert Brisbois, Spokane TribeKatherine Barker, Snoqualamie TribeWhitney Jones, Squaxin Island TribeTom Ashley, Stillaguamish TribeLinda Holt, Suquamish TribeLeon John, Swinomish TribeMarie Zacouse, Tulalip TribeSandra Sampson, Umatilla TribeMarilyn Scott, Upper Skagit TribeJanice Clements, Warm Springs TribeStella Washines, Yakama Nation

From the Chair:

Pearl Capoeman-Baller

It was nice to be on the Olympicpeninsula for our July Board meeting inPort Angeles. This is as close toQuinault as I can hope for, but theBoard’s Delegates have also chosenSquaxin Island as our January 2005 siteand voted to come to Quinault in April2005. I think this is called a hat trickfor the Olympic Peninsula tribes! Don’tworry, my desire to stay close to mygrandchildren won’t result in all ourmeetings being near my home—but thatwould be nice. I do want to be homewith family as much as I can be and Iappreciate every opportunity to beclose to home. The Board has alsodecided to visit Spokane this October(20, 21, 22) and we will return to theOregon coast in July 2005 for our jointmeeting with the California Rural IndianHealth Board. That meeting will behosted by the Confederated Tribes ofGrand Ronde and the Siltez Tribe at theChinook Winds Casino and Hotel(Siletz recently purchased the Ocean-front Shilo Inn) in Lincoln City, Oregon.

I was recently selected to be the chairof the Consultation Workgroup of theDepartment of Health and HumanServices. The charge of thisworkgroup is to review all the consulta-tion policies of the department and itsoperating divisions. We have drafts ofvarious documents and we expect tomeet Secretary Tommy Thompson’sdeadline of November 2004 forsubmission of proposed new policies.

I am also a member of the CMS TribalTechnical Advisory Group (TTAG). Thisgroup meets monthly by teleconferenceand three times a year in person inWashington DC. I attended our Sep-tember 22 meeting at the HubertHumphrey Building during the week offestivities celebrating the NationalMuseum of the American Indian. Triballeaders made it very clear about ourexpectations for a serious commitmentfrom CMS to work on issues identifiedby this group. Incidentally, the HubertHumphrey Building is located steps fromthe museum and was also the location fora reception celebrating the museumopening on September 21.

The week of September 18 to the 23was a very busy one for me in Washing-ton, DC. Between political rallies,museum celebrations, a Health Summitconference on Health Promotion andDisease Prevention, Senate consider-ation of both the Interior AppropriationsBill and the Indian Health Care Improve-ment Act, and just plain visiting with allthe Tribal representatives in DC, it wasan exhausting week. I firmly believe thatwe did show Washington DC thatIndian nations are thriving despite all thehardships and Indian people are proudof their cultures and ready to work topreserve and contribute both to theirnations and the nation of the UnitedStates.

I have given a great deal of my time thisyear to encourage Indian people toeducate themselves about our issues and

Continued on page 21


From the Executive Director:

Ed Fox

Northwest Portland AreaIndian Health Board

Projects & Staff

AdministrationEd Fox, Executive DirectorVerné Boerner, Administrative OfficerVacant, Finance OfficerBobbie Treat, G/L & Contracts AccountantMike Feroglia, A/P & Payroll AccountantVacant, Executive SecretaryVacant, Office Manager

Program OperationsJim Roberts, Policy AnalystSonciray Bonnell, Health Resource CoordinatorJames Fry, Information Technology CoordinatorChris Sanford, Network AdministratorGinger Clapp, Administrative Assistant

Northwest Tribal Epidemiology CenterJoe Finkbonner, DirectorJoshua Jones, Medical EpidemiologistEmily Puukka, NW Tribal Registry DirectorVacant, EpiCenter Project AssistantKatrina Ramsey, Navigator ProjectTam Lutz, TOT’s and ICHPP DirectorJulia Putman, TOT’s Project AssistantClarice Hudson, IRB Project AssistantLuella Azule, NTRC Project CoordinatorKerri Lopez, Western Tribal Diabetes DirectorRachel Plummer, WTD Project AssistantJennifer Olson, WTD Project SpecialistDon Head, WTD TrainerCrystal Gust, WTD and National ProjectSpecialist

Tobacco ProjectsGerry RainingBird, NTTPN Project DirectorTerresa White, NTTPN Project SpecialistNichole Hildebrandt, WTPP Project DirectorJoe Law, WTPP Regional CoordinatorKaren Schmidt, WTPP Project SpecialistVacant, Project Assistant

Northwest Tribal Recruitment ProjectGary Small, ProjectDirector

Northwest Tribal Cancer Control ProjectLiling Sherry, Project DirectorCicelly Gabriel, Project AssistantEric Vinson, Survivor & Caregiver Coordinator

Project Red TalonStephanie Craig, Project Coordinator

as though it were a relaxing workingvacation. Linda Holt was elected ViceChair in Bob Brisbois’s absence. SinceBob’s election defeat, we incorrectlyassumed that he was no longer ourSpokane Tribe delegate, but we learnedin September that the tribe has reaf-firmed their selection of Bob as theirdelegate. Thank you Spokane tribesharing Bob with the Board. He bringsgreat knowledge, hard work, and fierceadvocacy to our fight to improve Indianhealth status and respect for our tribes.

Tribal Technical Advisory GroupThe Centers for Medicare and MedicaidTribal Technical Advisory Group contin-ues to meet in very active teleconfer-ences. The first task of this group is toguide the implementation of the Medi-care Modernization Act. The mostimportant role of all remains separatefrom and outside the scope of duties ofthe TTAG: advocating for policies suchas the establishment of Indian health asan entitlement, which, once established,will be administered by CMS.

State MeetingsThe American Indian Health Commis-sion in Washington state continues tohave well-attended and productivemeetings. At the March 5 meeting, JimRoberts gave his usual update of thehealth issues being tracked by theBoard. The AIHC also has a veryactive workgroup looking at the devel-opment of a Benefits Package, and I

July Board MeetingWe had excellent attendance at our JulyBoard meeting at the Red Lion Hotel inPort Angeles, Washington. The MakahTribe provided delegates a full day ofactivities including a tour of theirwonderful museum, free time to explorethe reservation in its stunningly beautifulsetting, and a wonderful cultural eveningof food, song, and dance. Delegateslearned much about the Makah culturethrough all these activities. The inter-pretations of the ‘family songs’ werevery informative and reminded us of thegreat oral traditions of our tribes. JimRoberts and I were honored to receiveour Makah names, I am now ‘silversalmon’ (coho, or Tsooit and Jim isKing Salmon). The Port GambleS’Kllalam tribe also assisted in themeeting by providing presentations fromtheir very innovative drug court collabo-ration with the local county officials.

