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Title: Stone Center Panel

Hon. Melvin L. Watt, U.S. House of Representatives and Chair of the Congressional Black Caucus (CBC) [bio]

Gem Daus, MA (Director of Policy, Asian and Pacific Islander American Health Forum) (website) [bio]

Gary Grant (Executive Director, Concerned Citizens of Tillery [NC]) (website) [bio]

Carole Anne Heart (Executive Director, Aberdeen Area Tribal Chairmen's Health Board) (website) [bio]

Allan Noonan, MD, MPH (Director, Public Health Program, Morgan State University) (website) [bio]

Rosa Pérez Perdomo, M.D.,M.P.H.,Ph.D., Secretary of Health, Commonwealth of Puerto Rico [website] [bio]

Stephanie L. Crayton (Moderator), Media Relations Manager, Office of Public Affairs and Marketing, UNC Health Care [bio]

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Title:It Takes a Whole Indian Village: Decreasing Health Disparities in Indian Country [slides]

Carole Anne Heart [bio]

Abstract:

This presentation offers information about the structure of systems within the Indian Health Service and how the complex interaction with Tribal Governments has created a new prototype for health delivery. Gaps in funding leading to gaps in the delivery of quality health services has been and continues to be a major source of contention for Tribes. The government to government relationship established through the Constitution, Supreme Court Cases, Executive Orders and Congressional Acts creates a unique relationship between the Federal government and Tribal governments that still needs fine tuning.

Exploring why health disparities exist in the American Indian population is the focus of this session and examining strategies that have worked and can work to decrease the health disparities will be delivered. Many of the health issues are deeply rooted in social, behavioral, spiritual and emotional realms that it will take a complex and multi-faceted approach to solve.

One factor that is of utmost importance is for Tribes and tribal communities to tackle this enormous challenge and work to resolve this through participatory action, that is calling each community member, (the entire village) to become involved, take action and work to change the great health disparities faced by their communities.

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Title: Epidemiology of Diabetes: Prevalence, Complications and Health Services Disparities [slides]

Rosa Pérez Perdomo [bio]

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Title: Preventing HIV among Women: Diffusing a Group- and Community- Level HIV Prevention Behavioral Intervention Targeting Women [slides]

Cynthia Prather, Ph.D. [bio]

Winifred King, Ph.D. [bio]

Abstract :

The Centers for Disease Control and Prevention (CDC) coordinates the Diffusion of Effective Behavioral Intervention (DEBI) Project-a national level strategy to diffuse several science based HIV interventions to state and community level HIV programs. The SISTA and RAPP interventions are included in the repertoire of interventions that are nationally diffused. The SISTA intervention is a social-skills training HIV prevention intervention for heterosexually active African American women. It is aimed at reducing HIV sexual risk behavior and is comprised of five 2-hour sessions, delivered by peer facilitators in a community-based setting. The sessions are gender specific and culturally relevant and include behavioral skills practice, group discussions, role playing and homework exercises. This intervention was implemented in an African American community in San Francisco . Participants in the social-skills intervention demonstrated increased consistent condom use and assertive communication skills. In addition, the partners of participants in the social-skills intervention were more likely to adopt and support consistent condom use.

The Real AIDS Prevention Project (RAPP) is a community level intervention that was developed to help women and their partners reduce their risk for HIV infection. The intervention objectives are to increase consistent condom use by women and their partners, to change community norms so that practicing safer sex is seen as the acceptable norm, and to involve as many people in the community as possible. The two phases of the program include community assessment, which involves finding out about the community and how to talk to women and their partners about their risk for HIV infections; and, getting the community involved in a combination of risk reduction activities directed toward women and their partners. In the original study, women living in high risk intervention communities were more likely to have initiated condom use with their steady partners, negotiate condom use with steady and casual partners and consistently use condoms with both steady and casual partners.

Bibliographic Citations :

1. DiClemente, R.J., Wingood, G.M. (1995). A randomized controlled trial of an HIV sexual risk reduction intervention for young African American women. The Journal of the American Medical Association, 274 (16), 1271-1276.
2. Lauby, J.L., Smith, P.J., Stark, M., Person, B., Adams, J. (2000). A community-level prevention intervention for inner city women: Results of the Women and Infants Demonstration Projects. American Journal of Public Health, 90(2), 216-222.

