Mainstream entities test the waters of ACA in Indian Country

By S.E. Ruckman, Native Times Special Contributor

Two dancers in regalia work a Native American Professional Parent Resources outreach booth at the 2014 Gathering of Nations powwow in Albuquerque, N.M. | Courtesy Photo
Two dancers in regalia work a Native American Professional Parent Resources outreach booth at the 2014 Gathering of Nations powwow in Albuquerque, N.M. | Courtesy Photo

OKLAHOMA CITY – Despite living in a state where Medicaid was not expanded, Oklahoma’s 38 federally recognized tribes have found a way to state tribal liaison, Sally Carter – and she has found her way to them. In this newly created position, Carter is quick to tell you that she considers Oklahoma to have 39 tribes because even though the Euchee are not federally recognized, they are state recognized. Breathlessly, she says she is learning fast.

“I still count them,” she said.

Carter carries Euchee concerns on health matters back to the state capital as part of a new stance where the health decision makers seek to repair a long and tenuous relationship between historical archetypes. When the Affordable Care Act (ACA) was passed in 2010, a series of listening sessions between Oklahoma and the tribes occurred at six different tribal jurisdictions across the state to talk about the federal health overhaul.  Replete with opening ceremonies and songs, the state was figuratively stretching its hand toward its Native inhabitants.

From these beginnings, Carter takes the message back to the capital that the tribes want to be at the decision-making table with state leaders, including the newly re-elected Republican governor, Mary Fallin.

Carter said the tribes don’t just want to be told about important developments, they want to help shape the direction the state will take on things such as the implementation of the ACA and how to reduce health disparities like high smoking and diabetes rates in their nations.

To date, 1,638 American Indians in Oklahoma have enrolled for federal health insurance through ACA while 13,061 have enrolled nationally, according to a U.S. Department of Health and Human Services (HHS) report. When compared to the 9.1 million estimated Obamacare enrollees, American Indians number roughly 1 percent of all Americans who now have health insurance who had none before.

But that thing that makes Oklahoma’s Indian Country so different—that thing that separates it from other U.S. states with tribes – is that it has no official Indian reservations. A federal land allotment experiment from the 1900s crisscrossed the state’s territory into a veritable smorgasbord of jurisdictions – federal, tribal, municipal, state.

Carter is working on how to stimulate enrollment among Oklahoma tribes.

If the government wants to reach the American Indians here, it’s best to go to each tribe, Carter said. That was a go-to move state health officials embraced as they discussed ACA with the tribes. The things Carter found surprised her although she is an Oklahoma resident and had lived near various tribal jurisdictions for years.

“They are the only (minority) group that has to show their race,” she said, her voice lilting. “I mean, no other group has to do that. They have to prove it with an enrollment card of some kind.”

Official American Indian citizenship is important because the ACA has special provisions that allow Indians to “opt out” of having to enroll in federal health insurance, if they choose. But Indians need to fill out form OMB No. 0938-1190 that officially removes them, officials said. Not doing so will mean an eventual penalty.

“(ACA) is very complex and not one of us would say that we know it all,” Carter said. So the state took the best of what they knew after weeks of training on the health plan to several tribal jurisdictions. When all sides met, Carter said she was schooled. American Indians have strong opinions about the state/ federal government encroaching on their personal privacy and tribal sovereignty with this new federal health insurance.

Because Oklahoma chose not to expand Medicaid, enrolling American Indians in ACA takes a certain degree of cultural finesse and dogged persistence, Carter said. In other tribally populated states, like North Dakota, the move to expand Medicaid fills in where ACA may not be a strong priority, said Sen. Heidi Heitkamp, D-ND. The emphasis is reducing uninsured numbers, she said.

“The State of North Dakota expanded Medicaid, which has helped uninsured, low-income individuals and families, including many Native Americans throughout the state, get access to affordable health care,” Heitkamp said. “ Medicaid expansion is giving families opportunities they didn’t have before to afford to see a doctor regularly and get access to needed medications, while reducing costs for everyone – those with health coverage and those without.”

The Oklahoma tribal liaison added that even while enrollment curiosity abounded, many did not qualify for ACA because they did not file income tax returns. American Indians can enroll in ACA at any time – not just during enrollment periods, but their tax filings allow them also to file the exemption – if they chose to forgo coverage.