With the beautiful sunny skies and thehospitality of the two tribes and thelocal county officials, we felt verywelcome and comfortable for oursummer meeting where many of us felt Continued on page 14

Jim Roberts and Ed Fox receiving MakahIndian names from Makah tribal council


October 5, 2004 – For the first time infive years, Tribal leaders and Indianhealth advocates are as close as theyhave ever been to seeing the passage ofthe Indian Health Care ImprovementAct (IHCIA). The September 21st

grand opening of the National Museumof the American Indian in WashingtonD.C. coincided with a flurry of meetingactivities focused on American Indianand Alaska Native issues. On Septem-ber 22nd, both the Senate Committee onIndian Affairs (SCIA) and the HouseResources Committee passed theirrespective versions of the reauthoriza-tion of the Indian Health Care Improve-ment Act, S. 556 and H.R. 2440.

In the course of the past five years, it issafe to say that the reauthorizationefforts for the IHCIA would not havecome as far as they have had it not beenfor the role of Area Health Boards likethe Northwest Portland Area IndianHealth Board (NPAIHB), AlaskaNative Health Board, California RuralIndian Health Board, United South &Eastern Tribes and the Affiliated Tribesof Northwest Indians (ATNI). It was aresolution adopted at one of ATNI’sannual meetings and carried to theNational Congress of American Indian’s(NCAI) Annual Convention held in SanDiego in November 2002 that servedas a key advocacy piece for the reau-thorization efforts. Although, there wasalready a national effort underway, theNCAI resolution provided the neces-sary momentum for advocacy andsupport of S. 556 and H.R. 2440 in the108th Congress. It was Julia Davis-Wheeler, then Chairperson of NPAIHBand the National Indian Health Board

(NIHB), that sponsored the NCAIresolution.

Since 1998, Tribal leaders and Indianhealth advocates across Indian Countryhave worked to bring about the reau-thorization of the IHCIA. The IHCIAis the key federal law that authorizesappropriations for the Indian HealthService (IHS) programs. It estab-lishes the basic programmatic struc-ture for delivery of health services toIndian people and authorizes theconstruction and maintenance ofhealth care and sanitation facilities inIndian Country. Since its initialenactment in 1976 as P.L. 94-437,the IHCIA has been periodicallyreauthorized and amended, mostnotably in 1988 and 1992. Theauthorization provisions expired in2000, but Congress extended themfor one year through fiscal year 2001.Since that time no further formalextension of these authorizations hasoccurred.

During 1999, the IHS actively con-sulted with Indian country in order toallow Tribal and urban Indian health

programs the opportunity for input onprogrammatic and administrativerecommendations intended to providequality health care for Indian people.The Portland, Alaska, and CaliforniaAreas met in Reno in February 1999 todiscuss their proposals for the IHCIA.Shortly after, a National SteeringCommittee (NSC) on the reauthoriza-tion of the IHCIA was established in thesummer of 1999 to review the recom-mendations received during the consul-tation process, to reconcile differencesin the recommendations from thevarious areas of Indian country, andthen to complete a legislative draft thatreflected the final recommendations.Julia Davis-Wheeler served as thePortland Area representative on theNSC and was very instrumental in herrole on the committee as the Chairper-son of both NPAIHB and NIHB.Later, as the NSC continued its work,Ms. Davis-Wheeler was selected toco-chair the committee along withRachael Joseph, Chairperson of theLone Pine Paiute Tribe of California—aposition she served in for two years.

In 1999, the NSC proposal was intro-duced in the House and Senate in the106th and 107th Congresses with fewchanges from what the NSC proposed.Senator Campbell introduced his versionof the bill as S. 212, while RepresentativeGeorge Miller introduced the Houseversion as H.R. 1662. While hearingswere held in the Senate, no bill wasreported or reached the floor of eitherchamber. The Clinton Administration didnot take a position or offer formal com-ments on these bills. In March 2001, theCongressional Budget Office (CBO)“scored” — that is, estimated the Federal

Northwest Contributions to the

by Jim Roberts, Policy Analyst

Senator Inouye and JuliaDavis-Wheeler at a SenateCommittee on Indian Affairs

hearing, February 2003


budget impact — of the mandatoryspending parts of the Senate version ofthe bill. The CBO estimated these wouldcost $6.9 billion over 10 years and wasseen by the Administration and certainmembers of Congress as a hefty sum forIndian health care. Later in 2001, HHSSecretary Thompson, on behalf of theBush Administration, expressed concernsabout several parts of the Senate bill tothe Senate Committee on Indian Affairs.In early 2002, tribal technical representa-tives working with the NSC, beganmeeting with drafting specialists of theHouse Legislative Counsel’s Office (underthe sponsorship of the House ResourcesCommittee) to refine the proposal’slanguage in order to achieve the NSCobjectives. Many questions were posedfor tribal leaders to address and thelegislation was refined.

The Northwest Portland Area IndianHealth Board, responding to NorthwestTribal leaders’ concerns about the lack ofmovement on the reauthorization efforts,assumed a more active role in 2002-2003by sponsoring two NSC meetings. TheBoard also supported travel costs,conducted analysis, and developed awebsite dedicated to the IHCIA reautho-rization for the NSC and other Indianhealth advocates. In May 2002, Triballeaders met in Portland to address theHHS concerns, Legislative Counsel’squestions, and issues raised from variousparts of Indian Country. Several policycompromises were made to resolveconcerns presented by the Administrationand Tribes. The primary concerns raisedby HHS focused on the high costsassociated with some of the Title IV(Medicaid and Medicare) provisions ofthe Senate bill. In December 2002, the

NSC briefed the new IHS Acting Direc-tor, Dr. Charles Grim, on its IHCIAefforts, and he instructed tribal technicalrepresentatives to resume work withLegislative Counsel to prepare a reviseddraft in accord with the 2002 Portlandmeeting decisions. NSC members metagain in Portland (March, 2003) toreview the work done by LegislativeCounsel and tribal technicians on arevised bill.

Finally, on March 6, 2003—in whatbrings us to date on the current bills—Senators Campbell, Inouye, andMcCain introduced S. 556, the text ofthis bill was the same as S. 212, whichwas the bill that was introduced in the107th Congress (2001-02). The Sena-tors decided to do this while awaitingcompletion of a revised NSC bill. Thenon June 11, 2003, Representative DonYoung and 40 co-sponsors introducedH.R. 2440. This bill reflects thechanges made by the NSC in responseto concerns raised by the Administra-tion as well as tribal representatives,and is written in more precise legislativelanguage than the 1999 tribal proposal.

In the past five years, NPAIHB hasbeen actively involved in every stepleading to the development of S. 556and H.R. 22440. During this time,former NPAIHB and NIHB Chairper-son Julia Davis-Wheeler has testifiedbefore Congress on several occasionsadvocating for the passage of theIHCIA. Many other northwest Triballeaders like Ron Allen, Chairman,Jamestown S’Klallam Tribe; PearlCapoeman Baller, President, QuinaultNation; Garland Brunoe, former Chair-man, Warm Springs Tribe; Cheryl

Kennedy, Chairperson, Grand RondeTribe; and many others have beeninstrumental in the reauthorization effortsand advocating for the passage of theIHCIA. It seems only fitting that thegrand opening of a museum dedicated tohonoring this country’s American Indianscoincided with the SCIA and HouseResource mark-up on the IHCIA bills.Like the museum, Tribal leaders and theNSC have waited a very long time for thereauthorization of the IHCIA to happenand only hope that this Congress will takeaction and pass it. The Administration hasstill yet to formally provide its views onthe legislation, although Secretary Thomp-son and the Administration have con-veyed their support for its passage, whichmeans if it gets to the President’s desk hewill likely sign it. Only time will tell if thisCongress and the President truly support

Reauthorization of the IHCIA


Quinn Gallagher at the September 22,2004 NCAI sponsored rally in

Washington, DC


Washington DC

by Sonciray Bonnell, Health Resources Coordinator

Being in Washington DC with my daughter Quinn this September was a once in alifetime experience. We went to DC to attend meetings and a conference, to marchin the Native Nations Procession, and to participate in the many activities scheduledin conjunction with the opening of the National Museum of the American Indian.Work and play united throughout this week of momentous occasions as Quinn and Ijoined crowds of inspired attendees at these important political and cultural events.

