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One Sky Center/OHSU. The Value of AI/AN Public Health Curriculum: Challenges and Future Direction. Larry Murillo, DrPH, MPH, MS Assistant Professor School of Medicine Oregon Health and Science University. One Sky Center/OHSU. Vision Statement. - PowerPoint PPT Presentation
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The Value of AI/AN Public Health Curriculum:
Challenges and Future DirectionLarry Murillo, DrPH, MPH, MS
Assistant ProfessorSchool of Medicine
Oregon Health and Science University
One Sky Center/OHSU
Vision Statement Develop AI/AN specific Public Health
Curriculum to encourage community health resource development and access to THP. The long-term result will be stronger communities based on cultural values that promote a broader understanding of health.
One Sky Center/OHSU
Increase Access to THP
Undergraduate and Graduate Curriculum
Educate community of THP Use Describe current trend of traditional
health practice use in AI clinics and health programs.
Describe THP epistemology used in health care setting
One Sky Center/OHSU
Today’s situation: Why is THP and public health so important? Educators see health as
vital issue Culture lends context to
health Medical system is failing
to improve health Healthcare costs are
skyrocketing Increased use of
cultural health beliefs and practices
One Sky Center/OHSU
How Did We Get Here?
American Indian Religious Freedom Act
THP is hidden part of community AI/AN Professionals develop THP
health models. Clinics now openly use THP. Health concerns – huge disparity
One Sky Center/OHSU
Different/Complementary/Alternative
Pluralistic System of Care* Medical, Alternative, THP
Patients use both medical and THP services simultaneously. 70% in urban populations**
Biomedicine addresses physical symptoms while THP addresses circumstances from which those symptoms arise.*
Different forms of care are seen as complementary and not in conflict.***
• Gurley, D. et. Al. (2001)• **Buchwald, Beals and Manson (2000)• ***Csorda and Garrity, (1994)
One Sky Center/OHSU
What Might AI/AN PH Curriculum Look Like?
Balance of three perspectives Professional Community
Group and individual Traditional Health Practitioners Circle
One Sky Center/OHSU
AI/AN Public Health Issues Course
Does THP Work? Role of Medicine
Person Science vs Cultural
Med Medical limits Race, Religion and
Medical Model PubHlth Research CA Culture Trends
Urban vs. Rural Health IHS and PL 94-638 Cultural Community
Based Health Models US Policy and AI Health Land Based Religion
and Environmental Health
Cultural Models of Health
One Sky Center/OHSU
Challenges of THP Education Medical Model is dominant Average AI person is THP “expert”
Tension of being “out of loop” THP stigma
Savage, Paganistic, Unscientific, Family remedy
Privacy/public sharing issue
One Sky Center/OHSU
Levels of THP Practice
Common family knowledge Practitioners and protocol Spiritual Level
One Sky Center/OHSU
Clinic THP Perception
Administration – Political Issue Medical – Alternative Medicine Issue Health Education
Prevention message Community Intervention
Mental Health – Intervention Issue
One Sky Center/OHSU
Question
Have you ever been frustrated with college curriculum?
Did “multicultural” classes seem inadequate and too broad?
Have you ever taken a class specific to AI/AN that was not in the ethnic studies department?
One Sky Center/OHSU
Research Strategy
Describe present use of THP in clinics Develop ideas from epistemology of
current programs. Encourage community participation in
defining and broadening THP programs Create evaluation models of “Ideal”
THP program
One Sky Center/OHSU
Current Funding
Develop epistemology Interview Longstanding THP
Development Leaders Community Participation – Phil Lane, Jr. Cultural Competency – Terry Cross Wellness conferences – Billy Rogers Historical Trauma – Maria Yellow Horse
Brave Heart Red Road Alcohol Treatment – Gene Thin Elk Post-Colonial Psychology – Ed Duran
One Sky Center/OHSU
Closing Thoughts
How long before we “define” our own health
Use our own beliefs and ideas Acknowledge professionals and
medicine people Support existing ceremonies Interpret our lives and learn from
disease