American Indians have a higher unemployment rate than other groups–peaking in 2013, according to the Bureau of Labor Statistics Current Population survey. Indian unemployment rates averaged 11.3 percent compared to 9.1 percent of the mainstream during that time. High unemployment rates among Indians tend to keep more Indians ineligible for ACA enrollment, Carter said.

What has also dampened Oklahoma’s outreach has been a distrustful relationship between the state and tribes—this makes it harder for federal initiatives to come through the front door, said Terry Cline, Oklahoma’s commissioner of health. He points to the good faith of the tribal/state meetings.

“I considered the listening sessions a good start,” he said. An official summary on the sessions reported 193 attendees at the six sessions, several of which Cline attended.

“We held those sessions to have open dialogue,” he said. “What you hear from one tribe might be different from another tribe says.”

As for ACA and tribes,  a tribe’s type of relationship with the federal government, either Self-Governance or direct service, dictated outreach approaches because that’s how health dollars are administered by tribes in states, especially in Oklahoma, officials said.

Tribes that operate under provisions of the Indian Self Determination Act might outreach on ACA directly to members in their own tribally run health systems and tribes that are direct service entities may forgo outreach to their local Indian Health Service (IHS) service facility. In both regions, IHS and tribal facilities can accept ACA insurance from patients and lessen the amount of contract (out-of-IHS system) health dollars it spends, officials said.

“Tribes have a lot of interest in ACA,” Carter said. “Tribal leaders and the health department can inspire and direct tribal members to enroll.”

Both of the tribal-to-federal relationships are considered when the state of Oklahoma contacts tribes, and the state tends to follow the federal approach, Carter said. Putting on different hats to deal with different tribes is prudent.

“Tribes need to see people they know and that they can trust who know about American Indian provisions,” she said. “I believe in face-to-face interactions.  States usually contact them (tribes) with emails or letters, but a relationship needs to be worked on and allowed to develop.”

Cline said no special state appropriations exist to outreach to tribes for ACA enrollment in Oklahoma but he’s optimistic that other types of federal grants to reduce health disparities will help. The health commissioner said he knows Oklahoma has room for ACA Native growth through grants.

The HHS report points out that Oklahoma has the highest density of Indians among Federally Facilitated Marketplace (FFM) states with 3.5 percent of the population followed by Wyoming, with 3.1 percent. Wyoming’s total Native ACA enrollment stands at 309, the report shows.

At this point, Oklahoma seems to lead the state in the number of Natives it has enrolled, just exceeding figures for California. But as enrollment rolls on, officials expect more American Indians to register.  Indian Country (the term used to characterize where a federal-tribal relationship exists) extends beyond Oklahoma.

Other states with significant Native populations include Arizona, California, New Mexico, South Dakota and North Dakota. ACA data gathering for Native numbers is in its infancy, organizers said. They say the goal is to pool their information from various regions (via Indian advocacy agencies) to get a more precise picture of Native ACA enrollment. Due to their smaller population numbers, American Indian statistics are often overlooked, officials said.

Other mainstream entities who track the progress are unclear about just how many have actually signed up for ACA. Michelle McEvoy, vice-president of survey, research and evaluation for the Commonwealth Fund, said that no Native specific information has been garnered by her group.

“Latinos currently represent about 17 percent of the U.S. population, so they have a greater probability of being sampled than American Indians who represent about 1.2 percent of the U.S. population,” she said.

Likewise, the non-profit Enroll America, relies on Native ACA enrollment numbers from federal sources, wrote Jessica McCarron, deputy press secretary, by e-mail.

“We do work with partners at the local level to reach different communities, like Native American groups in certain parts of the country,” McCarron stated. “We work with a few partners who have made outreach to tribal communities a high priority.”

Meanwhile, Carter is optimistic about ACA enrollment and reaching American Indians in Oklahoma.

“(ACA) is bigger than all of us,” she said. “We can’t do this alone; it only happens when the state extends its hands across the table and says we need to do this for all the people.”

