Cheyenne River Sioux Research Articles

The Medicine Wheel Nutrition Intervention: A Diabetes Education Study with the Cheyenne River Sioux Tribe

Objective The Northern Plains Indians of the Cheyenne River Sioux Tribe have experienced significant lifestyle and dietary changes over the past seven generations that have resulted in increased rates of diabetes and obesity. The objective of this study was to determine if Northern Plains Indians with type 2 diabetes mellitus who are randomized to receive culturally adapted educational lessons based on the Medicine Wheel Model for Nutrition in addition to their usual dietary education will have better control of their type 2 diabetes than a nonintervention, usual care group who received only the usual dietary education from their personal providers. Design A 6-month, randomized, controlled trial was conducted January 2005 through December 2005, with participants randomized to the education intervention or usual care control group. The education group received six nutrition lessons based on the Medicine Wheel Model for Nutrition. The usual care group received the usual dietary education from their personal providers. Participants One hundred fourteen Northern Plains Indians from Cheyenne River Sioux Tribe aged 18 to 65 years, with type 2 diabetes. Methods Weight, body mass index (BMI), hemoglobin A1c, fasting serum glucose and lipid parameters, circulating insulin, and blood pressure were measured at the beginning and completion. Diet histories, physical activity, and dietary satiety surveys were measured at baseline and monthly through completion. Differences were determined using Student t tests, χ 2 tests, and analysis of variance. Results The education group had a significant weight loss (1.4±0.4 kg, P≤0.05) and decrease in BMI (1.0±0.1, P≤0.05) from baseline to completion. The usual care group had no change in weight (0.5±0.5 kg) or BMI (0.5±0.2). There were no between group differences due to intervention in energy, carbohydrate, protein, and fat intake and physical activity. Conclusions The culturally based nutrition intervention promoted small but positive changes in weight. Greater frequency and longer duration of educational support may be needed to influence blood glucose and lipid parameters.

Protecting Sacred Sites on Public Land: Religion and Alliances in the Mato Tipila-Devils Tower Litigation

Protecting Sacred Sites on Public Land:Religion and Alliances in the Mato Tipila-Devils Tower Litigation Eric Freedman (bio) Conflicts over Native American sacred places on public lands usually involve multiple interest groups. That was true in a dispute over a National Park Service (nps) policy to discourage climbing at Devils Tower National Monument during the month of the Sun Dance. Such conflicts sometimes end in court, as happened when a group called the Bear Lodge Multiple Use Association—a commercial guiding service—and recreational climbers sued the nps to challenge the plan as a violation of the Establishment Clause of the First Amendment; that clause provides that "Congress shall make no law . . . respecting an establishment of religion." The Cheyenne River Sioux Tribe and several of its spiritual leaders intervened on the side of the nps. What made this case unusual is that a variety of "mainstream" religious and religious rights organizations joined Native American groups and scholars who described themselves as "active in Federal Indian law and/or the religious issues under the First Amendment" in filing friend-of-the-court briefs in Bear Lodge Multiple Use Association v. Babbitt.1 The case reflects a broadening of the more common litigation alliances in which environmental groups participate alongside tribes and other Native American organizations. Here, no environmental groups participated as litigation allies. This case study uses interviews, judicial decisions, litigation documents, and other public records to examine the alliance in this lawsuit and its implications. This article discusses factors that informed decisions by Native American and "public interest" groups and the process by which they allied themselves. Mato Tipila (Bear Lodge)—also known as Devils Tower and, in Lakota, He Hota Paha (Grey Horn Butte)—is a rugged butte towering above the [End Page 1] Belle Fourche River in northeastern Wyoming. The United States' first national monument is a sacred place steeped in Native American culture and history, a place of religious practices and creation. The monument is open for recreational, aesthetic, research, and commercial uses under management by the nps, a unit of the U.S. Department of the Interior. It has become a magnet for as many as five thousand to six thousand climbers and their innumerable spectators among the monument's five hundred thousand annual visitors. As a result it is an economic asset for the regional tourism industry. In 1995 after three years of discussion including consultation with Native American groups, the nps adopted a Climbing Management Plan (CMP) to regulate recreational climbing activities and protect the monument's natural and cultural resources. The CMP culminated from a lengthy administrative planning process that acknowledged the potential for conflict between Indians and climbers.2 The process included extensive participation by stakeholders outside the nps: Native American communities strongly affiliated with the site; local and national climbing organizations; local and national environmental groups; and county government. There were work groups, mutual education efforts, "cultural brokering," and a compromise reflecting cultural values.3 As amended after the litigation began, the plan included educational and environmental programs; but the controversial component asked climbers to "voluntarily refrain from climbing . . . during the culturally significant month of June," when the Sun Dance and other Native American ceremonies occur.4 The CMP cited "the reverence many American Indians hold for Devils Tower as a sacred site." One goal of the plan was to teach the public about the site's character so the number of climbers would drop voluntarily to zero and thus forestall more stringent measures, including a possible mandatory ban. Ultimately, a U.S. district court judge and a federal appeals court rejected the challenge to the CMP. The U.S. Supreme Court refused to consider a further appeal. The voluntary ban remains in effect. The monument's Web site describes the policy this way, "Climbers are asked to refrain from climbing during the month of June out of respect for American Indians."5 The effect of the policy is reflected in an average annual 79 percent decline in the number of June climbers, compared to the 1990–1994 preclosure average for the month. However, the voluntary compliance rate has been declining [End Page 2] and reached a low of 69...

