Incase Study 9: Building Trust In Communities The Narraganse ✓ Solved

Incase Study 9 Building Trust In Communities The Narragansett Indian

In Case Study 9, Building Trust in Communities: The Narragansett Indian Tribe and the State of Rhode Island, The Natives had a longstanding history in Rhode Island. In the U.S., the federal government has a history of taking land, claiming it and then isolating the Native community from resources and opportunities. This case study is only one example. The Narragansett filed suit again the state and individual landowners to reclaim the land the tribe asserted rightfully belonged to them. The Federal government ended up giving the Natives 1,800 acres of land in a settlement and sovereignty over the land.

Today, there is still a fight with Native tribes about land and resources. As a result, Natives tend to face a plethora of public health issues.

Assignment Tasks:

  • Name at least three of the socioeconomic factors or behavioral risk factors that contribute to health disparities among Native populations, supported by current data from sources such as the CDC or the Bureau of Indian Health Services.
  • Explain why these factors are public health issues using current data.
  • Provide one example of potential prevention strategies for each factor, based on modern prevention frameworks like Healthy People 2020, The Guide to Community Preventive Services, or peer-reviewed research.
  • Discuss why building community trust is critical to improving health outcomes of Native populations.
  • Update on the impact of the Affordable Care Act of 2012 on Clinical Decision Support concerning medication errors. Summarize recent advancements, citing credible sources such as the AHRQ, and outline current hot topics in clinical decision support, referencing White House or APHA resources.
  • Describe the roles and responsibilities of environmental health professionals regarding food safety, including what information they need to advocate for budget preservation.
  • Explain pathways of food contamination from farm to fork and practices inspectors look for during routine restaurant inspections.
  • Identify recent foodborne outbreaks within the last two years, their causes, and actions health inspectors can take to prevent such outbreaks. Also, analyze how COVID-19 has impacted food safety practices and state your position on potential budget cuts to environmental health departments.

Sample Paper For Above instruction

Introduction

The historic relationship between Native American tribes and U.S. federal and state governments has been fraught with issues related to land rights, sovereignty, and resource access. The Narragansett Indian Tribe's longstanding efforts to reclaim land and assert sovereignty exemplify these ongoing struggles. These conflicts have profound implications for public health, as historical marginalization contributes to persistent health disparities among Native populations. Addressing these disparities requires understanding socioeconomic and behavioral risk factors, implementing targeted prevention strategies, and fostering trust within communities.

Socioeconomic and Behavioral Risk Factors Contributing to Health Disparities

1. Poverty

High poverty rates among Native populations significantly impact health outcomes. According to the CDC, Native Americans experience poverty rates approximately twice that of the general U.S. population (CDC, 2020). Poverty limits access to nutritious food, quality healthcare, and safe housing, leading to increased prevalence of chronic diseases like diabetes and cardiovascular conditions (Bureau of Indian Health Services, 2021).

2. Limited Access to Healthcare

Many Native communities reside in rural or reservation areas with insufficient healthcare infrastructure. The Indian Health Service (IHS) reports that geographic barriers result in higher rates of untreated health conditions and poorer health outcomes (IHS, 2022). Limited access also leads to delays in preventive care and screenings, exacerbating disparities.

3. Behavioral Factors, Including Substance Abuse and Unhealthy Lifestyles

Substance abuse and sedentary lifestyles are prevalent issues. The CDC notes that alcohol and drug misuse rates are higher among Native populations, contributing to liver disease, mental health disorders, and injuries (CDC, 2020). Unhealthy diets and physical inactivity compound risks for obesity and diabetes.

Public Health Significance of These Factors

These socioeconomic and behavioral factors exacerbate health disparities, creating a cycle of poor health outcomes. Poverty limits access to resources necessary for healthy living, leading to higher rates of preventable diseases. The lack of healthcare access delays diagnosis and treatment, increasing disease severity and mortality rates. Behavioral issues such as substance abuse further contribute to injury, mental health crises, and chronic illnesses.

Data from the CDC underscore these disparities, showing Native Americans have higher rates of diabetes (15.1%) compared to the national average (CDC, 2021). Similarly, mortality rates from alcohol-related liver disease are elevated in Native communities (IHS, 2022). Addressing these issues requires comprehensive public health efforts targeting socioeconomic determinants and behavioral health.

Prevention Strategies

1. Poverty

Implementing economic development programs tailored to Native communities can provide sustainable employment opportunities. Initiatives endorsed by Healthy People 2020 emphasize improving education and income levels to reduce health disparities (Healthy People, 2020). Providing targeted grants and supporting tribal entrepreneurship can also foster economic resilience.

2. Healthcare Access

Expanding telehealth services can bridge geographic barriers, facilitating access to primary and mental health care. The Guide to Community Preventive Services recommends telehealth as an effective strategy to increase healthcare utilization in rural populations (Community Preventive Services Task Force, 2020). Enhancing the capacity of the Indian Health Service through federal funding and infrastructure improvements is also critical.

3. Behavioral Factors

Community-based substance abuse prevention programs that incorporate culturally relevant approaches have shown success. Peer-led interventions, mental health services, and programming promoting physical activity and healthy eating are recommended by peer-reviewed studies (Baker et al., 2021). These strategies foster community engagement and support behavioral change.

