Grantee Helps Build American Indian Health Research through Trans-Disciplinary Collaboration
NIMHD welcomed Clinical Psychologist Dr. Amy Elliott last month to present a line of research to build American Indian health studies through transdisciplinary collaboration. Elliott explained the evolution of the Collaborative Research Center for American Indian Health (CRCAIH) program, an NIMHD-funded research grant, and how it helps tribal communities and health researchers collaborate on studies that focus on improving the social determinants of health of AIs in South Dakota, North Dakota, and Minnesota.
“There are three components that drive our work,” said Elliott. This is the main take away I want you to have from this presentation. We work to marry three components in all projects: good science, community engagement, and constant respect for tribal sovereignty.”
Dr. Elliott’s work began in the Northern Plains with the Safe Passage Study, a research grant funded by NICHD. The large prospective study intended to investigate the relationship between prenatal alcohol exposure and adverse outcomes, such as stillbirth and Sudden Infant Death Syndrome. The foundation for this work began in the early 90’s with the Aberdeen Area Infant Mortality Study, which was driven by a tribal request to investigate why the American Indian/Alaska Native (AI/AN) infant mortality rate was so much higher than other races in the same region. Unfortunately, this higher infant mortality rate persists today.
“Studies like the Aberdeen Area Infant Mortality Study and subsequently the Safe Passage Study planted the seeds for tribally-driven collaborative research,” Elliott said. “These studies included many discussions on relating the latest scientific knowledge with the questions that are most relevant in the involved tribal communities. These included many tough discussions involving data sharing, genetics studies, tissue collection to name just a few topics.”
To seek answers to the tough questions, CRCAIH was developed to fund cutting-edge transdisciplinary research that will address the significant health disparities experienced by AIs in South Dakota, North Dakota and Minnesota. According to CRCAIH, racial and ethnic minorities in the U.S. continue to have higher rates of disease and early death than the rest of the nation. The AI/AN population is one of the smallest U.S. racial and ethnic minority group. In spite of its small size, the AI/AN group has the highest health risk factors of any racial minority, the highest percentage of chronic disease of any racial minority, a life expectancy lower than that of the general U.S. population, a cancer mortality rate 40 percent higher than that of the general U.S. population, and a cardiovascular disease rate 100 percent higher than that of the general U.S. population.
Poverty, low levels of education, low socio-economic status, crime, and greater exposure to environmental hazards all contribute to the health crisis of the AI/AN population. In addition, there are regional health differences between American Indian populations. All CRCAIH projects embrace a “social determinants of health” theme leading to the improvement of American Indian health.
CRCAIH has four goals:
- Help tribes and health researchers build the strong relationships needed to plan and carry out research on regional American Indian health issues.
- Mentor tribes in all aspects of research, and provide technical assistance, so that the tribes can develop and conduct future research and lead their own health research agendas.
- Support three innovative research projects that address identified regional American Indian health issues.
- Support and monitor a pilot grant program to fund research in line with CRCAIH goals. Currently, CRCAIH has supported 10 pilot research projects.
As part of the grant, CRCAIH is required to conduct three innovative research projects that are likely to yield helpful information and result in sustainable health improvements. These three projects are currently being conducted: “Emergency Department Use and Care in American Indian Children,” “Culturally Targeted Education on Living Kidney Donation,” and “Factors Influencing Pediatric Asthma.” CRCAIH also offers pilot grants and other resources and training in the areas of research culture and bioethics, regulation, and methodology.
All CRCAIH research projects are transdisciplinary, using the involvement of many disciplines and perspectives to create new practices and problem-solving methods. CRCAIH project experts include tribal health administrators, spiritual leaders, academic health researchers in a wide variety of disciplines, and health care providers in a wide variety of disciplines.
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