Lummi Liberty and Freedom Totem Poles PresentationOn September 19, 2004 the Lummi Nation presented the thirdLiberty and Freedom totem pole to families of the victims of the 9/11terrorist attack on the Pentagon and the current and veteran membersof the U.S. military. The event was held in the south parking lot of thePentagon. Though we had gathered to honor the victims of 9/11 andtheir families, there was an overwhelming sense of joy as we cametogether as a community of witnesses in a ceremony of closure.

There were several moving speeches including one by Jewell James who spoke ofour ties to the land, ties that will never be broken (one reason why we have so manyAmerican Indians and Alaska Natives willing to protect this land by serving in themilitary). Mrs. Lisa Dolan, widow of Captain Robert Dolan, spoke of her life sincelosing her husband in the attacks on the Pentagon. Quinn and I, along with crowdsof other people, shook Mrs. Dolan’s hand in thanks for her courageous speech.

The Liberty and Freedom totem poles are gifts of the Lummi Nation to the familiesand victims of the September 11, 2001 terrorist attacks on the United States.Handcrafted by Jewell James, Lummi Councilman and master carver, the threetotem poles are a gesture of unity and support to the families of the victims of the 9/11 terrorist attacks. The first Liberty and Freedom totem pole was the Healingtotem pole presented at the site of the World Trade Center and is now permanentlylocated at Sterling Forest, one hour north of Manhattan. The second totem polewas the Honoring Pole presented at Shanksville, Pennsylvania.

NCAI Sponsored RallyThe National Congress of American Indians held a Living Cultures, ThrivingGovernments rally at the Upper Senate Park to highlight tribes’ political concernsin conjunction with the opening of the National Museum of the American Indian.Key tribal supporters had the opportunity to give positive support for issues facingAmerican Indian and Alaska Native tribes. Jackie Johnson, Executive Director ofNCAI, enthusiastically introduced the lineup of speakers that included: SenatorsMurray and Cantwell from Washington state, Ron Allen (Jamestown S’Klallam),and Senator Daschle. Quinn and I enjoyed the presentation of a Pendleton blanketto Senator Daschle by a Navajo Code Talker.

Lummi totem pole carvers

Navajo Code Talker presenting Sena-tor Daschle with a Pendleton blanket


September 2004

National Museum of the American Indian (NMAI)Established in 1989 by an Act of Congress, the NationalMuseum of the American Indian is dedicated to the life,languages, literature, history, and arts of the Native people ofthe Western Hemisphere. The museum is a dramatic250,000 square-foot sandstone work of art that occupies aspecial place on the National Mall. Most of the artifacts livein the Cultural Resources Center in Suitland, Maryland. TheOpening Ceremony of the NMAI took place on September21, 2004 and was preceded by the Native Nations Proces-sion. Verné and Conrad Boerner, my daughter Quinn, and Itoured the museum, though visiting and people watching wasstrong competition. The most memorable part of the mu-seum for us, was watching our young children learn aboutAmerican Indian and Alaska Native cultures and history.Even at ages 2 (Conrad) and 5 (Quinn), our children weregenuinely interested and engaged in the displays, interactivevideo screens, and sculptures. Think of the thousands ofchildren who now have this opportunity to experience and learnabout native cultures, and how this education will touch theirlives.

Native Nations ProcessionAn estimated 25,000 thousand Native people and non-Native supporters, many intraditional clothing, participated in the Native Nations Procession across the Na-tional Mall on September 21, 2004. Participants walked in alphabetical order withNative nations in the lead, following by organizations, and then independent partici-pants. The procession momentarily paused four times along the route to acknowl-edge the four musical groups representing each of the cardinal directions.

I had planned to wear my traditional Sandia Pueblo clothing in the Native NationsProcession all along, but when it came time to pack I had a “to do” list a mile long.Also, and maybe most important, I didn’t have anyone to help me dress in mytraditional clothing. At my mother’s insistence, I wore my Sandia Pueblo clothingand even found a friend to help me dress. My traditional clothing took up a third ofmy luggage space, leaving little room for mother daughter matching outfits—Quinnand I like to dress alike. It was wonderful to finally find the other Pueblos (so easyto spot!). Quinn and I walked the procession, thankful to be a part of history.

LtoR: Sonciray Bonnell (Sandia, Isleta,Salinan) NPAIHB and her daugher

Quinn Gallagher in Native Procession

LtoR:Tom Becker (OHSU),Verne Boerner (Inupiak)NPAIHB, and ConradBoerner

LtoR:Quinn Gallagher and

Conrad Boerner discoveringthe new National Museum

of the American Indian


Before my grandmother passed awayshe reminded me that during harvesttime, families gathered together, toharvest together and to eat together.When our friends and relatives camefrom the fields they were greeted withwater, not pop, not that pink andorange stuff from the supermarket. Iimagine that folks ate together a lotback then, drank many pitchers ofwater over the same lively conversa-tions we have now. We have oldphotographs of such occasions, cel-ebrations, holidays, harvest times, andfunerals. Long wooden tables linedwith Indian people, old and young,brandishing wide white smiles and leanbodies. It’s hard to imagine anyone inthose photos having diabetes; any ofthose Indian children having surgery toremove decayed, rotten teeth.

We continue to gather together forcelebrations, holidays and funerals, thatmuch hasn’t changed. No one in myfamily that I know of is still farming, butwe continue to catch fish, crab andcollect clams. But the presence ofwater has almost disappeared at ourtables. Where has it gone? Who tookit away? Who replaced it?

The presence of pop and other sugaredbeverages is undeniable. It is every-where. My cousin is a gracious host,always happy for a visitor. “C’mon in.Where ya been? It’s hot out, enit?Wanna pop or something? I got Coke,Sprite, Mountain Dew….” It iseverywhere. Now we have a beautifulcedar long house with beautiful carv-ings. One very large cedar carving ofan Indian woman in traditional dress,stands tall, her hands and arms upbidding thank you to the people, to thegreat spirit; below her are our longfolding tables all lined with plasticdisposable table cloths. On the tablesare bowls of crab legs and clams, fishon platters, salads, cobs of corn, breadand plastic cartons of sugared pink andorange drink. It is everywhere. Thekids now have a whole departmentdelegated to providing recreationalactivities. The neighborhood gym is fullof kids playing basketball and thehallways are lined with pop machinenext to an unused rusty water fountain.It is everywhere, in our homes, at ourfeasts, where our kids gather.

