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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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LEVERAGING CULTURE TO
ADDRESS HEALTH INEQUALITIES

Examples from Native Communities

Workshop Summary

Karen M. Anderson and Steve Olson, Rapporteurs

Roundtable on the Promotion of Health Equity and the
Elimination of Health Disparities

Board on Population Health and Public Health Practice

INSTITUTE OF MEDICINE
        OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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THE NATIONAL ACADEMIES PRESS   500 Fifth Street, NW   Washington, DC 20001

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This activity was supported by contracts between the National Academy of Sciences and Aetna Inc.; Kaiser Permanente; Health Resources and Services Administration; Kresge Foundation; Merck & Co., Inc.; National Institute on Minority Health and Health Disparities; and the Robert Wood Johnson Foundation. The views presented in this publication do not necessarily reflect the view of the organizations or agencies that provided support for this activity.

International Standard Book Number-13: 978-0-309-29256-6
International Standard Book Number-10: 0-309-29256-5

Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2013 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2013. Leveraging culture to address health inequalities: Examples from native communities: Workshop summary. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
×

Knowing is not enough; we must apply.
Willing is not enough; we must do.
”      

                                                —Goethe

image

INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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PLANNING COMMITTEE ON LEVERAGING CULTURE TO ADDRESS HEALTH INEQUALITIES1

JENNIE R. JOE (Chair), College of Medicine, University of Arizona

EVE J. HIGGINBOTHAM, Emory School of Medicine

JOHN C. (JACK) LEWIN, Lewin and Associates

NEWELL McELWEE, Merck & Co., Inc.

MILDRED THOMPSON, PolicyLink

WILLIAM VEGA, University of California, Los Angeles

ANTONIA M. VILLARRUEL, University of Michigan

TERRI D. WRIGHT, American Public Health Association

______________

1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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ROUNDTABLE ON THE PROMOTION OF HEALTH EQUITY AND THE ELIMINATION OF HEALTH DISPARITIES1

WILLIAM VEGA (Chair), University of Southern California

MILDRED THOMPSON (Co-Chair), PolicyLink

PATRICIA BAKER, The Connecticut Health Foundation

GILLIAN BARCLAY, Aetna Foundation

ANNE C. BEAL, Patient-Centered Outcomes Research Institute

AMERICA BRACHO, Latino Health Access

IRENE DANKWA-MULLAN, National Institutes of Health

JAMILA DAVISON, ACM Medical Transition Care

ALLAN GOLDBERG, Merck & Co., Inc.

NADINE GRACIA, Department of Health and Human Services

TOM GRANATIR, American Board of Medical Specialties

EVE J. HIGGINBOTHAM, Emory School of Medicine

A. MELISSA HOUSTON, Health Resources and Services Administration

CARA V. JAMES, Centers for Medicare & Medicaid Services

JENNIE R. JOE, College of Medicine, University of Arizona

JAMES R. KIMMEY, Missouri Foundation for Health

ANNE C. KUBISCH, The Aspen Institute

JEFFREY LEVI, Trust for America’s Health

JOHN C. (JACK) LEWIN, Lewin and Associates

NEWELL McELWEE, Merck & Co., Inc.

PHYLLIS W. MEADOWS, Kresge Foundation

GARY NELSON, Healthcare Georgia Foundation

ELENA O. NIGHTINGALE, Institute of Medicine

DAVID PRYOR, NBC Universal

AMELIE G. RAMIREZ, University of Texas Health Science Center

JOHN RUFFIN, National Institutes of Health

MELISSA SIMON, Northwestern University, Feinberg School of Medicine

SAM SO, Stanford University

PATTIE TUCKER, Centers for Disease Control and Prevention

ANTONIA M. VILLARRUEL, University of Michigan

WINSTON F. WONG, Kaiser Permanente

TERRI D. WRIGHT, American Public Health Association

______________

1Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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IOM Staff

KAREN M. ANDERSON, Senior Program Officer

ANDRÉS GAVIRIA, Research Associate (until August 2013)

ALEJANDRA MARTIN, Research Associate (until July 2012)

DORIS ROMERO, Financial Associate

HOPE HARE, Administrative Assistant

ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
×

Reviewers

This workshop summary has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:

Stacy Bohlen, National Indian Health Board

Loretta J. Fuddy, Hawaii Department of Health

Tom Granatir, American Board of Medical Specialties

Elena O. Nightingale, Institute of Medicine

David Pryor, NBC Universal

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Ned Calonge. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the authors and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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Abbreviations and Acronyms

ACA Patient Protection and Affordable Care Act
AI American Indian
AN Alaska Native
 
DHAT dental health aide therapist
 
FSM Federated States of Micronesia
 
IHS Indian Health Service
IOM Institute of Medicine
 
MRI magnetic resonance imaging
 
NCAI National Congress of American Indians
 
OHSU Oregon Health and Science University
 
SAMHSA

Substance Abuse and Mental Health Services Administration

SEARHC SouthEast Alaska Regional Health Consortium
 
UN United Nations
 
VA Department of Veterans Affairs
Suggested Citation:"Front Matter." Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18496.
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Leveraging Culture to Address Health Inequalities: Examples from Native Communities is the summary of a workshop convened in November 2012 by the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities of the Institute of Medicine. The workshop brought together more than 100 health care providers, policy makers, program administrators, researchers, and Native advocates to discuss the sizable health inequities affecting Native American, Alaska Native, First Nation, and Pacific Islander populations and the potential role of culture in helping to reduce those inequities. This report summarizes the presentations and discussion of the workshop and includes case studies that examine programs aimed at diabetes prevention and management and cancer prevention and treatment programs.

In Native American tradition, the medicine wheel encompasses four different components of health: physical, emotional, mental, and spiritual. Health and well-being require balance within and among all four components. Thus, whether someone remains healthy depends as much on what happens around that person as on what happens within. Leveraging Culture to Address Health Inequalities addresses the broad role of culture in contributing to and ameliorating health inequities.

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