Montana health leaders did not need a report card to tell them they have areas that need improvement.
They were already mindful of their shortcomings and were striving to make corrections, specifically in the area of health disparities and explicitly with American Indians, who represent 7 percent of the state's population.
When America's Health Rankings were released in December, Montana was found to have “challenges” with disparities in health. In Montana, obesity is more prevalent among American Indians at 42 percent than whites at 22.5 percent. The prevalence of diabetes also varies by race and ethnicity in the state; 14.4 percent of American Indians have diabetes, compared to 6.1 percent of whites, according to the report.
America's Health Rankings aim to spur action to improve the health of Americans.
Gov. Brian Schweitzer and the Department of Public Health and Human Services were provoked into action, actually further into action.
Long before the rankings came out, DPHHS formed an internal tribal working group to focus on how the department's programs, services and funding opportunities are being communicated to tribal governments and their health departments.
The tribal group is only one piece of a broader effort the state is making to bridge the gap of health disparities.
Myriad programs complement the work of the tribal work group, including Medicaid staff providing outreach to tribal communities; Healthy Montana Kids, a Medicaid program for children; and other programs and services.
Tom Eckstein, whose St. Paul-based Arundel Street Consulting has designed and published America's Health Rankings for the past 17 years, said DPHHS is doing the right thing.
“The proven way to bring up the average score and most cost-effective is to focus on disparities,” Eckstein said.
Montana is ranked 25th this year, after being 26th in 2009 and in 2008. Montana was at its healthiest in 1990, when it was ranked 12th.
DPHHS offers numerous health services and medical programs, but some may not be readily accessible to American Indians on the state's seven reservations.
Programs such as the Special Supplemental Nutrition Program for Women, Infants and Children, better known as WIC, and Temporary Assistance for Needy Families, may not be easily understood.
“Are we culturally responsive?” said DPHHS Director Anna Whiting Sorrell, an enrolled member of the Confederated Salish and Kootenai Tribes.
The tribal working group continues to develop, policies, procedures and information for staff to work with the disparate tribes. The goal is to reach out and capture a specific population that is a “major consumer” of the department's programs and services, Sorrell said.
“The high rates of unemployment, poverty, access to housing and substance abuse on our reservations create social factors that make it difficult for this population to focus on their health,” Sorrell said.
DPHHS is working with tribal governments to reach the populations that might need other resources such as housing programs, energy assistance and food banks. The aim is to help tribal governments and individuals better take advantage of the programs the department offers.
“If these needs are met, then one is better able to focus on their health and prevention of further health care needs,” Sorrell said. “The department recognizes this population has many disparities but we can alleviate some of them by making sure tribes are aware of all of our programs and services to provide comprehensive wrap-around services and help individuals focus on their health.”
Contact Cindy Uken at firstname.lastname@example.org or 657-1287.