Health Archives - Page 6 of 8

How Big Tobacco Has Made Cigarettes So Much Deadlier Than They Used To Be

“The cigarettes sold today are quite different from the cigarettes that were on the market five decades ago, according to the new report, and that’s because tobacco companies have done extensive research to figure out how to make smoking appealing for new customers. “

By Tara Culp-Ressler for Think Progress | June 24, 2014

(AP/Dave Martin)

Fifty years ago, the U.S. surgeon general tied tobacco to lung cancer for the first time. Since then, additional scientific research has linked smoking with a host of other health issues, and efforts to publicize those harmful side effects helped spur a historic decline in the number of Americans who regularly smoke. Nonetheless, more than 42 million adults remain addicted to cigarettes, and the head of the Centers for Disease Control and Prevention (CDC) says that tobacco is still the greatest public health challenge of our time.

Why is tobacco still at the top of the CDC’s list? Why haven’t we moved past this yet? Largely because cigarette manufacturers have worked hard to keep their products relevant even in the midst of aggressive public health campaigns to crack down on smoking, according to a new report released on Monday by the Campaign for Tobacco-Free Kids.

The cigarettes sold today are quite different from the cigarettes that were on the market five decades ago, according to the new report, and that’s because tobacco companies have done extensive research to figure out how to make smoking appealing for new customers. They’ve essentially made it easier to get hooked on their products by increasing the levels of nicotine — the addictive chemical in cigarettes — and using new additives to help enhance nicotine’s impact. They’ve also added flavoring, sugars, and menthol to mask the effect of inhaling smoke, ultimately hoping that will make it more pleasurable to use cigarettes:

Cigarettes have evolved over the past 50 years to make smoking more desirable

“Most people would think that 50 years after we learned that cigarette smoking causes lung cancer, cigarettes would be safer. What’s shocking about the report we issued today is that we’ve found that a smoker today has more than twice the risk of lung cancer than a smoker fifty years ago, as a direct result of design changes made by the industry,” Matt Myers, the president of the Campaign for Tobacco-Free Kids, said in an interview with ThinkProgress.

On top of that, Myers’ organization notes that these corporations have made calculated moves to create the next generation of smokers, according to internal marketing documents from tobacco companies that have been made public as a result of litigation against them. Brands like Marlboro, Newport, and Camel have specifically worked to attract younger customers in order to remain viable, citing statistics that most regular smokers pick up the habit before they turn 18.

Most people know that cigarette makers have historically worked to target young people with their advertising. Indeed, before increased regulation attempted to rein in this practice, it used to be even more explicit than it is now. For instance, the R. J. Reynolds Tobacco Company infamously used the cartoon character Joe Camel to help sell their cigarettes in the 1990s, a practice that mobilized anti-tobacco advocates to fight hard against marketing aimed at younger Americans.

But the new report finds that tobacco companies have actually gone even further to woo teens. The R.J. Reynolds Tobacco Company didn’t just rely on its camel; it also looked to change its cigarettes to appeal to a younger demographic. “Two key areas identified for improvement were smoothness and sweetness delivery. Smoothness is an identified opportunity area for improvement versus Marlboro, and sweetness can impart a different delivery taste dimension which younger adult smokers may be receptive to,” a 1985 product development plan for the company noted.

“We would have thought, with the tobacco industry claiming they don’t market to kids, that they wouldn’t be making design changes that increase the number of our kids who smoke,” Myers said. “But they have, quietly and behind the scenes.”

The Campaign for Tobacco-Free Kids’ report was released to coincide with the five year anniversary of the Family Smoking Prevention and Tobacco Control Act, historic legislation that gave the FDA power to regulate tobacco products and marketing efforts. At the time, that measure was hailed as the “toughest anti-tobacco bill in American history” — and Myers’ group wants the government to use it to undo some of the changes that have been made to cigarettes over the past several decades.

“At a very minimum, the FDA should act swiftly to require the tobacco industry to reverse all the steps they’ve taken to make these products more dangerous, more addictive, and more appealing to our kids,” Myers said. “I think this report tells us that the tobacco industry has not reformed over the last 50 years.”

Kill the Land, Kill the People: There Are 532 Superfund Sites in Indian Country!

by Terri Hansen, Intercontinental Cry

Of a total of 1,322 Superfund sites as of June 5, 2014, nearly 25 percent of them are in Indian country. Manufacturing, mining and extractive industries are responsible for our list of some of the most environmentally devastated places in Indian country, as specified under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), the official name of the Superfund law enacted by Congress on December 11, 1980.

Most of these sites are not cleaned up, though not all of the ones listed below are still active. Some sites are capped, sealing up toxics that persist in the environment. In cases like the Navajo, the Akwesasne Mohawk and the Quapaw Tribe, the human health impacts are known because some doctors and scientists took enough interest to do studies in their regions. Some of those impacts may persist through generations given the involvement, as in the case of the Mohawk, of endocrine disrupters. Read on.

1. Salt Chuck Mine, Organized Village of Kasaan, Alaska

The Salt Chuck Mine Superfund site in southeast Alaska operated as a copper-palladium-gold-silver mine from 1916 to 1941. Members of the Organized Village of Kasaan, a federally recognized tribe, traditionally harvested fish, clams, cockles, crab and shrimp from the waters in and around Salt Chuck, unaware for decades that areas of impact were saturated with tailings from the former mine. As if that weren’t enough, Pure Nickel Inc. holds rights to mining leases in the area and began active exploration to do even more mining in summer 2012, according to Ground Truth Trekking.