Beyond the Bench: Nurses Adapt to Changing Health Care Climate

Vol. 113, No. 12 EnvironewsOpen AccessBeyond the Bench: Nurses Adapt to Changing Health Care Climate Tanya Tillett Tanya Tillett Search for more papers by this author Published:1 December 2005https://doi.org/10.1289/ehp.113-a814AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit With increased emphasis being placed on the importance of environmental health comes the need for an expanded variety of environmental health care practitioners. Nursing is one of several professions that are augmenting and advancing the capabilities of their practitioners to meet this need. Now the Community Outreach and Education Program (COEP) of the University of New Mexico’s Center for Environmental Health Sciences has partnered with the New Mexico Environment Department to create an environmental health nursing internship as a component of its outreach program.In cooperation with the university College of Nursing, the partners recruit nursing students who are interested in implementing environmental health care initiatives in the surrounding community. For four years, the program has taken nursing students beyond the traditional curriculum and shown them firsthand how interaction with environmental factors affects human health. The program also gives students valuable experience in taking measures to abate hazardous exposures in communities.The interns are currently working on a number of projects that will affect different community members. They are helping to develop surveys and compiling data for a project investigating uranium exposure and subsequent kidney damage among the Navajo Nation, whose members live near and work in uranium mines. They are gathering and assembling materials for a community education and survey project on mercury in surface waters and other environmental health concerns among the Cheyenne River Sioux Tribe. They are helping COEP staff write and field-test an integrated environmental health curriculum on diabetes for middle school students. And in a fourth project, they are helping to develop a best-practices manual for applying farm waste fertilizer to croplands in a way that minimizes human exposure to aerosolized waste.The local ties of some of the nursing interns have enhanced the program’s role as an effective community advocate. Intern Krystyn Yepa is a Native American from the Pueblo of Jemez who became interested in environmental health nursing because she wanted to understand some of the health effects in her tribe resulting from exposure to different pollutants in the environment. “Learning about the different environmental health problems that exist in New Mexico has given me the willpower to finish nursing school to ultimately achieve my goal of improving the health and lifestyles of my people by placing importance on the environment,” she says.Yepa explains further, “As a Native American, I was raised to respect and appreciate the environment, and working at the COEP has only strengthened my values related to the environment.” She also credits the internship with teaching her important assessment tools that lay emphasis on the environment when completing a health history on patients, something a traditional nursing internship would not likely provide.“The nursing interns have been an incredible asset to our COEP,” says staff member Stefani Hines. “It is a mutually beneficial situation on many levels—the student nurses gather valuable real-world experiences in environmental health; the nursing school has access to additional, unique placements for their students; we have additional support for projects, which helps make them better; and the communities we work with benefit from the students’ efforts as well.”Dedicated, enthusiastic environmental health nursing interns will only continue to play an important role in advancing the COEP mission. One project currently in development will help community members get involved in city and county zoning processes, which will both encourage a healthy community mindset and minimize exposures to pollutants.Effecting change in Southwest communities.Krystyn Yepa (right) is one of several nursing interns working with Navajo and Sioux communities to reduce exposures and increase knowledge through a program of the University of New Mexico Center for Environmental Health Sciences.FiguresReferencesRelatedDetails Vol. 113, No. 12 December 2005Metrics About Article Metrics Publication History Originally published1 December 2005Published in print1 December 2005 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. 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Cancer Disparities Research Partnership in Lakota Country: Clinical Trials, Patient Services, and Community Education for the Oglala, Rosebud, and Cheyenne River Sioux Tribes

Native Americans served by the Aberdeen, Billings, and Bemidji areas of the Indian Health Service (IHS) have a cancer mortality rate approximately 40% higher than that of the overall US population. The National Cancer Institute has funded Rapid City Regional Hospital to provide clinical trials, behavioral research, a genetic protocol, patient navigator services (assisting patients with health care coordination and financial issues and helping them to understand their options), and community education for members of 3 western South Dakota tribes. Challenges faced by the project included obtaining multiple approvals from 3 tribes, 4 IHS facilities, and 5 institutional review boards; travel distances; lack of screening; red tape of referrals; and refusal by some payers to cover clinical trials. Building trust through ongoing communication and community presence is key to a successful project.

