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Honoring the Gift of Heart Health

Cardiovascular disease (CVD) has become the leading cause of death for American Indians and Alaska Natives (AI/AN). More AI/AN over 45 years die of heart disease than any other disease. Studies among numerous individual tribes have shown that rates of heart disease have dramatically increased over the past two to three decades. Incidence data clearly show that coronary heart disease (CHD) rates in American Indians now exceed rates in other U.S. populations and the CHD may more often be fatal in American Indians than in other groups1. In fact, recent studies indicate that incorrect CVD death rates have been reported previously due to racial misclassification of AI/AN and shows that the CVD death rates are not only substantially higher than the general population but continue to increase2,3. The alarming rise in incidence, mortality and morbidity rates is likely to continue unless effective prevention and treatment strategies are implemented. The 2003 and updated 2004 National Healthcare Disparities Reports4 confirm that health disparities related to race, ethnicity, and socioeconomic status permeate the American health care system and that improvements are possible.

In response to the rising rates of mortality and morbidity of CVD and CHD, the National Heart, Lung, and Blood Institute (NHLBI) is involved in community outreach and education activities to address the Healthy People 2010 (HP 2010) national health agenda. The two overarching goals of HP 2010 are to: (1) increase quality and years of healthy life of all Americans and (2) eliminate disparities in health. The NHLBI has also partnered with the Indian Health Service (IHS) to focus expertise and resources on the prevention of CVD in AI/AN communities.

The NHLBI, in collaboration with the IHS and Tribal communities, has developed a cardiovascular heart health initiative called Honoring the Gift of Heart Health (formerly known as Strengthening the Heartbeat of AI/AN Communities). The primary purpose of the initiative is geared toward providing science-based cardiovascular health (CVH) tools and training for Tribal communities and also providing consistent "standard" CVH information to AI/AN lay audiences.

One such tool is the Honoring the Gift of Heart Health curriculum manual, a comprehensive culturally appropriate, user friendly 10 session course on heart health education for American Indians and Alaska Native communities. The manual provides everything needed to conduct a 10-session educational program on heart health in American Indian and Alaska Native communities. It is an attractive, easy-to-use, illustrated, leader's guide with skills building activities and step by step help in planning and carrying out each session. The manual follows a Native family's journey to heart health and includes fun, hands-on activities, and heart healthy recipes.

The manual also contains printed masters for more than 72 pages of culturally appropriate handouts that can be reproduced and given to American Indian patients. Cover, spine, and 3-hole punched text is ready to assemble in a 1.5 inch binder. NHLBI Publication No. 5218. 2003. 303 pages.

A CD with visuals in Power Point comes with each manual. These visuals are used in each of the 10 sessions of the manual. NHBLI Publication No. 5220, 2003.

The manual and visual CD are both available online at the following NHBLI website:

The NHLBI and IHS recently completed 6 regional train-the-trainer workshops, which were held in various parts of the country. A total of 235 heart health educators were trained. Many of these same folks are now implementing cardiovascular disease education, prevention, and outreach activities within their communities, using the curriculum.

If you would like more information about Honoring the Gift of Heart Health, feel free to contact Rachael Tracy at the National Heart, Lung, and Blood Institute -National Institutes of Health @ 301-496-1051.

1Current Diabetes Reports, 2002, June; 2(3): 274-81.
2Circulation, 2005, March; 111: 1250 - 1256.
3Circulation, 1999, May; 99: 2389-2395.
4US department of Health and Human Service. National Healthcare Disparities Report 2004. Available at: Accessed on June 13, 2005.

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Indian Youth Telemental Health Demonstration Project Act of 2006

Congressional Suicide Statistics from the Indian Youth Telemental Health Demonstration Project Act of 2006

According to the Congressional Suicide Statistics from the Indian Youth Telemental Health Demonstration Project Act of 2006:

  • Suicide for Indians and Alaska Natives is 2 1/2 times higher than the national average and the highest for all ethnic groups in the United States, at a rate of more than 16 per 100,000 males of all age groups, and 27.9 per 100,000 for males aged 15 through 24, according to data for 2002;
  • According to national data for 2002, suicide was the second-leading cause of death for Indians and Alaska Natives aged 15 through 34 and the fourth-leading cause of death for Indians and Alaska Natives aged 10 through 14;
  • The suicide rates of Indian and Alaska Native males aged 15 through 24 are nearly 4 times greater than suicide rates of Indian and Alaska Native females of that age group;
  • 90 percent of all teens who die by suicide suffer from a diagnosable mental illness at the time of death; and
  • More than half of the people who commit suicide in Indian Country have never been seen by a mental health provider;
  • Death rates for Indians and Alaska Natives are statistically underestimated;
  • Suicide clustering in Indian Country affects entire tribal communities; and
  • Since 2003, the Indian Health Service has carried out a National Suicide Prevention Initiative to work with Service, tribal, and urban Indian health programs.

The Indian Youth Telemental Health Demonstration Project Act of 2006 will accept five applications for grant money to address the problem of youth suicide in individual tribal associations. The monies will specifically be used for telecommunication technology to prevent and treat youth suicide. Overseen by the Department of Health and Human Services’ Division of Mental Health, this project will provide telemental services to the five grantees over a period of four years.

For more information on the Indian Youth Telemental Health Demonstration Project Act of 2006 visit:

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