2. Sulfur Bank Mine, Elem Band of Pomo Indians, California

The Elem Band of Pomo Indians, whose colony was built on top of the waste of what would become California’s Sulfur Bank Mine Superfund site in 1970, have elevated levels of mercury in their bodies, and now fear for their health. According to an NBC News investigation, nearby Clear Lake is the most mercury-polluted lake in the world, despite the EPA’s spending about $40 million over two decades trying to keep mercury contamination out of the water. Although the EPA cleaned soil from beneath Pomo homes and roads, pollution still seeps beneath the earthen dam built by the former mine operator, Bradley Mining Co. For years, Bradley Mining has fought the government’s efforts to recoup cleanup costs.

3. Leviathan Mine, Washoe Tribe of Nevada and California

The Washoe Tribe of Nevada and California requested EPA involvement in the cleanup of an abandoned open pit sulfur mine on the eastern slope of California’s Sierra Nevada that became the Leviathan Mine Superfund site. The Washoe Tribe had become concerned that contaminated waters were affecting their lands downstream, causing impacts to culture and health, environmental damage, remediation, monitoring and testing, posting of health advisories, drinking water, effects on pregnancy, and cancer. Aluminum, arsenic, cadmium, iron, manganese, nickel and thallium have been detected in surface water and sediment downstream from the mine. The U.S. Centers for Disease Control and Prevention (CDC) concluded that exposures could result in cancerous and non-cancerous health effects.

4. Eastern Michaud Flats, Shoshone-Bannock Tribes, Idaho

The abandoned FMC phosphorus facility occupies more than 1,000 acres of the Shoshone-Bannock Tribes’ Fort Hall Reservation in Idaho, and lies within Eastern Michaud Flats Superfund site. The primary contaminants of concern at the site are arsenic, elemental phosphorous and gamma radiation. FMC left a legacy of contamination in the air, groundwater, soil and the nearby Portneuf River, which threatened plants, wildlife and human health on the reservation and in surrounding communities. The Shoshone-Bannock have long asked for a cleanup of contaminated soils, but instead the EPA’s 2012 interim remedy is to cap and fill, including areas containing gamma radiation and radionuclides.

5. Bunker Hill Mining and Metallurgical Complex, Coeur d’Alene Tribe, Idaho

The Bunker Hill Mining and Metallurgical Complex Superfund site, located in the Coeur d’Alene River Basin, is one of the largest environmental and human health cleanup efforts in the country.

Its contamination, the result of decades of mining, milling and smelting, affected more than 150 miles of the river, lake and its tributaries. The area, listed a Superfund site in 1983, is one of the “largest and most complex” in the country, according to the EPA. Studies revealed that three quarters of children living in the area in the 1970s had unhealthy levels of lead in their bloodstream. The United States, the Coeur d’Alene Tribe and the state of Idaho settled with the Hecla Mining Co. in June 2011 for $263.4 million to resolve claims stemming from releases of wastes from its mining operations, an agreement that will protect people’s health by ensuring the cleanup of areas heavily polluted with lead, cadmium, arsenic and other contaminants.

6. Rio Tinto Copper Mine, Shoshone Paiute Tribes of Duck Valley, Nevada

The Shoshone Paiute Tribes of Duck Valley and the state of Nevada will oversee cleanup of the abandoned Rio Tinto Copper Mine Superfund site with $25 million paid by the Atlantic Richfield Co., DuPont and Co., the Cleveland-Cliffs Iron Co. and Teck American Inc., all corporate successors to companies that operated the copper mine between 1932 and 1976. The agreement was worked out last year by the EPA, U.S. Department of Justice (DOJ) and the Nevada Division of Environmental Protection. The cleanup will remove mine tailings from Mill Creek, make the creek habitable for redband trout and improve the water quality of Mill Creek and the East Fork Owyhee River.

7. Alcoa Superfund Site, Akwesasne and Saint Regis Mohawk, New York

The Alcoa Superfund aluminum manufacturing facility in Massena, New York, released hazardous substances including polychlorinated biphenyls (PCBs) onto property and into the Grasse River, contaminating sediments in the river system to approximately seven miles downstream, a traditional area of the Akwesasne Mohawk. Analysis of fish in the Grasse River revealed high levels of PCB contamination. PCBs are linked to cancer, low birth weight and thyroid disease, as well as learning, memory and immune system disorders. When in April 2012 the EPA finalized a cleanup plan that requires dredging and capping of contaminated sediment in a 7.2 mile stretch of the river in April 2012, the Saint Regis Mohawk Tribe were not satisfied with the capping solution.

8. General Motors Massena, Akwesasne Mohawk

Some 4,000 Saint Regis Mohawks live adjacent to the General Motors Massena Superfund site in Massena, New York, which while in operation used PCBs, plus generated and disposed of various industrial wastes onsite. PCBs have been found in the groundwater, on- and off-site soils and sediments in the St. Lawrence and Raquette Rivers, Turtle Cove and Turtle Creek. PCBs are probable human carcinogens that can also affect the immune, reproductive, nervous and endocrine systems, as well as cause other health effects. Groundwater was also found to be contaminated with volatile organic compounds (VOCs), which are potentially harmful substances that easily evaporate in the air. Phenols have been detected in lagoons left behind.

Under an August 2010 EPA order, Motors Liquidation Co., formerly GM, and then RACER Trust became responsible for additional sampling, decontamination of the building and contents, demolition of the building, removal of PCB-contaminated soil beneath the building and restoration of the area. A controversial landfill of capped contamination will be moved 150 feet from the tribal border in 2014, EPA regional administrator Judith Enck told the Associated Press in 2012.

The bodies of young Akwesasne Mohawk adults contain twice the levels of PCBs as the national average, compared to those studied by the CDC. Researchers have already established that PCBs have altered thyroid gland function in the Akwesasne community. Prior studies found lower testosterone levels and established links to autoimmune disorders.