– This story was funded by the University of Southern California’s (USC) Annenberg School of Journalism as one project undertaken by the 2014 class of California Endowment Health Journalism Fellows. S.E. Ruckman is writing a three-part series on the Affordable Care Act (ACA) in Indian country. In addition to mainstream viewpoints, American Indian health advocates and American Indian enrollees are visited to gauge the national health plan’s implementation in Native populations. Fellows’ projects can be found at www.reportingonhealth.org.

NATIVE AMERICAN ACA ENROLLEES STATE ENROLLMENT TOTALS

*Wyoming: 309

*New Mexico: 566

*Oklahoma: 1,635

+California: 1,401

*Arizona: 514

*North Dakota: 82

*South Dakota: 271

TOTAL: 13,061

Sources:  (March 2014) *HHS Summary Report;  +California Department of Health Care Services

Tulalip Stop Smoking Program can help you reach your goals

Why becoming a quitter can make you a winner

By Brandi N. Montreuil, Tulalip News

The discussion to quit smoking cigarettes can be as stressful as trying to quit. The nagging. The pressure to succeed. The feeling of failure. The cost. The nagging. The fear. The withdrawals. The pressure. The nagging. Does this sound similar? Are you feeling like you need a smoke break as you read this? If so, then I know exactly how you feel and so does 42.1 million other people in the U.S. who smoke everyday.

I started smoking when I was 20-years-old, because it made me feel cool. Cliché as it is, it was my reason to commit to buying my first few packs and getting past the sick feeling I got every time I tried to inhale. Eventually I got over the sick feeling and I developed a habit.

Cigarettes contain 600 ingredients with nicotine as the key ingredient, giving it that addictive component. When smoked, a cigarette creates over 4,000 harmful chemicals including arsenic, commonly used in rat poison, formaldehyde, which is used as an embalming fluid, naphthalene, an ingredient found in moth balls, and tar, a material used to pave roads and to seal roofs.

According to the Centers for Disease and Control, Americans spent $8.4 billion on tobacco in 2011, and cigarette smoking is the number one leading cause of preventable death in the United States, “accounting for more than 480,000 deaths, or one of every five deaths, each year.”

My decision to quit smoking for good came in the beginning of 2014. I had tried, unsuccessfully to quit the previous year, but in 2014 I got the gusto to commit to quitting after meeting with the cessation specialist Ashley Tiedeman with the Tulalip Stop

Photo/ Brandi N. Montreuil
Photo/ Brandi N. Montreuil

Smoking Program. Now I have been smoke free for a year.

The Tulalip Tribes Stop Smoking program provides an essential lifeline for those trying to quit in the Snohomish County. Through the program you will receive one-on-one help tailored to your needs, free of cost. The program provides support and cessation supplies such as the popular nicotine patches and gum that help smokers kick the habit.

There were multiple factors that led to my decision to quit, which included the financial burden of smoking. I spent roughly $1,296.36 in 2013 on packs of Marlboros. The toll on my health was starting to be felt outwardly. I had decreased oxygen levels leading to shortness of breath. My teeth were yellowing and I experienced withdrawal symptoms when I couldn’t smoke, which include irritability, hunger, coughing, dry mouth, tiredness or drowsiness, and trouble sleeping.

When meeting with Tiedeman, I learned there were a variety of options available to me in my journey to quit the habit. The most common option smokers consider is the “cold turkey” method, which involves literally ceasing to smoke a cigarette, despite the withdrawal symptoms you experience. This is the method that I used to quit. Other methods include herbal remedies and medication to help tackle cravings, the number one obstacle people face when trying to quit.

The other obstacle smokers face trying to quit is fear of failure, which is why a majority of smokers try to hide their attempts at quitting. Routines developed as a smoker, such as pairing the activity of smoking with another daily activity like driving or after eating, also makes it difficult to quit.

To help participants, the Stop Smoking program helps smokers create a toolbox of resources to draw from when they experience temptations and cravings.

“There is no pressure. We help people develop coping skills to get past smoking. We meet with them on a weekly basis to help them stay on track, and help them assess where they succeeding and having difficulties, then develop action plans for them. There is no time limit to quitting. It is just day by day,” said Tiedeman.