Indian country has faced extinctionmany times before and survived. We

have outlived war. We have outlivedepidemics. We have outlived anenvironment that told us speaking ourlanguage, dancing our traditionaldances, singing our traditional songswas not okay. The language, thedances, the songs did not disappear butcontinue to be passed down within ourfamilies. Not long ago, only a fewcedar war canoes ever made it backinto the water each year. But thecultural value and practice of canoepulling was revived and now the tribehas a large canoe shed filled withcanoes and many families and youngpeople begin canoe-pulling season eachMay.

Water continues to be present in ourtraditional ceremonies, but water as thenormal beverage at our meals andthroughout the day has dangled on theedge of extinction. How can communi-ties and families revive water as abeverage and why should they care?

We should care because we love ourkids, all our kids. Because we want todo anything we can to make their liveshealthy and happy. We want them togrow up proud of whom they are. But

Getting Waterby Tam Lutz, TOTS Project Director

Article previously published inWell Nations May-June 2004 issuewww.wellnations.com


we don’t want to talk about it – kidsbeing fat, or pudgy, well fed, big boned,husky, thick. We don’t want to talkabout a 5-year-old starting school insize 8 pants taut around the middle,with pant legs so long we got to cutthem off and hem them up. We are notalone. Overweight in children hasemerged as a major health threat for allpeople. But rates of overweightchildren are highest among Indianchildren. Overweight people are moreat risk for diabetes and heart disease.We care because we see more of ourrelatives being diagnosed with diabetesand many diagnosed younger than theyears before. We care because beingoverweight doesn’t make anythingeasier — playing, making friends,buying clothes, fitting in a chair, manag-ing our health, or getting the respect wedeserve.

We care because overweight is startingearlier in our children than in others.What the mother eats has an effect onthe unborn baby, just like the use ofcigarettes or alcohol. What a child isfed after birth also makes a difference.Nature has made us well equipped tofeed our children. Breast milk helpsprevent babies from becoming over-weight. Yet many tribal communitieshave low breastfeeding rates and arestruggling to revive breastfeeding as acommunity value. When moms beginintroducing solid foods to baby, nowa-days water often is overlooked and isinstead replaced with juice and sugaredbeverages. The sugar in these drinks isvery unhealthy for our children. On theone hand, the extra calories that chil-dren “drink” fill them up so much thatthey have no space for healthy food.On the other hand, children eat nor-

mally and also drink those emptycalories on top, which is enough to tipthe scales towards becoming over-weight.

Beverage companies man very strongefforts to market the value of pop, inIndian communities, in all communities.This marketing comes in the form ofadvertisements, sponsorship of athleticprograms, and distribution contracts.These marketing efforts have us con-vinced that spending 75 cents for pophas some value and that spending onedollar for water is a waste of money.Water should be free, right? But whatare we really paying for? The real costof the bargain is the billions of dollarsthat we spend on obesity relatedconditions, diabetes, heart disease, andtooth decay each year that continues toworsen as it compounds over the cansof pop drank, the calories consumed,and the weight gained.

I’ve seen enough change and strongleadership in Indian Country to knowthat Indian Communities have power,more power than most white suburbs tomake positive changes for their commu-nities. Indian communities can oftenpull off health prevention efforts whereWhite America fails. Indian communi-ties were among the first to enactprimary seat belt laws and Indiancommunities have been able to imple-ment standards of care in immunizationrates upward to 90%.

Indian communities have a connectionwith others who live within the tribalcommunity unlike any white suburbiawhere few know their neighbor’s firstname. If the fisheries department wantsto let everyone on the rez know that

there is free fish being distributed at thedock, the moccasin telegraph can beactivated and soon a crowd will havegathered there. Communication cantravel fast. Our tribes are really madeup of a small number of very largefamilies. We need to tell our families tostop the pop; to get sugar out of ourchildren’s cups; to remove pop ma-chines from where our families gather;to stop using tribal dollars to providesugared beverage and to get waterback on the table and in the hands ofour youth once again. We need to actnow before the thought of drinkingwater has dried up and is gone. If youtell the Jefferson’s and I tell the Jamesand we get two other people to tell theLanes and Hillaires, we ought to havecovered about 75% of the rez. That’snot so hard, enit?

Tam D. Lutz is an enrolled member ofthe Lummi Nation and has ancestral tieswith the Quinault, Chinook, Cowlitz,Nooksack and Duamish Nations ofWashington State. She is the directorand the Junior Investigator of theToddler Overweight and Tooth DecayPrevention Project. This project isbased at the Northwest Portland AreaIndian Health Board’s Northwest TribalEpidemiology Center in Portland,Oregon. The project partners with theKaiser Permanente Center for HealthResearch and tribes in the Northwest.Tam lives in Washougal, Washingtonwith her husband Ed and two smallchildren Josephine and Rowan.

Back on the Table


Indian Health Service

by Jim Roberts, Policy Analyst

Status of IHS FY 2005 AppropriationsOn September 29, 2004 Congresspassed a continuing resolution fundingall non-defense government agenciesand programs at current levels throughNovember 20, 2004. Meanwhile, boththe House and Senate have takenaction to move their Interior Appropria-tions bills. The action taken by bothhouses is good news for Indian Coun-try. In what looked like it could be avery dismal budget year for the IndianHealth Service (IHS), is looking a littlebetter. When President Bush made hisState of the Union Address back inFebruary, he indicated that he wouldhold discretionary spending to less thanone percent. When the Presidentsubmitted his budget request to Con-gress it only included a 1.5% or $45million increase for the IHS.

On June 17, 2004, the full Houseapproved H.R. 4568, which provides$19.7 billion for the Department ofInterior and Related Agencies and $3.0billion for the IHS. The $3.0 billionappropriation represents a $112 millionincrease over the FY 2004 spendinglevels and is $66 million more than thePresident’s request. The PortlandArea’s FY 2005 Annual Budget Analy-sis estimates that it will take $380million just to maintain current services.The House amount falls short by $268million. On the Senate side, the fullAppropriations Committee moved tomark-up the FY 2005 Interior Appro-priations bill on September 14, approv-

ing $20.3 billion for Interior Related Agencies. The Senate bill provides $2.99 forthe IHS, an increase of $76 million over FY 2004. The Senate amount is $30.5million more than the Administration’s request. The Senate mark falls short by $304million to maintain current services.

The House bill represents $36 million more than the Senate Appropriations Com-mittee recommendations for the IHS. The key differences in the Senate and Houseamounts lie in the Hospital and Clinics and Contract Health Services (CHS) lineitems and the Health Facilities accounts. The House has approved $6.7 millionmore than the Senate for the Hospitals and Clinics line item. The Senate hasrecommended $12 million more for CHS than the House approved $479 million.Both have included $18 million for the Catastrophic Health Emergency Fund. TheSenate recommendation for CHS is $491 million. This means that the Senate billcurrently has more money for Clinical Services, at $2.12 billion, than the House’sapproved bill.