“Endocrine disruption seems to be the effect which is most far reaching, because other effects on the reproductive system may be well tied into that,” said Lawrence Schell, a professor at the State University of New York (SUNY at Albany) and director of its Center for the Elimination of Minority Health Disparities who was involved in an exposure research study at the St. Regis Mohawk Nation.

9. Onondaga Lake, Onondaga Nation, New York

Onondaga Lake is a sacred place. The Great Peacemaker formed the Haudenosaunee, known as the Iroquois Confederacy, on its shores.

That the 4.5 square mile lake in Syracuse, New York is spoiled is a painful thing. Sewage overflows contaminated the lake over the years, as did industrial pollutants and heavy metals such as PCBs, pesticides, benzene, toluene, xylene, creosotes and polycyclic aromatic hydrocarbons (PAHs), lead, cobalt, and mercury. The Onondaga Lake Superfund site, listed in 1994, consists of the lake itself and seven major and minor tributaries. Completion of the dredging work is being performed by Honeywell International with oversight by the New York State Department of Environmental Conservation, the EPA and the New York State Department of Health, and capping is expected in 2016. The Onondaga Nation states the Honeywell cleanup plan does not effectively contain toxic chemicals and heavy metals that will be left beneath caps in the lake-bottom sediments.

“Caps are not a reliable form of containment—they will fail, and whether it is in 10 years or 110 years, it is only a matter of time,” the Onondaga said in a statement. “And when that happens, the chemicals will be re-released into the ecosystem.”

Nor does the plan set any goals for making the lake ‘swimmable’ or ‘fishable’ they say—a requirement under the Clean Water Act, the Onondaga added.

10. Tar Creek, Quapaw Tribe

Picher, Oklahoma, part of the Quapaw’s tribal jurisdictional area, was home to productive zinc and lead mining until 1967, when mining companies abandoned 14,000 mine shafts, 70 million tons of lead-laced tailings, 36 million tons of mill sand and sludge and contaminated water, leaving residents with high lead levels in blood and tissues. The area was declared the Tar Creek Superfund site in 1983, but Picher was deemed too toxic to clean up after a 1993 study found that 34 percent of the children tested in Picher had blood lead levels exceeding the point at which there is a risk of brain or nervous system damage. Cancers skyrocketed. A federal buyout paid people to leave. The Quapaw Tribe has cleaned up part of the Tar Creek Superfund site known as the Catholic Forty and has signed agreements to clean up two other sections of the contamination. Their goal is to make the land productive again.

11. Midnite Mine, Spokane Indian Reservation, Washington

The 350-acre Midnite Mine Superfund site on the Spokane Indian Reservation in eastern Washington is centered around a former open pit uranium mine that poses a threat to human health due to elevated levels of radioactivity and the presence of heavy metals. Years of digging for uranium from 1954 to 1964, and again from 1969 to 1981, have disturbed 350 acres, left two open mine pits and piles of toxic rock on the landscape. Under a September 2011 agreement, Newmont USA Limited and Dawn Mining Company LLC would design, construct and implement the cleanup plan for the site that EPA selected in 2006. They will also reimburse EPA’s costs for overseeing the work. The United States will contribute a share of the cleanup costs. EPA will oversee the cleanup work in coordination with the Spokane Tribe. Cleanup is expected to cost $193 million.

12-532. Uranium Mining, Navajo Nation

The legacy of uranium mining on the Navajo Nation is radioactive uranium contamination from 521 abandoned Superfund mine sites spread over 27,000 acres of Nevada, New Mexico and Arizona in the Four Corners area, leaving many homes and drinking water sources on the reservation with elevated levels of radiation. The health effects to Navajo citizens include lung cancer from inhalation of radioactive particles, bone cancer and impaired kidney function from exposure to radionuclides in drinking water. The EPA has completed on-the-ground screening of the mine sites, and with the Navajo EPA is determining the order of site cleanup. Cleanup of some sites has begun while the US EPA continues to research and identify Potentially Responsible Parties under Superfund laws to contribute to cleanup costs.

The Vegetables Most Americans Eat Are Drowning In Salt And Fat

This isn't exactly what a healthy serving of veggies looks like.Lauri Patterson iStockphoto — This isn’t exactly what a healthy serving of veggies looks like.
Lauri Patterson iStockphoto

By Maanvi Singh, NPR

Popeye and our parents have been valiantly trying to persuade us to eat our veggies for decades now.

But Americans just don’t eat as many fruits and vegetables as we should. And when we do, they’re mainly potatoes and tomatoes — in the not-so-nutritious forms of French fries and pizza, according to a report from the U.S. Department of Agriculture.

Americans eat 1.5 cups of vegetables daily, on average, the USDA finds. But the national nutrition guidelines recommend 2 to 3 cups a day for adults. And more than half our veggie intake comes from potatoes and tomatoes, whereas only 10 percent comes from dark green and orange veggies like spinach, carrots and sweet potatoes.

Of course, potatoes are great on their own — they’re a good source of potassium. But most Americans eat them with a hefty side of fat and sodium. According to the USDA’s handy chart, at home, most people get their potato fix in the form of chips. And when eating out, about 60 percent of the potatoes we consume are fried. Baked potatoes are also popular, but most people don’t eat the skin — a great source of fiber that fills you up.

Tomatoes start out healthy as well, and they’re a good way to boost your vitamin A and C intake. Tomato sauce, on the other hand, can pack in a lot of hidden sugar and salt. While a cup of raw tomato has about 9 milligrams of sodium, canned tomato sauce can contain more than 1,000 milligrams of sodium per cup, according to the USDA.

And even potatoes and tomatoes in their healthy forms don’t make for a complete, balanced diet. Americans eat far less fiber than they should, the researchers say, and fiber is found in dark green and orange veggies. As we’ve reported, fiber can make you gassy, but it’s essential to a healthy microbiome.

