Despite decades of hard work by tribal and Indian Health Service (IHS) programs, in the year 2003 large disparities remain in the health status of American Indian and Alaska Native people compared to other population groups in the U.S. Simply stated, this means that in many ways Indian people bear a disproportionate burden of disease, disability, suffering, and death. Eliminating these health disparities will require a long and complicated journey for Indian people, Indian communities, and those who provide health services to them. To help us make this journey, we need a map that is straightforward and clear both to Indian communities and their health service providers. This map should contain milestones so that we can measure the progress we have made in raising health status, and the distance yet to be traveled.
Measuring health status can be a complicated and bewildering task. The best known system of measuring health in the U.S. is Healthy People 2010, which contains a total of 467 separate indicators of the health of the country. It would be impossible for Indian communities to use this entire document as their guide for improving health. However, a small subset of health indicators, called Primary Prevention Focus Areas, can serve as the roadmap Indian communities need for assessing current health status, designing and implementing programs to improve health, and evaluating the effectiveness of these programs. These focus areas can be used as "building blocks for community health initiatives".
The Primary Prevention Focus Areas have been carefully selected on the basis of the following general criteria:
- They are relevant and important to all communities.
- For each focus area there is a known preventive health activity that can be implemented by individuals and communities.
- Each focus area represents an aspect of health that can be accurately measured, and thus the results of efforts to improve health can be evaluated for effectiveness.
The IHS Director's Prevention Initiative is currently working with tribes, tribal organizations, IHS staff, and health consultants to develop a systematic and comprehensive way to focus prevention activities on these areas. The various sections listed below will provide Indian communities and health care programs with many of the tools they need to move ahead. In addition, the Prevention Initiative is working to mold the below Focus Areas into a useful and usable set of guidelines tailored specifically to help Indian communities (a) assess their current health status, and (b) monitor health status over time as prevention programs are implemented. Once the guidelines are completed, the Prevention Initiative plans to develop the capacity to assist Indian communities in utilizing this Indian-specific set of Focus Areas.
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