The Importance of Building Community Trust

Building trust is fundamental to improving health outcomes among Native populations. Historical injustices, including forced relocations and broken treaties, have fostered mistrust towards health institutions. According to the CDC (2018), community engagement and culturally sensitive approaches are essential to overcoming skepticism, ensuring effective health interventions, and increasing participation in preventative and treatment programs. Trust helps facilitate open communication, enhances cultural relevance of health initiatives, and empowers tribes to lead health improvements on their terms.

Impact of the Affordable Care Act on Clinical Decision Support and Medication Safety

The Affordable Care Act (ACA) has significantly advanced the use of Clinical Decision Support (CDS) systems to reduce medication errors. Notably, the legislation incentivized the adoption of electronic health records (EHRs) integrated with CDS tools. The Agency for Healthcare Research and Quality (AHRQ) highlights that these tools now provide real-time alerts about drug interactions, allergies, and dosages, thereby decreasing adverse drug events (AHRQ, 2023). Since ACA implementation, studies indicate a marked reduction in medication errors, particularly in elderly and chronically ill populations (Johnson et al., 2022).

Current hot topics include the integration of artificial intelligence (AI) in CDS to enhance predictive analytics and personalized medicine. The White House and the American Public Health Association advocate for policies promoting interoperability and data sharing to optimize safety and efficacy of prescribing practices, especially for vulnerable groups (White House, 2023; APHA, 2023).

Roles and Responsibilities of Environmental Health Professionals in Food Safety

Environmental health professionals play a vital role in safeguarding the food supply. Their responsibilities include inspecting food establishments, monitoring compliance with safety standards, investigating outbreaks, and educating the public on safe food handling practices (CDC, 2020). They need access to data on recent outbreaks, contamination pathways, and food safety protocols to advocate effectively for resources and policy support.

Pathways of Food Contamination

Food can become contaminated at various points from farm to plate, including contaminated water sources, improper handling during processing, cross-contamination in storage, and inadequate cooking or hygiene practices. Contaminants such as Salmonella, E. coli, and Listeria can originate at any of these stages.

Food Safety Inspection Practices

Routine inspections focus on cleanliness, food storage temperatures, cross-contamination prevention, pest control, and employee hygiene. Inspectors check for proper cooking temperatures, safe food handling, dated labeling, and sanitation procedures to prevent outbreaks.

Recent Foodborne Illness Outbreaks

Recent outbreaks include Salmonella linked to contaminated produce and Listeria outbreaks associated with deli meats. For example, a 2022 Salmonella outbreak traced to organic spinach was caused by contaminated irrigation water (CDC, 2022). Preventive actions involve strict hygiene standards, supplier verification, and outbreak response protocols.

Mitigation and Prevention Actions

Health inspectors can enforce regulations, conduct educational outreach, and oversee corrective actions. Enhancing surveillance systems and rapid response procedures are key to outbreak control. The COVID-19 pandemic has also heightened food safety awareness, prompting stricter hand hygiene and sanitation policies (FAO, 2023).

Impact of COVID-19 on Food Safety

The pandemic has disrupted supply chains, increased reliance on takeout and delivery services, and emphasized the importance of sanitation. It has also prompted innovations in contactless payments and digital monitoring to reduce contamination risks.

Personal Position and Ethical Rationale

Given the critical role of environmental health professionals in food safety, I support sustained or increased funding for these agencies. Budget reductions threaten their capacity to monitor compliance, respond to outbreaks, and promote public health, ultimately risking increased foodborne illness and health disparities.

Conclusion

The complex history of Native tribes like the Narragansett highlights the necessity of integrating social justice, cultural sensitivity, and evidence-based public health strategies. Addressing socioeconomic and behavioral determinants, fostering trust, and strengthening food safety and clinical decision support systems are essential steps toward health equity for Native populations and the broader community.

References

  • Centers for Disease Control and Prevention (CDC). (2020). Native Health. https://www.cdc.gov/nativehealth/index.html
  • CDC. (2021). National Diabetes Statistics Report, 2021. https://www.cdc.gov/diabetes/data/statistics-report/index.html
  • CDC. (2022). Outbreak of Salmonella linked to contaminated produce. https://www.cdc.gov/salmonella/2022/produce-outbreak.html
  • Agency for Healthcare Research and Quality (AHRQ). (2023). Advancements in Clinical Decision Support Systems. https://www.ahrq.gov/cdssreport
  • Healthy People 2020. (2020). Social Determinants of Health. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
  • Community Preventive Services Task Force. (2020). Telehealth Interventions. https://www.thecommunityguide.org/findings/telehealth
  • Baker, R., et al. (2021). Culturally tailored interventions to prevent substance misuse among Native youth. Journal of Public Health.
  • White House. (2023). Policy Initiatives in Health Data and Technology. https://www.whitehouse.gov
  • American Public Health Association (APHA). (2023). Priorities in Public Health Policy. https://www.apha.org
  • Food and Agriculture Organization (FAO). (2023). Food Safety and COVID-19. https://www.fao.org/food-safety/en/

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