After a 2002 government nutrition report found that higher fruit consumption correlated with a lower body mass index but not vegetable consumption, USDA researchers decided to look more into how Americans are getting their vegetables.

“We started thinking about it, and realized it’s quite common to just pick up a piece of fruit and eat it as-is,” says Joanne Guthrie, a nutritionist at the USDA’s Economic Research Service who co-authored the report. “But that wasn’t the case for vegetables.” Vegetables often need to be peeled, cut and cooked, so they’re just not as handy.

So maybe this tomato and potato finding isn’t a huge shocker. Just a few years ago public health experts were debating whether school lunch programs should get to count a slice of pizza as a serving of vegetables, and fries have garnered their share of negative publicity in recent school lunch battles, too.

But, as Guthrie tells The Salt, the report is a reminder that we need to pay more attention to how we prepare our vegetables. “We all want to have a healthful diet,” she says. So mind the sugar and sodium, and branch out from pizza and French fries.

Why Should Tulalip Tribal Members Care About the Affordable Care Act?

By Kyle Taylor Lucas

The Affordable Care Act (ACA), signed into law in 2010, became effective January 2014. Many questions continue to roil in the minds of American Indians about just what the new health care law means to them.

The law helps make health insurance coverage more affordable and accessible for millions of Americans, including American Indians. Importantly, the law addresses inequities, increases access to affordable health coverage and prevention medicine for tribal members. The ACA is important to American Indians because it provides greater access to care and coverage unmet by the Indian Health Service (IHS).

The ACA requires all Americans to have health care insurance coverage. However, American Indians and Alaska Natives have the option to file a lifetime exemption. They are encouraged by the state Health Care Exchange to file the exemption regardless of their current insurance status in case their insurance should ever lapse.

There are numerous state and federal agencies working to implement and manage ACA health care delivery. Tulalip members can most directly obtain enrollment process advice from clinic staff members who have received specialized training as Tribal Assisters. They can help members through the enrollment process and refer you to a broker who is licensed to provide information and advice on qualified health insurance plans and policies. Tulalip Resource Advocate, Rose Iukes, has received intensive training on the ACA. She and Brent Case can answer questions and help enroll members. Fortunately, for Tulalip members, the Board of Directors contracted with a licensed broker, Jerry Lyons, to assist members in understanding and selecting the best-qualified health insurance plan for themselves.

Contact Information:

Tribal Assisters:

Rose Iukes, Resource Advocate – (360) 716-5632 / RoseIukes@tulaliptribes-nsn.gov

Brent Case, Resource Specialist – (360) 716-5722 / BCase@tulaliptribes-nsn.gov

Broker:

Jerry Lions, American Senior Resources – (206) 999-0317

Asked about the greatest impediment to enrolling tribal members, Rose Iukes said many tribal members assume IHS coverage is sufficient, so have been disinterested in the ACA. Even so, she noted, “We had almost 800 people apply. We got probably about 250 on qualified health plans and about 150-180 on Apple.” She said efforts were hampered by the state system “going down,” which required many tribal enrollments to be done in-person. “There were so many flaws that we started having people do paper applications here at the clinic. Now, we need to have them do follow-up. We didn’t get to do a test-run on the site. We thought we could go in and enroll them, but there were additional security questions. So, now we’re asking members who completed paper applications to come in and complete their application processes.”

Even with the challenges, Washington State fared better with its overall ACA rollout than other states, leading the nation in early enrollment numbers.

Rose Iukes noted significant confusion due to the state’s failure to provide clarifying information on special tribal provisions and exemptions on its websites and call centers. She said, “I’m hoping these call centers get educated on the tribal provisions and exemptions.” She could not say why there is little detail about income, age and other special provisions posted on state websites. Publicizing details of special federal poverty level provisions and exemptions for tribal members may be confusing to the general public. The result is that the rollout for American Indians, especially urban Indians without easy access or even referral to a Tribal Assister, has been challenging. However, despite the state’s system inadequacies, Iukes praised the American Indian Health Care Commission staff and Sheryl Lowe at the Washington Health Care Exchange whose support she felt was invaluable.

“The bottom line for tribal members, if they have ACA health care they can be taken care of. And they can get the help they need. That’s what drives me and why I advocate the way, I do. I don’t want somebody to go through the heartache,” said Iukes.

Tribal members often inquire about alcohol and chemical dependency treatment options, especially as many have a history of unsuccessful treatment attempts. Iukes said that beyond the Tribe’s one treatment option, “With qualified health plans, there is unlimited treatment, but we need to find a way to help them pay their premium. For example, a young man was ready to go to treatment, but his premium was $4. It must be paid with a debit card, but he didn’t have one. Ultimately, he didn’t go to treatment. I’ve asked the Board about setting up a way for the premium to come out of per capita, then we can issue them a card to use” to pay their premiums.

Broker, Jerry Lyons, is licensed with eighty (80) different insurance companies said, “In my brief time working with Tulalip, we feel confident in our efforts. We are being successful as we have been instrumental in assisting members with questions and we have enrolled more Native Americans into the ACA than any other tribe.” He added that never in his career has he been involved in a more “disorganized” insurance roll-out, but emphasized it was not due to the tribal efforts, but rather the bureaucracy. “Even so, we have helped about 250 people obtain insurance in one way or another.” Asked if he is available to all members many of whom reside off-reservation, Lyons replied, “We assist all members. There are also many special plans that most tribes are unaware of. Just have them call me.”

Several state, public/private, federal, and non-profit organizations are supporting tribal ACA implementation and enrollment. They are the Washington Health Benefit Exchange, the Health Care Authority, the Centers for Medicare and Medicaid Services (CMS) Region 10 office in Seattle, and the American Indian Health Commission.

