June 20, 2017
By Greg Peters
The rhythmic sounds of drums blend with the mesmerizing voices of American Indian singers filling the Field House at Johnson County Community College in Overland Park, Kansas, on a recent spring weekend as dancers dressed in the traditional regalia of their tribal nations move around the dance floor. Participants have come from across the United States and Canada to take part in the 11th annual American Indian Health Education Alliance (AIHREA) Our Nations Energies (O.N.E.) Health and Wellness Powwow.
AIHREA is an alliance of tribes and organizations dedicated to improving health and medical knowledge among American Indians. The alliance is led by the Center for American Indian Community Health at the University of Kansas Medical Center and the Center for American Indian Studies at Johnson County Community College.
For many, the music and dance provide powerful links to traditions and celebrations dating back centuries among indigenous peoples. And while the pageantry of the performances and competitions attracted many of the 2,000 visitors to the powwow, attendees also benefitted from access to free health screenings. The screenings have become an important part of the powwow because they provide access to medical care for American Indian populations - a group that has historically been underserved medically, often times resulting in significantly higher rates of death and at younger ages.
"Our event has become extremely important to reach American Indians who might not otherwise seek health care because of a lack of access and mistrust of the medical community," said Jason Hale, assistant director of community engagement and education for the Center for American Indian Community Health (CAICH) at the University of Kansas Medical Center, one of the event's sponsors. "The comfort and familiarity of the powwow setting encourages people to participate in health screenings, who may not otherwise get checked."
With the help of medical practitioners from the University of Kansas Medical Center and The University of Kansas Cancer Center, CAICH volunteers screened for a variety of medical conditions during the two-day powwow, including diabetes, obesity, blood pressure and lung function. They also educated attendees about nutrition, diabetes and mental health issues. The University of Kansas Cancer Center and the Midwest Cancer Alliance screened for skin cancer and provided educational materials for other cancers, including prostate, colon and breast cancers. And the KU Center for Child Health and Development screened for child-development issues.
"Our medical services included an 'ask a doctor' table where we reviewed the results of health screenings received at the event, including those for mental health, cardiovascular disease, blood pressure, diabetes, lung disease and others," said Allen Greiner, M.D., who is the medical director to screening operations for the CAICH and professor and vice chair in the KU Department of Family Medicine. "Counseling is provided on ways to promote behavior changes as well as information about local resources to assist participants needing follow-up treatments or care."
Screenings for cancer, diabetes, obesity and heart disease are especially important because these conditions are among the most common experienced by American Indians. The Centers for Disease Control and Prevention (CDC) has found that death rates were greatest among Northern and Southern Plains Indians, an area where many of the powwow's attendees reside.
"Lower life expectancy and disproportionate disease burdens exist perhaps because of inadequate education, disproportionate poverty, discrimination in the delivery of health services and cultural differences," notes the Indian Health Service, a federal agency that serves members of 567 federally recognized American Indian and Alaska Native tribes.
In 2014, the CDC published a paper outlining the key health findings for American Indian and Alaska Natives (AI/AN), including a death rate nearly 50 percent greater than for non-Hispanic whites from 1999 to 2009. The report concluded that the patterns of death were strongly influenced by the high incidence of diabetes, the prevalence of tobacco use, problem drinking and other health-harming social influences. The CDC noted that AI/AN infants were four times more likely to die from pneumonia and influenza and the death rate from sudden infant death syndrome (SIDS) also was higher.
Cancer was the leading cause of death, with deaths from lung cancer showing little improvement, during the time of the study. The CDC estimated that the AI/AN population had the highest prevalence of tobacco use by any population segment in the United States. About 120 cancer screenings were performed at this year's powwow.
"Certain cancers are more common in American Indians than the general United States population," Greiner said. "Part of this stems from relatively high rates of tobacco use. Many American Indian populations use tobacco at a rate of about 40 percent, compared to approximately 18 in the general population. This significantly increases not only the risk of lung cancer but also the risks of other cancers such as throat and mouth cancers, colon cancer, bladder cancer and others."
This year's powwow started on the evening of May 5 with the grand entrance of participants and continued throughout the afternoon and evening of May 6. With nearly 200 dancers and seven to 10 drum groups competing, the AIHREA O.N.E. Powwow has become a place to celebrate and embrace the culture of North America's indigenous peoples, while helping attendees care for their health.
"Powwows are important to many American Indians as a way to celebrate the unique culture and reinforce the identity of American Indian adults and youth," Hale said. "It has become both a celebration of culture through the songs and dances and also a way to help people learn about their health, so they can take preventative measure for better health outcomes."
During the powwow, approximately 800 to 1,000 screenings were performed. Greiner said they try to use the powwow as a time to strongly encourage people to use less tobacco. A smoking-cessation program, developed by KU Medical Center's Center for American Indian Health called All Nations Breath of Life has been culturally tailored for the American Indian community, and it was offered as a resource at the powwow.
"The involvement of the KU Cancer Center in the AIHREA Powwow assures the screenings and health promotion services are backed by an organization with the resources to facilitate the involvement of American Indians in cancer clinical trials," Greiner said. "Because American Indians have typically been underrepresented in these trials, we believe the collaboration of KUCC with the powwow is a great community resource."