For help quitting smoking or more information on the program, please contact Ashley Tiedeman at 360-716-5719.

 

Brandi N. Montreuil: 360-913-5402; bmontreuil@tulalipnews.com

Mom’s death inspires advocacy for those living with addiction

Dan Bates / The HeraldRico Jones-Fernandez waits in a gravel lot outside a vacant building on the Tulalip Reservation on Tuesday for anyone wishing to exchange needles.
Dan Bates / The Herald
Rico Jones-Fernandez waits in a gravel lot outside a vacant building on the Tulalip Reservation on Tuesday for anyone wishing to exchange needles.

 

By Andrew Gobin, The Herald

 

TULALIP — Since his mother’s death four years ago from a drug overdose, Rico Jones- Fernandez has worked to save other lives that might be lost.

His focus has been on people living with addiction on the Tulalip Indian Reservation.

“I have the ability to do something, so it is my responsibility to do something,” he said.

Jones, a member of the Tulalip Tribes, has been an advocate for expanding outreach programs on the reservation, particularly efforts that reach people who are not yet ready for rehabilitation.

Last year, Jones worked to develop a law that shields addicts from arrest and prosecution of misdemeanor offenses when they are seeking medical assistance to save a life. In recent months, Jones also has played a key role in bringing a syringe exchange to the Tulalip community, the first program of its kind for the reservation.

 

In 2010, Jones’ mother, Lois Luella Jones, died of a drug overdose. Her friends did nothing to help her, fearing they themselves would be arrested.

His mother’s story inspired Jones to draft a 911 Good Samaritan law for the Tulalip Tribes in hopes that others might be saved.

In June, the Tulalip Tribal Council passed the Lois Luella Jones Law, which provides temporary immunity from prosecution for low-level offenses if the person is attempting to get medical attention for themselves or somebody else in any emergency.

A higher value is placed on saving lives than filing misdemeanor drug charges, Jones said.

In May of last year, Tulalip Prosecutor Dave Wall told Tulalip News, “In terms of the war on drugs, when someone is overdosing, the war has been lost. The battle for that person’s life is now the focus.”

Jones began volunteering with the Snohomish County Syringe Exchange in 2014 to learn how he might start a similar program on the reservation. The exchange offered to expand their service and two months ago began exchanging needles at Tulalip every Tuesday.

The goal is not to enable drug use, but to prevent the spread of disease.

“Hepatitis-C and HIV get on everything, not just syringes. We exchange everything. The cooker, the cottons and the tourniquets,” Jones said.

Some criticize syringe exchanges, concerned these types of programs are giving needles away, fueling a problem.

“People already have needles that they are using, and reusing,” Jones said. “This isn’t about giving them needles, it’s about making sure they have a place to safely dispose of dirty needles in exchange for clean, safe syringes.”

His mother’s death continues to drive him, but it is the promise of the future that fuels Jones’ perseverance.

“I get tired. I face a lot of opposition when I try to bring programs like this to our community,” Jones said. “But I made a promise to myself and my son that this would be a safer place for him. I can’t give up.”

Currently, Jones is seeking approval from the tribal council to increase access to Naloxone on the reservation. If approved, people would be trained to administer Narcan, a compound that counters the effects of a drug overdose.

Jones, who has never been an addict, hopes to spare others the sorrow of loss he knows too well.

“It’s not about drugs or enabling people; it’s about people’s lives. All I do is in hopes of saving lives,” he said.

In 2013, 580 people died in Washington from opioid drug overdoses, 86 of whom were from Snohomish County, and Providence Regional Medical Center Everett reportedly treated 440 cases of opiate poisonings.

Grounding Yourself in Uncertain Times

Do you have things that are weighing you down from last year, the year before, the years before that?

There is a new group at Tulalip to help you work through some of those issues, perhaps some grief, frustration, confusion, all the feelings one has when things happen in life that leave you off center.

This is a drop in group, open to the Tribal Community

 

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Exercising Can Help Mental Health

 

By Kara Briggs Campbell, Tulalip News

 

The Mayo Clinic, a nationally known medical facility with clinics in Minnesota, Arizona and Florida, published on its website this list of benefits and protocols for starting an exercise program. This is the time of year when many people will make exercise a New Year’s Resolution. But in this time, as many in the Tulalip community are trying to cope with trauma, grief and loss, mental health professionals say exercise can help almost everyone to relieve stress and begin to feel better.