The House and Senate did not request any additional funds for Contract SupportCosts (CSC) despite a projected shortfall for CSC funding of $112 million in FY2004. Likewise, there was no additional funding requested for the Office of Self-Governance. When last year’s rescissions are factored in, these accounts areactually losing money in the appropriations process. The CSC line item lost $3.3million last year and was funded at $1.6 million less than the previous year! Thismeans there is no money for Tribes to pursue contracting and compacting arrange-ments and has quite literally halted self-determination of IHS programs.


Budget Update

The Administration’s request cut the Health Facilities accounts by $37 million. TheHealth Facilities Construction line item alone was cut by $52.8 million. The Housebill restores the health facilities accounts and even increases them by 3.4%. TheSenate bill requests $55.4 million for facilities construction, a net loss of $39 millionfrom last year’s level. The Portland Area does not benefit as much as other Areasfrom the Health Facilities accounts, so the Senate appropriations are looking muchbetter for the Northwest Tribes.

What holds for the appropriations process? Well it is unlikely that Congress willcomplete its business prior to the October recess when Members head home tocampaign prior to elections. You can expect that the Congress will not move anyother appropriations this session. The Defense bill is the only appropriation passedthus far by Congress. It is anticipated that all remaining appropriations will moveduring a “lame duck” session when both chambers return after the election andestablish a conference committee to construct a large omnibus bill.


Linda Holt (Suquamish)accepting position asNPAIHB Vice Chair

LtoR: Ed Fox, Executive DirectorNPAIHB and J.T. Pethrick, Executive

Director NIHB

Makah songs to start the July 2004 QBM in a good way Makah dancers welcoming the July 2004 QBMDelegates and participants

July 2004 QBM Pictures

Morning walkers

Debbie Wachendorf (Makah Delegate)so delighted to host the July 2004 QBM


Makah youth dancing

Makah girls preparing for a dance

Crystal and Gordon Dennyand family

Makah dancer

Makah girls delivering dinner plates to guests

July 2004 QBM - Makah Activities

Slug on Cape Flattery

Cape Flattery


attended their last meeting at the Puyallup Tribe. Jim Roberts has been very activein Idaho working with many new tribal representatives at that state’s meetings.Oregon, more so than the other two states, continues to reduce programs, and weutilize the state meetings to make our view known.

NPAIHB Personnel

This quarter saw some changes in personnel. Liling Sherry has returned to theBoard as the director of the Cancer Control Project. Mylen Shenker has resignedas the Board’s Finance Officer. The Board has hired Chris Sanford as the NetworkAdministrator, formerly held by Brian Moss. Brian moved with his family to Ne-braska to be near his wife’s family. The Board is also hiring a Human ResourcesDirector this fall. This position promises to raise the level of support for profes-sional and organizational development at the Board and ensure personnel practicesmeet Board, state, and federal guidelines.

Lobbying Activities

Finally, I want to thank all the tribes who sent in their donations to our lobbying fundin a year with such dismal results for the Indian Health Service Budget and theIndian Health Care Improvement Act. It is always hard to say where we would beif we did not go to Washington DC to lobby, but I truly believe that the work of theBoard still earns the respect of the Administration, the Congress, and tribes andtribal organization nationwide. I know it is hard to tell when we are lobbying andwhen we are simplying serving on workgroups, but I am very clear in the division ofthese activities so we follow all federal lobbying restrictions on the use of federalfunds.

Continued from page 3

January 18-20, 2005 hosted by Squaxin Island

April 19-21, 2005 hosted by Quinault

July 19-21, 2005 hosted Siletz/Grand Ronde(joint meeting with the California Rural Indian Health Board)

Future NPAIHB Quarterly Board Meetings


Western Tribal Diabetes Project(WTDP) staff recently attended aTaking Control of Your DiabetesConference (TCOYD) held in SantaRosa, California, on August 28, 2004.Kerri Lopez, Rachel Plummer, andCrystal Gust joined approximately 425conference attendees for the daylongconference that addressed communitymembers with diabetes.

The TCOYD conference includedspeakers on motivational interviewing,blending traditional and modern medi-cine and empowering patients withdiabetes to manage their own care.Darryl Tonemah presented on motiva-tional interviewing/counseling forbehavior modification and also doubledas the lunchtime entertainment playinghis original music. Darryl has traveledacross the country for the NationalInstitutes of Health doing Diabetes’sPrevention seminars. Don Warne(Oglala Lakota Sioux), M.D., MPH,spoke on how to blend traditional andmodern medicine. Don comes from along family line that practices TraditionalMedicine. Dr. Kelly Moore (CreekNation), presented on the challenge ofchildhood obesity, “Preventing diabetesin the first place: It starts with our kids.Dr. Steven Edelman addressed em-powering patients; his message, andtheme of the conference; TakingControl of Your Diabetes. Billy Mills,American Indian Olympic gold medal-ist, also gave an inspiring lunchtimeaddress to conference participants.The conference closed with speakerAnn Bullock (Chippewa) who spokeabout the effect of historical grief and

trauma on Native Americanhealth. There were also addi-tional workshop sessions and awell-attended health fair heldthroughout the day.

The TCOYD conference alsogave the WTDP an opportunityfor a final sharing of the toolsdeveloped as well as a chance tobid farewell to the tribes that staffhave worked with under TheCalifornia Endowment project. Whileparticipating in the health fair, many ofthe California tribes expressed theirgratitude for the training provided byWTDP and were sorry to see theproject leave California. It was aprivilege for the WTDP staff to workwith the California tribes who are nowat a 100% submission rate for theirdiabetes audit data as well as a 91%rate for submitting the audit electroni-cally.

Diabetes Conference

Registration table

Billy Mills presenting during luncheon


The Portland Area Indian HealthService (PAO) has been very fortunateto have received eights energy awardssince 2002 for the conservation ofenergy and natural resources. TheIndian Health Service (IHS), Depart-ment of Health and Human Services(DHHS), and Department of Energy(DOE) presented these awards.

The awards are from the efforts ofindividuals and teams. The PAO staffdoes everything they can do to con-serve resources and be the best stew-ards of the assets assigned to them.Their view is that utility money saved isone more dollar for the delivery ofhealth services or support thereof. Asutility costs have escalated in the pastseveral years, several sites have beenable and fortunate to hold the line onutility expenses while providing anappropriate environment for patients.

FY 2002 Awards:

DHHS IHS Energy and WaterConservation AwardWellpinit Service Unit

From FY 1990 to FY 2000, an overallenergy consumption reduction per grosssquare foot of 68 percent in the 25-year old, 12, 250 square foot healthclinic. These results are further vali-dated by the fact that when comparedto data from the Energy InformationAdministration, the clinic uses two tothree times less energy than the nationalaverage for buildings of similar type andfunction.

The Wellpinit Service Unit does notattribute the success of their energymanagement program to a singlealternative, innovation, or “magicbullet.” Their program success is a storyof continued facility improvements,excellent preventative maintenance(PM) practices, and strong programsupport. The facility management at theclinic recognizes not only the environ-mental benefits of energy and waterefficiency, but also the health benefits totheir patients in both the budgetarysavings on energy that can be redi-rected to health programs, and acleaner environment.