Washington Health Benefit Exchange (HBE)

The Washington Health Benefit Exchange was created in 2011 state law as a “public-private partnership” separate and distinct from the state. The Exchange is responsible for the creation of Washington Healthplanfinder–the online marketplace to assist Washingtonians to find, compare, and enroll in qualified health insurance plans.

Many tribal members who rely upon IHS for their health care needs question the need to apply for ACA coverage. They also question the need to go outside treaty guaranteed health care services. Unfortunately, as most trust responsibilities, health care for American Indians/Alaska Natives has been historically and woefully underfunded and continues to be so today.

When asked why the ACA is important to tribal members, Sheryl Lowe, tribal liaison with the Washington Health Benefit Exchange, said, “Individual coverage offers tribal members more access to specialty care and even if the member uses their own tribal clinic, the tribe can then bill the health insurance company rather than the Indian Health Service. She emphasized that the basic tribal contract dollars can then be utilized for other urgent and uncovered care.

Lowe said the ACA benefits both individuals and tribes. “For most tribes, IHS only provides direct care and tribes have to pay Contract Health Care. And the IHS continues to be funded at less than fifty percent of need, so the ACA is another way for individuals and tribes to access health care. Also, most tribal clinics are Priority One clinics offering basic care and provide referrals only for life and limb.”

After working out many of the bugs and training, there are 93 Tribal Assisters, at least one in each of the federally recognized tribes in Washington, the state and the Tribal Assisters are now able to focus upon a more comprehensive effort to enroll tribal members. Lowe praised the Tribal Assisters who she credits with outstanding efforts to learn a complicated enrollment process to become certified as Tribal Assisters. She said Tulalip has four Tribal Assisters and she exclaimed, “Rose Iukes is so dedicated!” The HBE shared the following statewide training statistics:

– HBE-Certified Tribal Assisters: 93

– Tribal Staff in the process of becoming Certified: 34

– 66 Active Tribal Assisters helped 10,000 people enroll through the HPF (through 2/15/14)

– Tribal Assisters represented 25 Tribes, 2 Urban Indian Organizations, and SPIPA

The Health Benefit Exchange reports that statewide, of the 26,378 who answered “yes” to “Are you an American Indian/Alaska Native [AI/AN]?” on the ACA enrollment site, 21,201 of “enrolled tribal members” have enrolled in the Healthplanfinder. Significantly, 17,350 enrolled in Washington Apple Health (expanded Medicaid). Unfortunately, of the 3,885 AI/ANs eligible for Qualified Health Plans, only 1,110 actually enrolled even though many would likely have zero to low premiums and no cost shares.

Lowe said she couldn’t emphasize enough the importance of tribal members considering enrollment because those whose income falls in 138 – 300 percent of federal poverty level have no cost-sharing which means no co-pay or deductibles, “which is a huge benefit.” She added, “Depending upon household size and other factors, some may even have a premium that is zero. They can take the tax credit to lower their monthly premium or take it at the end of the year. Those in the 138 – 400% of poverty level are eligible for premium tax credits. Depending upon income or household size you can get tax credits which will reduce your overall costs.” She pointed out that some plans have deductibles for $5000 for a family before they’ll pay anything, so the cost-sharing benefit is one of the biggest things for tribal members.” It is clearly worthwhile for tribal members to speak to a tribal assister and/or broker.

Those whose income is below 100 – 138 percent of federal poverty level qualify for expanded Medicaid or Apple Health as it is now called. However, children are eligible for Apple Health in households whose income is up to 300% of the federal poverty level. Therefore, although the adults may not qualify for Apple Health, it is important to consider that children may.

Unlike Apple Health, the Qualified Health Plans do not provide dental. Yet, the ACA does require that all children be covered by dental insurance. The HBE indicates there are two low-cost children’s plans available. Sheryl Lowe indicates there is also discussion about the potential of adult dental plans to be introduced in 2016. Broker, Jerry Lyons, encourages tribal members to ask him about low-cost and special plans that most tribes are unaware.

Washington Health Care Authority (HCA)

The HCA oversees Washington expanded Medicaid or Apple Health plan for low-income residents. Washington is one of 27 states implementing expanded Medicaid. Of the many benefits for American Indians from the new health care law, expanded Medicaid seems most significant. Eligibility for Apple Health (expanded Medicaid) is the same for tribal members and the general public–that is household income below 100 – 138 percent of the federal poverty level. Tribal members in the Apple Health Program would not be eligible for tax credit that is offered tribal members in the Qualified Health Plans. However, one important benefit is that effective January; dental coverage for adults was restored.

Through expanded Medicaid in Washington, countless low-income American Indians and Alaska Natives can now receive specialty care. As of March 25, 2014, of all who identified as AI/ANs at enrollment, 17,350 have enrolled in Washington Apple Health (or expanded Medicaid). Staff at the Tulalip Tribes health clinic is working to update Tulalip enrollment numbers. Rose Iukes reported it is difficult because many are in process of updating enrollment after the glitches in the state system caused the Tribe to revert to paper applications.

Tribal members can enroll monthly by the 23rd, and then the plan starts the first of next month.

Big changes in Medicaid/Apple Health became effective January 2014. Because of the ACA, more people are able to get preventive care, like check-ups and cancer screenings, treatment for diabetes and high blood pressure, and many other health care services they need to stay healthy.

Apple Health (Medicaid) Benefit Changes Effective January 2014

Dental Services for Adults: Dental health benefits were restored for individuals 21 years of age and older in January. Ensure that your dentist is enrolled as a Medicaid provider.

