For Immediate Release
Contact: Media Relations, (202) 777-2509

New APHA Book Examines Cross-Cultural Health Care Needs

Strategies for Cultural Competency in Indian Health Care

Authors: Mim Dixon, Ph.D., and Pamela E. Iron

Washington, D.C., September 6, 2006 –American Indians and Alaska Natives face some of the nation’s greatest health disparities related to the treatment of medical conditions such as diabetes, infant mortality, HIV/AIDS, substance abuse and mental health. Yet many health providers lack the understanding of the history and culture necessary to effectively communicate with their American Indian and Alaska Native patients.

Real world, practical models to address the cross-cultural health care needs of American Indians and Alaska Natives are explored in Strategies for Cultural Competency in Indian Health Care, newly published by the American Public Health Association (APHA). The book’s authors, Mim Dixon, Ph.D., and Pamela E. Iron, offer key perspectives and insights on how culturally competent care programs may be replicated in settings across the nation.

The book highlights six programs in California, Oklahoma, Alaska, Michigan and Washington that overcame obstacles to effectively educate health care providers about the culture and history of the patients they serve. There are more than 560 federally recognized tribes in the United States and more than 2.5 million Americans are members of these tribes, including 1.5 million who are able to use health care facilities and services funded through the Indian Health Service (IHS). Nationally, however, only about a third of tribes and about half of urban Indian clinics have programs to teach health care providers about their history and culture.

Dixon has worked with tribes as a health care administrator, policy analyst, researcher and facilitator. She previously served as executive director of the Division of Health Services for the Cherokee Nation and was health center director for Chief Andrew Isaac Health Center, a tribally operated ambulatory care clinic that serves 12,000 Alaska Native people in Fairbanks and 35 villages in interior Alaska. Pamela E. Iron is the executive director of the National Indian Women’s Health Resource Center (NIWHRC) and founded the Tulsa Indian Health Care Resource Center in 1976. She served as the health director and chief of staff for the Cherokee Nation from 1989 to 1995.

“Health care providers are often confused and demoralized by their inability to change behaviors such as alcoholism and other drug abuse, domestic violence, suicide and poor nutrition,” Mims and Iron wrote. “They are often unaware of past federal policies of genocide, separating families, destroying cultures, abuse of children placed in boarding schools and other practices that have had devastating consequences. In the remote locations of reservations and other types of tribal communities, providers often feel isolated, ineffective and discouraged.”

Strategies for Cultural Competency in Indian Health Care contains information that appeals to a broad audience, including tribal health care administrators, health care professionals who work with American Indian and Alaska Natives, architects interested in designing health care facilities for the Indian Health Service and tribal health entities and academics working to include cultural competency in curriculums for health care providers.

“This book offers great insights into how challenging it can be for health care providers to truly understand their patients and the historic, social, cultural, spiritual and other contexts their patients bring to the health care encounter,” wrote David Satcher, MD, PhD, former U.S. surgeon general and director of the Center of Excellence on Health Disparities at the Morehouse School of Medicine, in the book’s foreword.

“[The book] offers great hope about how tribes, tribal councils, tribal leaders, and health care providers have worked together so that providers can be more culturally competent and apply and integrate that knowledge about culture in the way that they provide health care and services,” Satcher wrote.

A free 31-minute DVD film, “Creating Space for Culture and History in Indian Health Care,” accompanies the book and offers compelling narrative with visual images and interviews at each of the six sites that have developed successful training programs for health care professionals.

Ordering Information: Published by American Public Health Association, 2006, ISBN: 0-87553-070-2, 155 pages, cost is $26.95 ($18.85 for APHA members), plus shipping and handling. To order, call toll free (888) 320-APHA; fax (888) 361-APHA; e-mail or visit APHA’s Web site:

Please send your request for a review copy on letterhead to APHA Publications Marketing, 800 I Street, NW, Washington, D.C. 20001-3710, or fax to (202) 777-2531.

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