Exercise for stress management

  • It pumps up your endorphins: Physical activity helps to bump up the production of your brain’s feel-good neurotransmitters, called endorphins. Although this function is often referred to as a runner’s high, a rousing game of tennis or a nature hike also can contribute to this same feeling.
  • It’s meditation in motion: After a fast-paced game of racquetball or several laps in the pool, you’ll often find that you’ve forgotten the day’s irritations and concentrated only on your body’s movements. As you begin to regularly shed your daily tensions through movement and physical activity, you may find that this focus on a single task, and the resulting energy and optimism, can help you remain calm and clear in everything that you do.
  • It improves your mood: Regular exercise can increase self-confidence and lower the symptoms associated with mild depression and anxiety. Exercise also can improve your sleep, which is often disrupted by stress, depression and anxiety. All this can ease your stress levels and give you a sense of command over your body and your life.

A successful exercise program begins with a few simple steps.

  • Consult with your doctor: If you haven’t exercised for some time and you have health concerns, you may want to talk to your doctor before starting a new exercise routine.
  • Walk before you run: Build up your fitness level gradually. Excitement about a new program can lead to overdoing it and possibly even injury. If you’re new to exercise, start at the moderate level and then add vigorous activity as your fitness improves.
  • Do what you love: Virtually any form of exercise or movement can increase your fitness level while decreasing your stress. The most important thing is to pick an activity that you enjoy. Examples include walking, stair climbing, jogging, bicycling, yoga, tai chi, gardening, weightlifting and swimming.
  • Pencil it in: Although your schedule may necessitate a morning workout one day and an evening activity the next, carving out some time to move every day helps you make your exercise program an ongoing priority.

 

Where can I call for help?

  • To report an emergency dial 911
  • National Suicide Prevention Line: 1-800-273-TALK (8255)
  • Snohomish County Crisis Line: 1-800-584-3578
  • Crisis TEXT Line: Text “Listen” to 741-741
  • 24 Hour Crisis Line: 1-866-427-4747
  • TEENLINK: 1-866-833-6546
  • Tulalip Tribes Behavioral Health Family Services: 360-716-4400

 

Tulalip Healing: Exhaling the Pain

By Kara Briggs Campbell, Tulalip News

When people talk about trauma recovery, they often talk about mental health counseling.

While this is important for many, there are also others ways to approach healing that are complimentary to counseling and help people to maintain balance amid painful times.

Laura van Dernoot Lipsky, founder and director of the Trauma Stewardship Institute, reminds us that trauma requires processing, or metabolizing. The trauma may be felt by a community after a senseless, horrific school shooting, or may be any of the other ways that families or individuals come to loss and grief.

Some of the questions that Lipsky asks include, “What is one’s ability to metabolize the trauma we are bearing witness to? And, if someone finds wave after wave crashing down on them, have conditions been created to help them to metabolize?”

Finding ways to cope or metabolize with trauma is important because trauma is all around us. But so are practices and techniques for processing healing from trauma and grief.

In her book “Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others,” Lipsky helps people to think about how to cope with the cumulative impact of ongoing exposure to heartbreak.

“There are a lot of people who will say, ‘I am not open to going to counseling, for whatever reason,” Lipsky said. “There aren’t a lot of people, however, who will argue with the benefit of exercising. People have far fewer barriers to the idea of exercising than what they think of as mental health counseling.”

One of the primary things people need to know, whether they are getting counseling or pursuing an alternative-healing path, is you are not alone.

She wants to encourage people to talk with someone about what they are feeling. And f the first counselor or friend you try to talk with doesn’t feel helpful, she said, keep looking for another person with whom you can connect. You might ultimately connect with a counselor but it could also be a cultural leader, a minister, a friend, or a therapy dog.

“Find someone to connect with who can remind you that you are not alone,” Lipsky said.