Health on the Banks of the Rio Grande

At the New Mexico Center for Environmental Health Sciences (NMCEHS), community concerns and relationships are as much at the center’s foundation as the latest research techniques. According to center director Scott Burchiel, the unique populations of New Mexico—including a high number of Hispanics and Native American tribes, pueblos, and sovereign nations—steer the center’s course. “One of the things we have tried to do is to determine what these populations’ concerns are for environmental health, because we want our center to be focused on environmental public health, and we want to work on basic research projects that address issues that people in this region are particularly interested in,” he says. Based in Albuquerque as a partnership of The University of New Mexico Health Sciences Center and the Lovelace Respiratory Research Institute (LRRI), the NIEHS-funded center comprises major research cores in environmental cancer and oxidative stress, cardiovascular toxicology, environmental lung disease, and population health and epidemiology. The center also includes world-class facility cores (particularly for inhalation toxicology), a pilot project program to provide funding for small innovative research studies, and an unusually strong community outreach and education program (COEP). Community input is essential, as is trust. “We have investigators who may have certain interests for certain kinds of projects and want to work with communities,” says Burchiel. “But when we go to the community, we find out that [the community has] a different agenda, different interests. We’ve been learning how to work with communities since we’ve had this environmental health center.” It’s a process that involves a lot of development of community relationships and trust relationships. Burchiel says that investigating environmental health problems such as asthma requires a broad definition of environment. He says, “In our center, we define the environment quite broadly. It includes nutritional, social, behavioral, economic, and built environment components. . . . We have not only environmental epidemiologists [but] also social epidemiologists who help us look at social factors in assessing economic and poverty factors.”

Adiponectin and Coronary Heart Disease: The Strong Heart Study

To the Editor: The adipocyte secreted protein, adiponectin, is of particular interest in metabolic and vascular disease because of its close associations with insulin sensitivity and obesity.1 Lower levels of adiponectin are associated with later development of type 2 diabetes.2 Recent observations from the Health Professionals Follow-Up Study3 suggest that lower adiponectin concentrations might also be associated with incident myocardial infarction, findings in keeping with prior observations in patients with end-stage renal failure.4 We examined prospective relationships of adiponectin to vascular disease in a case–control series selected from the Strong Heart Study (SHS). The SHS is the largest study of cardiovascular disease in American Indians, a group at particular risk of obesity and type 2 diabetes and in whom an increasing incidence of coronary heart disease (CHD) is seen.5 Cases and controls were selected from the SHS cohort.6 The SHS recruited 4549 volunteers of American Indian heritage from 3 geographic areas (Arizona, North and South Dakota, and Oklahoma).6 Volunteers (59% female) were invited to a study examination on three occasions (SH1, 1988 to 1992; SH2, 1993 to 1995; SH3, 1997 to 1999) and remained under continued surveillance for development of vascular disease as described previously.7,8 Because of availability of plasma samples, baseline data for this study were taken from the second examination (SH2), and participants with prevalent cardiovascular disease at SH2 (definite CHD and stroke), …

Natives on the Electronic Frontier

Natives on the Electronic Frontier

The prevalence of diabetic retinopathy and associated risk factors among Sioux Indians.

To estimate the prevalence of and risk factors for diabetic retinopathy among Sioux Indians of South Dakota. Strong Heart Study (SHS) participants with diabetes who are members of the Cheyenne River Sioux Tribe and the Oglala Sioux Tribe were invited to have ophthalmological examinations in 1991. A total of 417 people had eye examinations out of the 488 diabetic SHS participants of the two tribes (85% participation rate). Fundus photographs were obtained of each eye and graded for severity of retinopathy using the modified Airlie House Classification Scheme. Risk factors for retinopathy were determined from the SHS database. The prevalence of diabetic retinopathy among participants from these tribes was 45.3%. Risk factors associated with severity of retinopathy include mean fasting glucose, level. HbA1c, systolic blood pressure, urinary albumin-to-creatinine ratio, renal dialysis, and duration of diabetes. The prevalence of diabetic retinopathy among diabetic Sioux Indians is similar to or higher than the prevalence in other diabetic Indian and non-Indian populations. Aggressive glycemic and blood pressure control is urgently needed to reduce this high rate, and annual eye examinations to detect and treat diabetic retinopathy should be emphasized.