DHHS Excellence in Managementof an Energy ProgramDale Mossefin, P.E., Portland AreaIndian Health Service

Dale Mossefin was recognized forsustained superior performance inmanagement of the PAO EnergyConservation Management Program.Mr. Mossefin manages and implementsPAO energy conservation projects toreduce energy consumption in accor-dance to Executive Order 13123.During Mr. Mossefin’s tenure, the IHSPAO exceeded the Executive Order’s25% energy reduction goal for 2010.His commitment, exceptional perfor-mance, and contributions towardachieving FY 2010 goals nine years inadvance are a testimony to his superiorperformance. Mr. Mossefin recognizedthat each dollar saved in energy isanother dollar available for IHS healthcare services

FY 2003 Awards:

DHHS Excellence in Managementof an Energy ProgramPortland Area Facilities Board

The Health Facilities Board consists ofTribal and PAO representation. TheHealth Facilities Board includes IHSPAO management and directors,service unit directors, administrativeofficers, and representatives, andmembers of the Northwest PortlandArea Indian Health Board (NPAIHB).NPAIHB represents all 43 tribalgovernments in the Portland Area andlobbies on their behalf in the HealthFacility Board and in several otherarenas. Members of the Health FacilityBoard are responsible for the allocationof funds for all facilities projects. TheBoard has shown continued interest andemphasis for energy projects.Throughout the years, the HealthFacilities Board has been the keysupporter of energy projects by ensur-ing funding and making energy projectsa priority. The Board recognizes thatthe promotion of energy conservationprovides cost savings that improvestheir ability to provide health careservices and improvements to theenvironment. The 34% energy reduc-tion since baseline FY 1990 documentsthe Health Facilities Board’s dedicationto energy conservation.

Indian Health Serviceby Wes Bell, Portland Area Indian Health Service


DHHS Energy and Water Conser-vation AwardNeah Bay Service Unit

The Neah Bay Service Unit is a small,isolated site located on the northwesttip of the Olympic Peninsula in Wash-ington. With limited resources, theNeah Bay Service Unit Plant Technol-ogy and Safety Committee has diligentlypursued and implemented highlysuccessful energy management prac-tices. Over the past ten years, totalenergy consumption per square foot hasdecreased more than 38%. During FY2002 the Neah Bay Service Unitconsumed less total energy and electric-ity than any prior year.

Furthermore, the Neah Bay ServiceUnit has met the criteria to be officiallydesignated as an ENERGY STAR®

Building. Meeting this criterion recog-nizes that the Neah Bay Service Unitenergy consumptions levels are in thetop 25% as compared to other build-ings of similar use.

DHHS Energy Efficiency/EnergyManagementHealing Lodge of the Seven Na-tions

The Healing Lodge of the SevenNations, Youth Residential TreatmentCenter is located in Spokane, Washing-ton. The facility is a 24-hour treatmentcenter and has been categorized as anenergy-intensive facility. In FY 2001,the Indian Health Service (IHS) in-stalled a direct digital control (DDC)

system on the major mechanical ele-ments: HVAC, AHU, chillers, andboilers at the Healing Lodge.

Fiscal Year (FY) 2002 saw greatincreases in unit energy cost due toregional and national shortages. For theHealing Lodge, unit energy cost ratesfor FY 2002 were, on average, ap-proximately 40% more than FY 2001rates. If the Healing Lodge had notaccomplished an energy consumptionreduction in FY 2002, i.e. consumptionfigures remained identical for FY 2001and 2002, the cost to the HealingLodge would have been approximately$68,000 in FY 2002 funds. From thatperspective, the Healing Lodge’senergy program in FY 2002 potentiallysaved $20,600.

The local utility company also recog-nized a future annual savings of $4,300for the proposed DDC installation atthe Healing Lodge. This made theHealing Lodge eligible to receive$16,470 credit from the utility com-pany. The total cost for installation andequipment associated with the DDCsystem was $47,565 plus tax. Thus thetotal cost of the project after utilityrebate was $31,095. As stated in theannual energy and cost savings, in FY2002 alone the Healing Lodge couldhave saved a potential of over $20,000.Therefore, the DDC system has alreadypotentially paid for over 60% of theinstallation and equipment throughenergy cost savings in one year.

Energy Savers Showcase AwardWellpinit Service Unit

With the completion of a major newprimary health addition to the existingWellpinit Service Unit clinic, this award,was presented by the Department ofEnergy to the Department of Health andHuman Services – Indian HealthService for combining new high effi-ciency HVAC systems, energy efficientlighting and occupancy sensors, low-ewindows, additional exterior wall andceiling insulation, and new plumbingfixtures with improved preventivemaintenance practices which resulted inenergy savings of 56% per gross squarefoot at the Wellpinit Service Unit.

FY 2004 Award:

DHHS Excellence in Managementof an Energy ProgramPAO Division of Facilities Manage-ment

The Portland Area Indian HealthService Division of Facilities Manage-ment Division received an award fromthe Department of Heath and HumanServices for sustained excellence inmanagement of its energy managementprogram. The management teamexceeded the goal of 25% per Execu-tive Order 13123, to greater than a35%. The employees’ long termcommitment and success in implement-ing energy conservation measures toachieve it goals were commended.

Energy Awards


this country’s commitment to honor itstreaty obligations to provide health care toAmerican Indians.

Current Status of the IHCIA

The House Resources Committeeconsidered HR 2440, along with nineother bills and passed them all byunanimous consent. The House struckkey components of H.R. 2440 thatwere adopted and supported by theNSC. The House eliminated the“Declaration of National Indian HealthPolicy” section. From the standpoint ofTribal leaders, this is significant, in thatthis section would have declared it apolicy of the United States that thehealth status of American Indian andAlaska Natives should be raised by2010 to the same level as is set forother Americans, instead of establishinglower thresholds as has previously beenaccepted, and establishes a policyrequiring “meaningful consultation” withIndian Tribes, Tribal health organiza-tions, and urban Indian organizations.Quite possibly the Administration andHHS oppose this policy statement,since it would take a considerableinvestment into the health care needs ofIndian people, and the price tag thatcomes with this is more than thisAdministration is willing to deal with.

The Resources Committee also in-cluded language that limits the dentalhealth aide program under the Commu-nity Health Aide Programs (CHAP)currently operated in Alaska. Thechanges will limit considerably what theCHAP are allowed to do under currentlaw and is viewed as a major setback inAlaska. This provision met with heavy

opposition from the dental lobby thatincludes the American Dental Associa-tion, American Association of Oral andMaxillofacial Surgeons, AmericanAcademy of Pediatric Dentistry, amongothers. Interestingly, the basis of thedental lobby opposition is premised onthat dental health aides would beperforming irreversible procedureswithout proper training. However, mostIndian health advocates would arguethat dentists are more concerned aboutcompetitive forces since the CHAPprovision could be expanded to the restof Indian Country. Many health advo-cates in this country will agree, that thedentists have failed rural America andmost certainly, Indian Country, by notbeing able to recruit dentists to work inthese communities. Many Indianpeople will continue to go withoutdental services in Tribal communitiesacross this country.