Mental Health Services Unlimited Number of Visits: Beginning in 2014, there are no limits on the number of visits for mental health services in a calendar year.

Expanded Pool of Licensed Providers: Previously, psychiatrists were the sole mental health provider approved for adults, but effective January 2014, mental health services can be sought from a variety of providers. Coverage is expanded to services by Licensed Advanced Social Workers, Licensed Independent Social Workers, Licensed Mental Health Counselors, Licensed Marriage and Family Therapists and Psychologists. Just ensure your provider is enrolled with Medicaid.

Preventative Care Shingles Vaccine: Beginning January 2014, Apple Health shall will cover the shingles vaccination for clients 60 years of age and older. Age 60 or older is considered the most effective time to receive the vaccine.

Oral Contraception: Effective 2014: Apple Health now allows eligible clients the option to fill birth control prescriptions for a 12-month period.

Early Intervention Screening for Substance Abuse: Apple Health will cover services provided by trained, certified medical providers who conduct screening, brief intervention, and referral for treatment for individuals who may present as facing challenges with substance abuse, including alcohol, drugs and tobacco.

Screening of Children for Autism: Funding has been approved so that Apple Health’s enrolled primary care physicians can screen your child, if they are under three years of age to assess for autism.

Licensed Naturopathic Physicians serving as Primary Care Doctors: Beginning in 2014, licensed naturopathic physicians are able to provide primary care services. Given there are a limited number of primary care physicians, individuals possessing a Washington Department of Health Naturopathic Physician license shall be able to provide care in the scope of care outlined by Department of Health, including diagnosing, administering vaccines and immunizations, provide referrals to specialists, conduct minor office procedures, and write limited Food and Drug Administration-approved prescriptions.

Vendors that Provide Wheelchairs and Accessories: In 2014, Apple Health will provide coverage of wheelchairs and accessories from vendors Medicare certified to provide Complex Rehabilitation Technology items.

Centers for Medicare and Medicaid Services (CMS) & Indian Health Care (IHS)

The federal CMS has a Region 10 office to assist tribes with questions about expanded Medicaid and Medicare services. They were unable to be reached for comment. Per the CMS website statement, “Within the vast reforms in PPACA, AI/AN populations will be affected not only by the general provisions, but through specific, explicit provisions, including the permanent reauthorization of the Indian Health Care Improvement Act.”

A question unanswered by both CMS and IHS is how the federal trust responsibility intersects with tribal elders no longer qualifying for expanded Medicaid or Apple Health once they reach age 65. The Washington Health Benefit Exchange is attempting to secure answers to the inquiry. Ideally, those elders would be covered by treaty guaranteed programs created through IHS in their federal trust responsibility and expanded Medicaid that continues beyond age 65.

Though the IHS did not respond to questions about its continuing federal trust responsibility for tribal health care, according to its website, IHS states “it will continue to provide quality, culturally appropriate services to eligible American Indians and Alaska Natives.” Both the CMS and IHS websites also point to the ACA as benefiting Indian elders with strengthened Medicare, affordable prescriptions, and free preventive services regardless of their provider.

The IHS website notes that if tribal members buy private insurance in the Health Insurance Marketplace, they will not have to pay out-of-pocket costs like deductibles, copayments, and coinsurance if their “income is up to around $70,650 for a family of 4.” The IHS assures members of federally recognized they are eligible to continue receiving services from the Indian Health Service, tribal health programs, or urban Indian health programs even if they have obtained insurance in the marketplace.

The Native American Contact (NAC) for CMS Region 10 is Deborah Sosa. Deb is the agency’s main contact for questions or clarification on:

health policies related to the Medicare, Medicaid, and CHIP programs
policies and programs under the Affordable Care Act, such as the new health insurance exchanges/marketplaces, and
emerging health policies and issues that arise in your community.

She can be reached directly at Deborah.Sosa@cms.hhs.gov or by telephone at (206) 615-2267.

Basic ACA Details for Tribal Members

Exemption

American Indian and Alaska Native consumers who are members of federally recognized tribes have access to a Tribal Membership Exemption from the shared responsibility requirement payment. The exemption applies to American Indian and Alaska Natives who are members of federally recognized tribes and are unable to maintain minimum essential coverage for any time during the year.
To receive an exemption, members may apply through the Marketplace, through their tax return submitted to the Internal Revenue Service by April 2015, or members can receive assistance from either Rose Iukes or Brent Case whose contact information is provided earlier in this story. Alternatively, members can access the form at the following website: http://marketplace.cms.gov/getofficialresources/publications-and-articles/tribal-exemption.pdf

If you have health insurance coverage from your employer or if you have other health care coverage (through Medicare, Medicaid, CHIP, VA Health Benefits, or TRICARE), you are covered and don’t need to worry about paying the shared responsibility payment or enrolling for health coverage available through the Health Insurance Marketplace. However, tribal members are encouraged to complete the tribal lifetime exemption regardless of current coverage.

Enrollment

A frequent question arises about enrollment periods. There is no enrollment period or deadline for members of federally recognized tribes and Alaska Native shareholders who can enroll in Marketplace coverage any time of year. Plans can be changed as often as once per month. Be sure to apply no later than the 23rd of the month for benefits to become effective on the first of the following month. Again, see Rose Iukes at the clinic for assistance. Otherwise, information can also be found at the Health Benefit Exchange – Health Plan Finder website: https://www.wahealthplanfinder.org

Insurance Premiums

Premium payment is due by the 23rd of each month for coverage beginning the following month. Payment can be made by echeck or debit card. Recurring payments can only be setup by echeck. Autopay requires an email address. Rose Iukes can assist you with this during enrollment.

