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Eastern Shoshone Tribe receives diabetes care and management grant

WASHINGTON – The Merck Company Foundation has begun funding a tribal effort to reduce diabetes and to address problems associated with it.

The foundation has agreed to provide a portion of $15 million to the Eastern Shoshone Tribe and its collaborating health partners in Fort Washakie, Wyo. to improve access to diabetes care and management among Wind River Indian Reservation residents and members of the Northern Arapaho Tribe. The remaining portion of the funds will go to supporting four other minority communities battling diabetes throughout the nation.

The funding comes at a time when approximately 12 percent of adults on the Wind River Reservation have been diagnosed with diabetes. Diabetes has been reported as the fourth leading cause of death among American Indians living on reservations in Montana and Wyoming.

The tribal funding is part of Merck’s recent launch of a program called the Alliance to Reduce Disparities in Diabetes. The Merck foundation is the philanthropic arm of the larger pharmaceutical company.

The overall alliance is intended to improve health care delivery among populations most at risk for diabetes, including African-American, Hispanic and Native American adults.

Enid Johnson, a spokeswoman for the alliance, said the specific goals of the tribal program are to increase the proportion of American Indians with diabetes or pre-diabetes who are successful in managing their condition; increase the skills of health care providers to enable them to work effectively to assist patients in managing their diabetes; and to strengthen the health system and community support system to serve people with diabetes.

“A lot of this is about communication,” Johnson said. “The tribal grantee plans to be more aggressive in its outreach to the individuals it is targeting. Education and self-management are big components of this program.”

Johnson said the Eastern Shoshone Tribe was selected for the grant based on its response to a request for proposal and the needs of its population.

She noted that Center for Disease Control research indicates that nearly 24 million Americans are currently living with diabetes. American Indian youth aged 10 – 19 are more likely than any other group to be diagnosed with Type 2 diabetes, and Natives are disproportionately more likely to die from diabetes-related causes than other Americans, according to the U.S. Commission on Civil Rights.

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Indians not only have the highest rates of diabetes, but evidence suggests that these minority groups are also less likely to be insured or have adequate access to local health resources.

“We are aware of the challenges diverse and economically disadvantaged communities face in ensuring effective prevention and management of diabetes,” said Garth Graham, secretary for minority health at the U.S. Department of Health and Human Services,” upon the launch of the alliance Feb. 25.

“Together, we can take the steps necessary to make a difference in racially and ethnically diverse communities that are most burdened by this deadly disease.”

The Eastern Shoshone tribal partners are expected to receive funding over the next five years, while implementing comprehensive diabetes programs that offer interventions for patients, clinicians and health care delivery systems.

Along those lines, the tribe is working to establish a strong working group comprised of tribal leaders, tribal health directors, tribal diabetes program managers, lay health educator managers and IHS diabetes providers and staff.

The tribe plans to hold several workshops on tribal culture, traditions, health beliefs and attitudes, patient-provider communication and health literacy issues for IHS and other providers who work with tribal members with diabetes.

Health leaders are also recruiting tribal members with diabetes or diagnosed with pre-diabetes to participate in diabetes self-management education classes that will be offered on an ongoing basis.

At the national level, the alliance plans to disseminate information and undertake collaborative projects aimed at strengthening the efforts of organizations across the country, while enlarging the network of partners who share the alliance’s goals.

The Center for Managing Chronic Disease at the University of Michigan is serving as the national program office coordinating the efforts. Its leaders hope to use lessons learned from the Eastern Shoshone project to help tribes nationwide.

“Evidence-based work at the local level and vigorous support at the national level could dramatically change the picture of diabetes disparities in this country,” said Noreen Clark, director of the Center for Managing Chronic Disease and national program office director.