Cheyenne River Sioux

Cheyenne River Sioux

To the Sioux Nation, Cheyenne River Sioux Reservation, Eagle Butte, South Dakota, 4 September 1995

To the Sioux Nation, Cheyenne River Sioux Reservation, Eagle Butte, South Dakota, 4 September 1995

Cultural Factors Associated with Health-Risk Behavior Among the Cheyenne River Sioux

A field study was conducted to identify cultural factors--values, beliefs, and related characteristics--associated with health-risk behavior among adult members of the Cheyenne River Sioux Tribe. The Cultural Values Survey (CVS), an instrument for measuring cultural values and related characteristics, was developed and pilot tested in the study population. This instrument, along with the Health Risk Appraisal (HRA) (an instrument developed by the Centers for Disease Control to quantify major health-related behaviors), was administered to a random sample of 429 adults in the study community. Significant differences between females and males for both cultural characteristics and health-risk behaviors were found. Females had significantly higher HRA-calculated Health Index values than males, reflecting overall healthier behaviors. Females who scored higher on cultural factors consistent with more traditional Lakota Indian lifestyles (e.g., degree of Indian blood, Lakota language spoken in the home, traditional Lakota beliefs) had higher HRA Health Index values than females scoring lower in these characteristics. Males who scored higher in factors related to self-determination (e.g., hard work, personal control, industriousness, individual action) had higher Health Index values than those who scored lower in these areas. Further testing of the CVS instrument, as well as further research from both epidemiologic and social science perspectives is essential to elucidate the nature of the relationship between cultural factors and health-related behavior.

Alcohol and the Future of Native Americans-Reply

ABSTRACT In Reply. —Dr Prager's response to my Editorial on hypothermia deaths and pedestrian motor vehicle accidents among American Indians in the Southwest highlights some important issues. He states that we need bold-thinking Native Americans [the preferred term is American Indians among many American Indians and American Indian scholars] who can deal with the root causes of alcoholism by finding ways to strengthen their own traditional and rich cultures while incorporating what they feel is the best of all American civilization. Prager may be interested to know that many tribes and tribal members have been doing this for years and continue to strengthen their culture through tribal sovereignty. In fact, the Cheyenne River Sioux Tribe where Prager briefly worked has been very aggressive in its efforts to gain greater control and regulation over the sale and distribution of alcohol.The Cheyenne River Indian Reservation demonstrates that the exercise of tribal sovereignty

Alcohol and the Future of Native Americans

<h3>To the Editor.</h3> —The article¹and Editorial²in the March 11, 1992, issue of<i>JAMA</i>regarding alcohol-related deaths of Native Americans brought back vivid memories of my 2 years in the Indian Health Service on the Cheyenne River Sioux Indian Reservation in Eagle Butte, SD. I compiled a list of all deaths on the reservation from July 1,1969, through June 30,1971.³The results were depressing: 53% of the deaths were from unnatural causes—motor vehicle accidents, hypothermia, suicides, and drowning. Almost all were alcohol-related. The average age at death of this group was 24 years. Gallaher et al suggest that by legalizing alcohol on their reservations, the Navaho nation might decrease the striking excess mortality from auto accidents and hypothermia by obviating the need for long auto rides by intoxicated Native American men traveling from bars off the reservation back to their homes. In this regard, the Eagle

Madonna Swan: A Lakota Woman's Story.

In Madonna Swan: A Lakota Woman's Story, Mark St. Pierre skillfully weaves together his interviews with Madonna Swan-Abdulla to capture the indomitable spirit of a Lakota woman as she celebrates the joys and endures the sufferings of her remarkable life on the Cheyenne River Sioux Reservation in South Dakota.Born in 1928, Madonna Swan was winona - the first-born daughter-of Lucy High Pine and James Swan. She held a special place in an extended family of grandparents, parents, and ten brothers and sisters. For the Swans, as for other Lakota Sioux, life on the reservation in the first half of the twentieth century was appallingly difficult. In her narrative, Madonna details her life-her earliest childhood memories, the Lakota traditions taught by her grandparents, the daily struggle against poverty and prejudice, and her education at Stephan Mission, South Dakota. Stricken with dreaded tuberculosis at age sixteen, she survived nearly seven years in Sioux Sanitorium, a place where most other Sioux victims of TB quickly expired. Madonna's strength of spirit and determination to live carried her through the chanhu sica bad lungs-and into a new life, free of disease. She survived to marry, have a family, go to college, and teach in the reservation's Head Start program. A symbol of courage for all women, Indian and non-Indian alike, Madonna Swan-Abdulla was named North American Indian Woman of the Year in 1983. She still lives on the Cheyenne River Sioux Reservation, where her Lakota people honor her as matriarch.