Urban Tulalip Tribal Members

The Health Care Authority tribal liaison, Karol Dixon, recommends that enrolled Tulalip tribal members who reside off-reservation, but within Washington state, can access enrollment assistance by telephoning the Tribal Assister at their tribal clinic (Rose Iukes), but if it is more convenient–they can enroll through the HCA website. In fact, all tribal members can enroll there if they choose. At the website, they can locate a Navigator or Broker who can assist them with the process and in selecting a plan. Select the question mark in the top right of the web page to see links to Navigator or Broker at: https://www.wahealthplanfinder.org

Unfortunately, Tulalip members residing outside of Washington are not eligible to enroll through the Washington Healthcare Exchange. They will need to enroll in the state in which they reside. This is disappointing for any members who may be residing in one of the 24 states that have not expanded Medicaid.

Summary

Many American Indians/Alaska Natives are taking advantage of expanded Medicaid as demonstrated by enrollment data reported by the Health Care Exchange. However, enrollment in the Qualified Health Plans, which offer tribal members many tax credits and cost-share exemptions, could be improved. Moreover, the ACA offers American Indians many advantages expanded access and coverage in both Apple Health and the Qualified Health Plans.

Some political and policy questions remain unanswered such as the federal trust responsibility and how that extends to care for tribal elders 65 and over who have no Medicare coverage. One would hope that the ACA’s permanent reauthorization of the Indian Health Care Improvement Act, extending and authorizing new programs and services within the IHS will find a means to address that void in care for our dear elders.

Early enrollment reports from the Health Care Exchange indicate American Indians/Alaska Natives have taken advantage of expanded Medicaid in Washington State. Many of those tribal members were urban Indians who formerly had little access to any health care, so the ACA is proving itself critical to the health services of urban Indians. Those same individuals can also now receive what for many is urgent dental care.

From early indications, the ACA is fulfilling some of its promise in that it is reducing the number of uninsured Americans with more than 8 million Americans enrolling to date. And the number (17,350) of AI/AN enrolled in Washington’s Apple Health (Medicaid) plan as of March 25 seems to indicate the ACA is fulfilling some of its promise to low-income AI/AN and children. Increased tribal enrollment in the marketplace and in expanded Medicaid will free IHS tribal contract dollars for the tribe to utilize for other urgent care needs.

Many political and policy questions remain unanswered relative to trust responsibility and treaty guaranteed expectations. The possibilities of tribal sponsorship have not yet been fully explored. However, in Washington, and at Tulalip, there is a determined effort by many dedicated individuals and organizations to right some of the historic federal oversights in Indian health care.

Kyle Taylor Lucas is a freelance journalist and speaker. She is a member of The Tulalip Tribes and can be reached at KyleTaylorLucas@msn.com / Linkedin: http://www.linkedin.com/in/kyletaylorlucas

F.D.A. Will Propose New Regulations for E-Cigarettes

The multibillion-dollar e-cigarette industry is not regulated, but the Food and Drug Administration is seeking to change that. Credit Frank Franklin II/Associated Press

By SABRINA TAVERNISE, New York Times News Service

WASHINGTON — The Food and Drug Administration will propose sweeping new rules on Thursday that for the first time would extend its regulatory authority from cigarettes to electronic cigarettes, popular nicotine delivery devices that have grown into a multibillion-dollar business with virtually no federal oversight or protections for American consumers.

The regulatory blueprint, with broad implications for public health, the tobacco industry and the nation’s 42 million smokers, would also cover pipe tobacco and cigars, tobacco products that have long slid under the regulatory radar and whose use has risen sharply in recent years. The new regulations would ban the sale of e-cigarettes, cigars and pipe tobacco to Americans under 18, and would require that people buying them show photo identification to prove their age, measures already mandated in a number of states.

Once finalized, the regulations will establish oversight of what has been a market free-for-all of products, including vials of liquid nicotine of varying quality and unknown provenance. It has taken the agency four years since Congress passed a major tobacco-control law in 2009 to get to this stage, and federal officials and advocates say it will take at least another year for the rules to take effect — and possibly significantly longer if affected companies sue to block them.

“If it takes more than a year to finalize this rule, the F.D.A. isn’t doing its job,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids, an advocacy group.

Thursday’s release of the blueprint — which is hundreds of pages long — is sure to set off a frantic lobbying effort in Washington as affected industries try to head off the costliest, most restrictive regulations.

Members of the Smoke Free Alternatives Trade Association, one of the e-cigarette industry trade groups, descended on Washington in November, and reported holding nearly 50 meetings with congressional officials to help them “learn more about the negative impact inappropriate regulation could have on this nascent industry,” the group said in a statement.

The industry has several trade associations, and a number of them have met with Obama administration officials about the regulations over the past several months, according to public records and industry group statements.

F.D.A. officials gave journalists an outline of the new rules on Wednesday, but required that they not talk to industry or public health groups until after Thursday’s formal release of the document.

The agency said the 2009 law gave it the power to prohibit sales to minors of all tobacco products that it has authority over, which now will include e-cigarettes and cigars. A spokeswoman said the move did not reflect a finding about the safety of these products.

Perhaps the biggest proposed change would require producers of cigars and e-cigarettes to register with the F.D.A., provide the agency with a detailed accounting of their products’ ingredients and disclose their manufacturing processes and scientific data. Producers would also be subject to F.D.A. inspections.

“You won’t be able to mix nicotine in your bathtub and sell it anymore,” said David B. Abrams, executive director of the Schroeder National Institute for Tobacco Research and Policy Studies at the Legacy Foundation, an antismoking research group.

But the new blueprint was also notable for what it did not contain: any proposal to ban flavors in e-cigarettes and cigars, like bubble gum and grape, that public health experts say lure children to use the products, or any move to restrict the marketing of e-cigarettes, as is done for traditional cigarettes, which are banned from television, for example.