Both the House and Senate havestripped out the Medicare provisionscontained in Title IV. The decision toremove the Medicare provisions was acompromise that had much to do withlast year’s passage of the MedicareModernization Act (MMA). TheIHCIA is a very complex piece oflegislation in that it crosses manyCongressional committee jurisdictionlines. It was felt that if the Medicareprovisions were to remain intact, then itwould invite tremendous scrutiny by thevarious committees. Those samecommittees recently worked on theMMA and are very reluctant to passany legislation that contains any Medi-care provisions. It was felt that thiswould be a deal breaker for theIHCIA. The House Energy and

Commerce Committee has concurrentjurisdiction along with the HouseResources Committee and still needs toaddress the bill before it can be sent tothe House floor for enactment. It isunknown whether the House Ways andMeans Committee will exercise itsjurisdiction on the bill.

The Senate Committee also passedtheir amended version of S. 556,Reauthorization of the IHCIA, a bill thatclosely resembles the House companionbill H.R. 2440. Several months ago theSCIA began to adopt language fromH.R. 2440, the bill that has beenworked on for over 12 months by theIHCIA National Steering Committee.Senator Thomas, also member of theSenate Finance Committee, raisedconcern with Medicaid, Medicare, andSCHIP provisions. The Senate FinanceCommittee is the other committee ofjurisdiction for the IHCIA. Sen.Thomas indicated that these issueswould need to be resolved by the timethe Finance Committee reviews the bill.The SCIA has to meet with othercommittees who may have an interest inthe bill in order to bring it to the floorfor passage under unanimous consent.

Senators Tom Daschle and TimJohnson have called on the Republicanleadership to allow an immediate voteon the bill passed by the SCIA, indicat-ing that the bill has bipartisan supportand enjoys broad support across IndianCountry. Senators Daschle andJohnson cite health disparities amongAmerican Indian people as a compellingreason for the Senate to take immediateaction.


IHCIA continued


At long last, the competitive grantprocess for the Special Program forDiabetes for Indians is complete. Thisprocess included tribal consultation,development of the request for applica-tions, selection of reviewers for thegrant application, and putting themechanism into place to oversee thegrantees. This new funding allocated byCongress in 2004, mandated that aportion be distributed in a competitivegrant process. Dr. Grimm, the Directorof Indian Health Service, designated$54 million for competitive grants aftertribal consultation, Tribal LeadersDiabetes Committee input, recommen-dations from Area Health Boards, andNational Diabetes Programs recom-mendations.

Fourteen programs from the PortlandArea applied for funding. Of thosefourteen, nine programs were awardedfunding through the competitive grantprocess. Six programs were awardedprevention grants, and three programswere awarded the cardiovasculardisease component. The competitivegrants are in addition to current SDPIgrants. The grants require rigorous datacollection, establishing baseline datameasures, implementing interventionprograms, and measuring the successover a four-year period.

On October 7, 2004, Dr. Grimm visitedthe Portland Area Office of the IHS andpresented oversized checks to threeprograms from the Portland Area that

had been granted funds from the SDPI. These included Warm Springs, Coeurd’Alene, and the consortium of Coquille, Cow Creek, and Klamath. In his addressto the gathering, Dr. Grimm applauded the Portland Area for being awarded ninegrants out of fourteen applications, which tied another Area for number of grantsreceived.

The Warm Springs grant will be following the Diabetes Prevention Project template.Walking and running clubs, water aerobics, and the Health and Wellness Centerfigure largely in the activities of the Warm Springs grant. Coeur d’Alene will beusing the Hearts in Motion curriculum. The consortium of Coquille, Cow Creek,and Klamath will be conducting diabetes screenings using the Diabetes ScreeningToolkit, developed with tribes, the Western Tribal Diabetes Project of theEpiCenter, and IHS, among other activities.

Dr. Grimm had visited the Seattle Area on October 6, and presented the tribes inWashington with their funds.

The Board would like to congratulate the programs that were successful in procur-ing funding. In some small way, the Western Tribal Diabetes Project hopes that thetechnical assistance, and constant message of the importance of data collection andthe importance of the diabetes registries contributed to the success the granteesexperienced. The Western Tribal Diabetes Project would also like to give a “hatsoff” to all the programs that applied, as the process of writing a grant is both timeconsuming and challenging. Good luck to the programs that received the funding!

Prevention$404,000 - Warm Springs (Warm Springs, OR)$404,000 - Tribal Consortium of Coquille, Cow Creek & Klamath$330,000 - SPIPA Tribal Consortium - Chehalis, Skokomish, Shoalwater Bay,

Squaxin Island, and Nisqually$330,000 - Quinault$330,000 - Couer d’Alene$330,000 - Colville

Cardiovascular$330,000 - Seattle Indian Health Board$400,000 - Yakama$330,000 – Tribal Consortium of Swinomish, Nooksack, and Upper Skagit

Competitive Grants for Northwest Tribes

by Western Tribal Diabetes Project Staff


Just how important are nutrition anddietary factors in health and chronicdisease prevention? A new studyreleased by Department of Health andHuman Service’s Centers for DiseaseControl and Prevention shows thatdeaths due to poor diet and physicalinactivity rose by 33 percent over thepast decade and may soon overtaketobacco as the leading preventablecause of death (JAMA2004;291:1238-1245).

How does one determine a healthyrecommended diet? According to the5 A Day for Better Health Program,numerous research studies and reviewshave found that diets rich in fruits andvegetables are associated with reducedrisks for chronic diseases and manytypes of cancer. 5 A Day is a compre-hensive national nutrition program thatseeks to increase the number of dailyservings of fruits and vegetables thatAmericans currently eat, to five ormore each day by the year 2010.During the past 10 years, the 5 A DayProgram has been jointly sponsored bythe National Cancer Institute (NCI)and the Produce for Better HealthFoundation, and involves many part-ners from health agencies and theagriculture industry (www.5aday.gov).

According to the Director of theAdministration on Aging (AoA), in astatement before the Senate Committeeon Indian Affairs, diet, sedentarylifestyle, and obesity are modifiable riskfactors for the development of diabetes(The Health Concerns of NativeElders, 7-10-02). AoA annuallyawards grants to provide nutrition

services and support for tribal elders.In 2002, AoA awarded 236 grants toover 300 tribes, which provides ser-vices to approximately 100,000 tribalelders. AoA requested their NationalResource Center on Native AmericanAging to develop a needs assessmentthat provides each tribe with an accu-rate picture of the status of their elders.In 2001, 83 tribes completed the needsassessment, and according to the needsassessment, many more tribal elders areoverweight (75%) than their non-Indiancounterparts (53%). Additionally, tribalelders may be less aware of theiroverweight status since 44% consideredtheir weight to be “about right.”

Research on the eating habits of tribalelders is scarce. The AoA facilitatedinteractions between Utah State Univer-sity and tribes in Utah and the North-west for gathering traditional foods.These interactions resulted in the 2001study entitled, “Creation of a DietarySurvey for Northwest Tribal Elders”which is the first dietary assessment ofNorthwest tribes and was led byFrancine Romero and Deb Gustafson.