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Title: The Health of U.S. Pacific Islander Populations: Emerging Directions

Sela Panapasa, Ph.D. [bio]

Abstract:

Many federally-sponsored conferences on the health of the Asian and Pacific Islander American population have documented the lack of systematic information on the health of Pacific Islanders and the negative consequences of this deficit on health policy and planning, and ultimately the welfare of Pacific Islanders. Traditionally, government agencies have aggregated Pacific Islanders with Asian populations for statistical reporting purposes. This artificial grouping has created ongoing measurement problems due to the high level of heterogeneity within the Asian Pacific Islander American (API) category. Moreover, the "model minority" myth often erroneously applied to the heterogeneous API population has little or not relevance to the health and SES of Pacific Islanders. Recently, the Federal government's Office of Management (OMB) has established a new racial category, Native Hawaiian and Other Pacific Islander (NHPI) and mandated that federal agencies collect and present data on five racial groups instead of four.

While this mandate offers the potential for significantly expanding our understanding of Pacific Island people, we have yet to see what kind of data will emerge as data reporting practices are modified. This presentation will examine the challenges with measuring the health status of NHPIs and the implications of the OMB decision for future research, health policy and planning.

Bibliographic Citations:

1. Braun, K.L., Yang, H., Onaka, A.T., Horiuchi, B.Y. (1997). "Asian and Pacific Islander mortality differences in Hawaii." Social Biology; 44(3-4):213-227.
2. Chen, M.S. Jr., Hawks, B.L. (1995). "A debunking of the myth of the healthy Asian American and Pacific Islanders." American Journal of Health Promotion ; 9:261-8.
3. Cho, Y., Hummer, R.A. (2001). "Disability Status Differentials across Fifteen Asian and Pacific Islander Groups and the Effect of Nativity and Duration of Residence in the U.S." Social Biology ; 48:171-195.
4. Ghosh, C. (2003). "Healthy People 2010 and Asian American/Pacific Islanders: Defining a Baseline of Information." American Journal of Public Health; 92;2093-2098.
5. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington , DC : US Dept of Health and Human Services; 1991. DHHS publication PHS 91-50212.
6. Hoyert, D.L., Kung, H. (1997). "Asian or Pacific Islander Mortality, Selected States, 1992." Monthly Vital Statistics Report. 46(1).
7. Frisbie, W.P., Cho, Y., Hummer, R.A. (2001). "Immigration and the Health of Asian and Pacific Islander Adults in the United States : a systematic review." JAMA ; 28:3170-3146.
8. Hayward , M.D., Heron, M. (1999). "Racial Inequality in Active Life among Adult Americans." Demography ; 36(1); 77-91.
9. Sirinivasan, S., Gullimero, T. (2000). "Toward Improved Health: Disaggregating Asian American and Native Hawaiian/Pacific Islander Data." American Journal of Public Health ; 90(11):1731-34.
10. Williams, D.R., Collins, C. (1995). "US Socioeconomic and racial difference in health: Patterns and explanations." Annual Review of Sociology ; 21:349-386.
11. Williams, D.R. (1999). "The Monitoring of Racial/Ethnic Status in the USA : Data Quality Issues." Ethnicity & Health ; 4(3):121-137.
12. Yoon, E., Chien, F. (1996). "Asian American and Pacific Islander health: A paradigm for minority health." Journal of American Medical Association ; 275:736-737.
13. Yu, E.S.H., Liu, W.T. (1994). "Methodological issues." In N. Zane , D.T. Takeuci, K. Young (Eds). Confronting critical health issues of Asian and Pacific Islander Americans . Sage Publications, Thousand Oaks , CA ; 22-50.

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Title: False Promises and True Disparities: Why Healthy People 2010 Will Fail [slides]

H. Jack Geiger, M.D., M.Sci.Hyg., Sc.D. (hon.) [bio]