The next thing she advises is to find a way to engage with your breathing. Many indigenous communities have profound breath work practices that could include singing, dancing, or paddling a canoe. Many studies have found that physical activity helps people, including children, to recover from trauma.  Exercising is one of the most effective, most efficient and most accessible ways to help one’s body and spirit sustain.

“Unless you are medically advised not to, we find there is great benefit to folks elevating their heart rate and breaking a sweat,” she said. “Some people can even hearken back to their ancestors’ ways of engaging breath that allow you to metabolize everything you have experienced.”

In the United States, overall, we are part of a mainstream culture that doesn’t support one’s need to intentionally and mindfully move through your trauma and grief. As a result, many people around us are hemorrhaging unprocessed feelings.

Some signs that you’re a hemorrhaging your trauma may seem like little things. You don’t let people merge in front of you on the freeway, or you find yourself screaming at your cat, or you are sobbing at a funny movie. Often whatever you find to eat, drink or inhale that keeps you numb is merely temporarily distracting from your grief, she said.

“We know it is very, very scary to feel deeply,” Lipsky said. “It is very uncomfortable. We also know it is unsustainable to not feel.”

“One common way that we distance ourselves form our feelings is to bring something on board like caffeine, sugar, nicotine, highly processed foods, alcohol or drugs, she said. “Or you are dis-integrating  your mind, body and soul in some other way. The toll of not feeling can be extraordinary.”

EPA to Develop Federal Clean Water Standards for Washington, if State Won’t

Courtesy Environmental Protection AgencyThe U.S. Environmental Protection Agency will issue water quality rules to uphold certain levels of fish consumption.
Courtesy Environmental Protection Agency
The U.S. Environmental Protection Agency will issue water quality rules to uphold certain levels of fish consumption.
Terri Hansen, Indian Country Today

 

The U.S. Environmental Protection Agency (EPA) has told the State of Washington it intends to step in to develop a federal plan for the state’s human health water quality criteria as the state did not finalize a plan by year’s end, a deadline EPA gave the state last April.

The EPA’s rulemaking process, in part tied to the human fish consumption rate, will overlap the state’s potential timeline but preserves the EPA’s ability to propose a rule in case the state does not act in a timely manner, EPA regional administrator Dennis McLerran wrote to Department of Ecology head Maia Bellon on December 18.

Related: Toxic Waters: Consumption Advisories on Life-Giving Year-Round Fish Threaten Health

Under the federal Clean Water Act, the state must adopt standards that ensure rivers and major bodies of water are clean enough to support fish that are safe for humans to eat. Washington’s current standard assumes people eat just 6.5 grams of fish a day, or about one filet a month.

Tribal leaders with the Northwest Indian Fisheries Commission, which represents 20 western Washington tribes, met with the EPA’s McLerran in September seeking to step in and set new water-quality rules for the state, after sending Washington Gov. Jay Inslee a letter expressing dissatisfaction with his proposed draft rule change last July.

Inslee’s draft rule would raise the fish consumption rate to 175 grams a day to protect people who eat one serving of fish per day, a figure that tribal leaders accept. But it has taken the state two years to work out the new draft rule in a political push-pull between business interests and human health advocates, which have each missed their own deadlines in the process.

Tribal leaders say they are also “deeply concerned” about a proposal privately advanced by Inslee that would allow a tenfold increase in allowable cancer risk under the law. The EPA letter asks Washington to explain why a change in the state’s long-standing cancer risk protection level is necessary.

Related: Inslee Weighs Tenfold Increase in Cancer Risk for Fish Eaters

The state’s draft rule is now expected in January, but since the EPA believes it can complete a proposed federal rule by August 2015, the state is looking at a limited time period in which to finalize its rulemaking process.

If not, the EPA is prepared to move forward with rulemaking that McLerran wrote considers the best science, and includes an assessment of downstream water protection, environmental justice, federal trust responsibility, and tribal treaty rights.

 

Read more at http://indiancountrytodaymedianetwork.com/2014/12/26/epa-develop-federal-clean-water-standards-washington-if-state-wont-158441

Taking charge of our health

Rocky Renecker has his blood-pressure readings explained. Photo/Micheal Rios
Someone has a little fear of needles. Luis
Hernandez has his blood drawn for the A1C diabetes screening. Photo/Micheal Rios

 

by Micheal Rios, Tulalip News

Despite growing awareness, men usually take a back seat approach to maintaining their health. We will shy away from seeking advice, delaying possible treatment and/or waiting until symptoms become so bad we have no other option but to seek medical attention. To make matters worse, we refuse to participate in the simple and harmless pursuit of undergoing annual screenings.

