Childhood Obesity in the Cherokee Nation

1
Childhood Obesity in the Cherokee Nation
Health Services HEALTHY NATION

• CDR David Gahn, MD, FACOG
• Cherokee Nation
• Surveillance Programs

2
Cherokee Nation Public Health

• Working towards PHAB accreditation
• Self-determination

3
(No Transcript)
4
Factors that Affect Health
Eat healthy, be physically active Patient
education
Counseling Education
Rx for high blood pressure, high cholesterol,
diabetes
Clinical Interventions
Immunizations, brief intervention, cessation
treatment, colonoscopy
Long-lasting Protective Interventions
Changing the Context to make individuals default
decisions healthy
Fluoridation, 0g trans fat, iodization,
smoke-free laws, tobacco tax
Socioeconomic Factors
Poverty, education, housing, inequality
5
Data Collection Goals

• Quantify the problem for Cherokee Nation
• Native American ? Cherokee
• Find the disparities within Cherokee Nation

6
Cherokee Nation Health
7
CHEROKEE NATION Tribal Jurisdictional Service
Area (TJSA)
Nowata Health Center
Vinita Health Clinic
Bartlesville Health Clinic
Sam Hider Jay Community Clinic
Claremore Indian Hospital
A-Mo Salina Health Center
Hastings Indian Medical Center
Legend
Wilma P. Mankiller Health Center
Cherokee Nation Clinic IHS Hospital Main Complex
Three Rivers Health Center
Redbird Smith Health Center
8
Childhood Obesity in the US
9
How do we measure obesity?

• Obesity excess body adiposity
• BMI screening tool that indicates excess weight
  for height
• Children BMI percentile
• 85th percentile overweight
• 95th percentile obese
• 99th percentile extremely obese

10
Prevalence of obesity among US children and
adolescents by age, 1971-2008
Source CDC/NCHS NHANES I,II,III, and 1999-2008
11
Prevalence of overweight and obesity, 6-19
years, 1999-2008
Overweight Obese Severe obesity
Source Ogden, JAMA, 2010
12
Methods

• 16,530 children age 2-19
• Cherokee Nation beneficiaries
• Data from RPMS
• Compared to national data from CDC

13
Results
14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
Teenage Pregnancy and Obesity
18
Intervention What does the evidence say?

• CDC Guidelines
• Institute of Medicine Prevention
• Government
• Industry
• Communities
• Schools
• Homes

19
Bottom Line All levels of the environment
20
Fighting the Winnable Battle

• Childhood Obesity Task Force
• Group of local experts
• Informed policy recommendations
• Communication
• Technical support
• Evaluation and monitoring
• Joining Public Health and Clinical Services

21
(No Transcript)
22
Chiefs School Health Leadership Grant Program

• 42 Schools
• 10K Each
• Fitnessgram

23
School Health Index

• Informs schools of areas for improvement
• Policies
• Lunch
• Recess
• Soda machines

24
Built Environment

• Parks
• Sidewalks
• Safe routes to school

25
Clinical

• Persistent message
• Childhood Obesity Toolkit
• AAP
• Adaptable, culturally appropriate

26
Surveillance

• How do we measure progress
• Clinical data
• School data (government mandated?)
• NHANES
• BRFSS
• WIC

27
THANKS!