The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70028

Ane Marie McDonald, PhD, Interface Assistance, 2160 Sandcastle Way, Sacramento, CA 95833, 916/359-1122, amcd@winfirst.com

BACKGROUND: The health care system used by American Indians differs considerably from that used by other demographic groups in the United States. This study attempts to determine how these differences, and others, impact the understanding and treatment of diabetes experienced by members of two California tribes, the Morongo and Torres-Martinez Bands. Both are Cahuilla tribes, and members of the Riverside-San Bernardino County Indian Health Program. METHODS: Ethnographic research was conducted among members of the local communities, tribal members diagnosed with diabetes, political and spiritual leaders, and health care providers. Qualitative methods included observations, surveys, and interviews, and aimed to understand how the physical and cultural environments facilitate and retard the development of diabetes, how patients experience diabetes, and the factors that influence providers’ diagnosis and treatment decisions. FINDINGS: Each tribe owns and operates its own health clinic, which is open only to members of its respective tribe, and share a number of health programs with another ten tribes in the local area. One of these programs provides diabetes education, diagnosis and treatment. The clinics are financed by the federal Indian Health Service (as partial payment for the abrogation of treaty rights) and by the tribes themselves. This case study will present and discuss research findings, including: 1) the significant differences between the experience of diabetes between tribal members and non-Indians living in the two counties; and 2) how the divergent economic and social conditions of these two desert tribes impact the experiences of diabetes prevention, management and treatment.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to:
• 3. Understand the key differences between the mainstream health care system and the health care available to American Indians.
  6. Identify some effects of these differences on diabetes incidence and treatment.
  9. Identify the impact of social and economic conditions on the experience of diabetes.

Keywords: Diabetes, Ethnic Identity

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Riverside-San Bernardino County Indian Health, Inc.
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am an evaluator of The California Endowment's Diabetes Initiative