Enter the Annual Men’s Health Fair held at the Tulalip Health Clinic on December 12. This year’s health fair provided us men the opportunity to become more aware of our own health. With various health screenings being offered for the low, low price of FREE we were able to get in the driver’s seat and take charge of our own health. Cholesterol screening, prostate screening, diabetes screening, and dental screening were among the options for men to participate in. Along with all the preventative health benefits of participating in these screenings, as if that was not reason enough, they gave out prizes and a complimentary lunch to every man who showed up.

At 16.1 percent, American Indians have the highest age-adjusted prevalence of diabetes among all U.S. racial and ethnic groups. Also, American Indians are 2.2 times more likelyto have diabetes compared with non-Hispanic whites (per Diabetes.org). Clearly we are at a greater risk when it comes to diabetes, making it all the more crucial to have glucose testing and diabetes screenings performed on an annual basis. For those men who attended the health fair, they were able to quickly have their glucose (blood sugar) tested with just a prick of the finger.

 

Rocky Renecker has his blood-pressure readings explained. Photo/Micheal Rios
Rocky Renecker has his blood-pressure readings
explained. Photo/Micheal Rios

 

“The blood glucose test is a random check. Random is good, but doesn’t give you all the information which is why we do the A1C testing. It’s just nice to know if you are walking around with high blood sugar. This is a good way of saying ‘Hey, you need to go see your doctor.’ It’s not a definitive diagnosis,” said Nurse Anneliese Means of the blood sugar test.

Taking diabetes awareness one step further, an A1C test was available, by way of a blood draw that would also be used to test for high cholesterol.

“A1C is a diabetes screen. A1C is more of a long term indicator of glucose control as opposed to a regular blood glucose screening, which is here and now.  A1C tells you what your blood glucose has been doing for the past 3 to 4 months,” states lab technician Brenda Norton.

How often should we have a diabetes screening performed? “Everyone should be checked once a year,” Norton said.

According to the Centers for Disease Control and Prevention (CDC), heart disease is the first and stroke the sixth leading cause of death among American Indians. High blood pressure is a precursor to possible heart disease and stroke. High blood pressure is also very easily detected by having routine checks of your blood pressure taken periodically.

Nurse Tiffany Lee-Meditz states, “Measuring your blood pressure basically gives us a non-invasive look at your heart health. It can tell us if your heart is too large, if its beating too fast, if its pumping enough blood for the flow to get to all of your tissue and organs, and it can tell us if we need to look further. It can also tell us the health of your vasculature or your vessels, and if we need to look further into that.”

Along with the various health screenings being offered there were information booths available that ranged from alternative health care options in the local area, ways to have cleaner air in your home, and methods to change eating habits as to live a heathier life. There was a booth where we could have our grip tested, a method used for assessing joint and muscle fatigue. Another booth offered us the opportunity to have our BMI (body mass index) and body fat percentage measured. Wondering if you need to cut back on those weekend treats? Or if you need to start leading a more active lifestyle? Well if that BMI was too high and you didn’t like what your body fat percentage was, now you know the answer.

Face it, as we get older, we all need to become more aware of the inevitable health concerns that may one day affect us. The possibility of having to deal with high cholesterol, high blood pressure, diabetes, or the possibility of prostate cancer looms over us all. The only way to avoid such health concerns to heighten our awareness of these preventable conditions. Health educators empower us to be more proactive about our health by getting annual screenings, detecting issues early, as well as seeking medical treatment before a simple, treatable issue becomes life altering.

 

 Tribal member Mike Murphy having an oral cancer screening performed.Photo/Micheal Rios
Tribal member Mike Murphy having an oral cancer screening performed.
Photo/Micheal Rios

 

To all of the men who attended the Men’s Health Fair, Jennie Fryberg, front desk supervisor for the Tulalip Health clinic, issued the following statement, “Again thanks for all the men that came out today. Thanks for taking care of your health, and thanks for the staff that helped me today and made today a huge success for our men. Thanks again.”