This study assessed the traditional foodsconsumed by tribal elders from threeparticipating Northwest tribes todetermine the cancer preventive nutrientcontent of these foods. The premise ofthis study is that the number and typesof cancer within Northwest Indianpopulations seems to be increasing andthe change in what people eat nowcompared to what they ate in the pastmay account for some of this. Further-more, since the risk of developingcancer increases with age and people

live longer, information on what tribalelders eat will provide invaluableinformation on how to develop appro-priate cancer control programs. Theresults of this study are available atwww.npaihb.org.

One reason to return to the consump-tion and production of traditional foodsis that the ceremonies, songs, andstories of many tribes are inextricablylinked to the planting and harvestingcycle of particular crops. According toprofessor Nabhan of Northern ArizonaUniversity’s Applied Indigenous StudiesProgram, modern hybrids are nosubstitute for these particular crops(Nabhan, November 25, 2003). Mostimportantly, the physical benefits ofharvesting these particular crops, andthe invaluable lessons taught by tribalelders provide education and healthyactivity for youth.

An approach used by tribal diabetesprevention programs on several SiouxReservations to encourage tribalmembers to return to the consumptionof traditional foods is the adoption ofthe Medicine Wheel Model for NativeNutrition. The Model was developedwith the belief that tribal memberswould benefit from a familiar model toreflect their traditional diet compositionand practices, but it also incorporatesnew foods. According to NorthernPlains Nutrition Consulting’s RegisteredDietitian, Kibbe Conti, the Model is anideal one for diabetes prevention. TheModel offers hope that members canprevent obesity and diabetes by adher-

Returning to a Traditional Diet

by Lynn DeLorme



ing to the same four dietary principlesthat their ancestors followed. Accord-ing to Ms. Conti, when one finds animbalance in their modern life, oneneeds to look back to a healthier timeto see what it is that one is doing tocause the imbalance.

The Medicine Wheel is a sacredsymbol used by Northern Plains Tribesand others to represent all knowledgeof the universe. It is represented by thefour sacred colors or races of mankind:red, white, black & yellow; the fourelements: water, fire, air and earth; thefour seasons; and the four ages of thelifecycle. In the case of nutrition, Ms.Conti claims that tribal members havestrayed from the four aspects of theirancestral diet: water, lean meat, fruit orvegetable, and starchy vegetable orgrain. Ms. Conti claims that if tribalmembers model their plate after theModel for Native Nutrition, thenmembers honor the essence of theirearlier food way. Traditional diet,combined with an active lifestyle willallow tribal members to live in a waythat is more similar to that of earliergenerations who were free of diabetes,obesity, and cancer (Diabetes Beat,Summer 2002;V5, N2). It is hopedthat collaborative efforts of AoA, theIndian Health Service, NorthwestPortland Area Indian Health Board,tribal health programs, and socialservice departments will continue indeveloping nutrition programs such asthis.


candidates positions on those issues. Many of you know of my active supportfor Senator Kerry’s candidacy, but I encourage each of you to vote no matterwho you support. It is primarily about ‘winning’ but it is also about showing theCongress and the Administration that Indian people are participating in theprocess and want their voices to be heard after the elections are over.

I was not able to attend the Affiliated Tribes of Northwest Indians Meeting inPolson, Montana this September, but I was able to attend the National Con-gress of American Indians meeting in Fort Lauderdale, Florida. I will report onthat meeting at our Quarterly Board Meeting in Spokane on October 21, 2004.



National Council on Urban Indian Health Conference

October 25-27, 2004At the Bahia Resort Hotel in San Diego, CaliforniaFor more information go to: http://www.ncuih.org/conference.htm

Rural Women’s Health Conference

October 28-30, 2004At the Hershey Lodge and Convention Center in Hershey, PennsylvaniaFor more information go to: http://www.hmc.psu.edu/ce/RWH/Contact.htm

Wellness and Spirituality Conference

November 1-4, 2004At the DoubleTree Hotel at Reid Park in Tucson, ArizonaFor more information go to: www.hpp.ou.edu

Tribal Leaders Health Summit

November 4-5, 2004At the Upper Skagit Casino Resort in Bow, WashingtonFor more information go to: www.aihc-wa.org

American Public Health Association 132nd Annual Meeting and ExpoNovember 6-10, 2004In Washington, DCFor more information to go www.apha.org

Healthy Nations: Taking Action for Positive Policy

November 17-19, 2004At the Wild Horse Pass Resort in Phoenix, ArizonaFor more information go to: http://www.tpskins.org/

DMS Training

December 9-10, 2004At NPAIHB in Portland, OregonFor more information go to: www.npaihb.org

OCTOBER

NOVEMBER

DECEMBER

Upcoming Events


Health News and Notes is published by the Northwest Portland Area Indian Health Board (NPAIHB).NPAIHB is a nonprofit advisory board established in 1972 to advocate for tribes of Washington, Or-egon, and Idaho to address health issues.

New NPAIHB EmployeesHi there! My name is Chris Sanford and I’m the new network administrator here atNPAIHB. I’ve lived in the Northwest for eleven years, but I grew up in the South-west (Santa Fe, NM and on a small farm in Western Colorado) and sometimes I stillmiss the sunshine and smell of sage and creosote. I’m a geologist by training,however, I’ve been working in the Information Technology field for over seventeenyears and I still find it both rewarding and interesting. Most recently I was the ITdirector for a non-profit here in Portland called ‘Ecotrust’ and before that I haveheld various IT and programming positions, both in the corporate world (EDS andIntel) and in government (Mesa County Department of Human Services). When I’mnot working, I like to play guitar, tinker with old amplifiers, and spend time with mytwo teenage sons.

I’m very excited about working at NPAIHB, and look forward to the challenges thatthis job will bring.

Greetings! My name is Stephanie Craig and I am the new Project Red Talon ProjectCoordinator for a new grant received by NPAIHB from the Centers for DiseaseControl and Prevention (CDC).

For the past two years I have worked with the Western Tobacco Prevention Project,providing tribal program coordinators with information, training, and resources oncommercial tobacco prevention, cessation, program planning, and policy develop-ment. Prior to joining the Western Tobacco Prevention Project in October 2002, Icompleted my Masters of Public Health concentrating on International Health Devel-opment, and worked as a research assistant at Boston University’s School of Medi-cine and School of Public Health.

I love working for the Northwest Tribes, and look forward to jumping onto this newand exciting position.


Northwest Portland Area Indian Health Board

527 SW Hall Street • Suite 300 • Portland, OR 97201

NORTHWESTPORTLANDAREAINDIANHEALTHBOARD

NON-PROFIT ORG.U.S. POSTAGE

PAIDPORTLAND, OR

PERMIT NO. 1543

July 2004 QBM Resolutions

RESOLUTION #04-04-01Evaluation of Innovative HIV Prevention Interventions for High-Risk Minority Populations

RESOLUTION #04-04-02Support for Toddler Overweight and Tooth Decay Study (TOTS)

RESOLUTION #04-04-03Opposition to New IHS Eligibility Policy to Serve Ineligibles Under Section 813(b) of the IHCIA

RESOLUTION #04-04-04Support for National Centers of Excellence in Women’s Health

health news & notes - npaihb€¦ · health news & notes • october, 2004• page 1 health...

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