Are there any similar health issues on Indian reservations and in rural areas or are they different?
The same problems facing AI/ANs are the same problems confronting rural America, except the percentage of the population affected on reservations is greater because poverty is greater and there are fewer resources available. For instance, the diabetic epidemic obviously hit AI/AN before anybody else, but now it’s all over, the obesity epidemic got AI/AN first, and now it’s all over. It’s not that the problems are different, it’s just that they may be magnified. I also think it’s because we have a health technology system that allows us to track the data and looks at the outcomes that enables us to do the reporting. In some ways, what we have that rural communities don’t have is an integrated health system—50 percent of it is run by tribes–but there is an integrated presence that lets people learn from each other, and share successes and new models of delivery that are effective. And it lets us track a population with multiple morbidities. The health IT system is the enabler because it