Domestic Violence: You’re Not Fooling Anyone But Yourself

A pile of bedroom doors was building up outside the house.
A pile of bedroom doors was building up outside the house.
Lynn Armitage, Indian Country Today

 

A collection of old bedroom doors began to pile up beside our house. To the neighbors and anyone who walked by, it probably looked like a major home renovation was under way inside. In fact, that’s exactly what I told them.

But if anyone had looked a little closer, they would have noticed an odd similarity about each of those doors: They all had big, splintery holes in them toward the bottom, about the size of a man’s foot.

See, it wasn’t a home renovation after all. Inside my house, behind doors and windows that I would rush to close when the shouting started, a relationship was being ripped off its hinges. One by one, those doors had been kicked in during fits of rage by the man I lived with—and loved. He had a problem controlling his temper sometimes. At least that’s what he told me.

The real problem was that just about anything angered him. Inattentive waiters, surly sales clerks, slow drivers. Anyone who got in his way or didn’t give him due respect incurred his wrath. Especially me and my “controlling nature.”

Even though our relationship was splintering like that real and metaphorical pile of rotting wood outside, we continued to fake it and live up to everyone’s expectations of us as the happy little couple. We threw parties at our new home, invited friends over for barbecues and summer swims. No one really knew what was going on behind our slammed, kicked-in doors. By this time, I had been called a “fucking bitch” and “idiot” so many times that they now felt like endearments.

I had become the Great Pretender.

My sisters knew bits and pieces, but I didn’t tell them everything.  I was too ashamed for them to see that their strong, feisty sister had been reduced to this shadowy nub of a woman. My oldest sister was not fooled.

“Lynn, he’s crushing your spirit,” she would say.

My neighbors were not fooled either. I would later learn that I didn’t need to frantically shut the windows to soundproof his rage because they could hear him screaming loudly and clearly at me anyway.

There are many reasons why domestic violence victims try to hide the abuse from family, neighbors and friends. For me, it was shame and embarrassment that my “man radar” had been so far off. I was the smart sister, so how could I be so stupid?

Vivian Clecak is the co-founder and chief executive officer of Human Options in Orange County, an emergency shelter for battered women and children. She understands all too well why I covered up my abuse.

“Ours is a culture that makes a big deal out of romance—the fancy wedding, the white dress,” she said. “Women are considered responsible for relationships. So when something goes wrong, like abuse, the woman is ashamed and embarrassed. Not only does she blame herself, but society also blames her. Again and again, society asks: ‘What’s wrong with her?’ ‘What did she do to cause it?’ ‘Why did she stay?’ ”

Clecak said there is another dynamic in play, too, about why women pretend everything is perfect at home when it is far from it.

“The couple’s bond is very strong even when there’s abuse,” she said. “He promises it will get better, and maybe it will for four or five months. She desperately wants to believe him because it’s her home and her family.”

If you suspect a friend is being abused, Clecak said, start a conversation.

“Don’t be afraid to ask if you are worried about someone,” she said. “Don’t be afraid to give them the hotline number. People will talk about it when someone cares enough to ask.”

In my case, I’m not sure that would have helped. I wasn’t ready to give up my fantasy of the white picket fence just yet. We still had children to bring into the world.

RELATED

Part 1: Domestic Violence: Every Ending Has a Beginning, and That’s a Good Place to Start Healing

Part 2: Domestic Violence: If the Abuse Is so Bad, Why Do You Stay?

Part 3: Domestic Violence: Women Must Never Forget How Powerful and Sacred They Really Are

Let’s help empower each other by keeping the conversation going about domestic violence. We invite you to share your story of abuse with us on Twitter at #WhyThisNativeStayed and #WhyThisNativeLeft, as part of the campaign started by CNN a few weeks ago, #WhyIStayed and #WhyILeft.

Lynn Armitage is an enrolled member of the Oneida Tribe of Indians of Wisconsin. 

 

Read more at http://indiancountrytodaymedianetwork.com/2014/12/14/domestic-violence-youre-not-fooling-anyone-yourself-158249