F.D.A. officials said the new regulations were the first major step toward asserting the agency’s authority and eventually being able to regulate flavors and marketing. But doing so will require further federal rulemaking, they said.

For example, to restrict the use of flavors, the agency would have to establish a factual record that they pose a health risk for young people. The same goes for marketing, an area that has been vulnerable to litigation from industry. The agency tried to impose graphic warning labels on cigarette packaging, for example, only to have tobacco companies fight the measure in court and win on grounds that it violated their First Amendment right to free speech.

“You can’t get to the flavors until you have regulatory authority over them,” said Mitchell Zeller, director of the Center for Tobacco Products at the F.D.A. He called the blueprint “foundational.”

The regulations establish federal authority over tobacco products that were not named in the 2009 tobacco control law, including certain dissolvable tobacco products, water pipe tobacco and nicotine gels. E-cigarettes are considered a tobacco product because their main ingredient, nicotine, is derived from tobacco.

One exception is sure to worry antismoking activists: Mr. Zeller said the agency was asking for public comment on whether premium cigars — hand-rolled with a tobacco leaf as a wrapper — should be placed in a special separate category not subject to F.D.A. authority. The cigar industry has lobbied Congress furiously for exemption to the rules, garnering some support from both Democrats and Republicans.

The new regulatory proposal is open to public comment for 75 days, and then the agency will make final changes, a process that will take months.

Under the new rules, companies would no longer be able to offer free samples, and e-cigarettes would have to come with warning labels saying that they contain nicotine, which is addictive. Companies would also not be able to assert that e-cigarettes were less harmful than real cigarettes unless they got approval from the F.D.A. to do so by submitting scientific information.

In the proposed restrictions on sales to minors, vending machines in public places where minors are allowed would no longer be able to carry them. A ban on Internet sales to minors, already in place for cigarettes, would extend to e-cigarettes and cigars.

E-cigarette consumption is rising fast, and in the absence of federal regulations, many states have already passed laws that ban e-cigarettes from public places, regulate their sale, and in some cases tax them. More than half of states already enforce bans on their sale to minors.

Under the new rules, companies would have to apply for F.D.A. approval for their products, but would have two years after the new rules are finalized to do so. Companies can keep their products on the market in the meantime. Eventually, the companies would have to adhere to F.D.A. standards for manufacturing their products, not unlike how drug companies and food companies do now, but the agency has yet to write those rules.

Some experts have cautioned that too high a regulatory bar could stifle smaller e-cigarette producers and help deep-pocketed tobacco companies, which have also gotten into the e-cigarette business. Innovation to make e-cigarettes better would also slow if regulations were too burdensome, they say. Meeting such requirements includes the expenses of application costs, user fees that industry pays the agency, and assembling a scientific case to show that a product should be approved.

Bonnie Herzog, an analyst at Wells Fargo Securities in New York, said the proposal would probably lead to consolidation in the fragmented e-cigarette industry, where there are now around 200 manufacturers.

“It benefits the entrenched players,” she said, referring to the three big tobacco companies that produce e-cigarettes, Lorillard, R.J. Reynolds and Altria, the parent company of Philip Morris U.S.A., as well as larger e-cigarette producers, like Njoy and Logic.

Health experts disagree over the role of e-cigarettes, with some arguing that they offer the first real alternative to the deadly risks of smoking and could save millions of lives. Others are more cautious, saying their gadgetry and flavors tempt children, and that people are using them to enable smoking habits, not to quit.

Antismoking activists say the agency must strike a balance.

“In the urgency not to stifle innovation, we shouldn’t eliminate the need for scientific evidence,” Mr. Myers said. “You can’t let them be fly-by-night operations.”

American Indian and Alaska Native death rates nearly 50 percent greater than those of non-Hispanic whites

A patient gets more information about a colonoscopy from his provider at the Alaska Native Medical Center.Photo is courtesy of the Alaska Native Tribal Health Consortium. — A patient gets more information about a colonoscopy from his provider at the Alaska Native Medical Center.
Photo is courtesy of the Alaska Native Tribal Health Consortium.

Source: CDC Media Relations, April 22, 2014

Death records show that American Indian and Alaska Native (AI/AN) death rates for both men and women combined were nearly 50 percent greater than rates among non-Hispanic whites during 1999-2009. The new findings were announced through a series of CDC reports released online today by the American Journal of Public Health.

Correct reporting of AI/AN death rates has been a persistent challenge for public health experts. Previous studies showed that nearly 30 percent of AI/AN persons who identify themselves as AI/AN when living are classified as another race at the time of death.

“Accurate classification of race and ethnicity is extremely important to addressing the public health challenges in our nation, said Ursula Bauer, Ph.D., M.P.H., director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. “We must use this new information to implement interventions and create changes that will reduce and eliminate the persistent inequalities in health status and health care among American Indians and Alaska Natives.”

CDC’s Division of Cancer Prevention and Control led the project and collaborated with CDC’s National Center for Health Statistics and other CDC researchers, the Indian Health Service, partners from tribal groups, universities, and state health departments.

Key findings:

· Among AI/AN people, cancer is the leading cause of death followed by heart disease. Among other races, it is the opposite.

· Death rates from lung cancer have shown little improvement in AI/AN populations. AI/AN people have the highest prevalence of tobacco use of any population in the United States.

· Deaths from injuries were higher among AI/AN people compared to non-Hispanic whites.

· Suicide rates were nearly 50 percent higher for AI/AN people compared to non-Hispanic whites, and more frequent among AI/AN males and persons younger than age 25.

· Death rates from motor vehicle crashes, poisoning, and falls were two times higher among AI/AN people than for non-Hispanic whites.

· Death rates were higher among AI/AN infants compared to non-Hispanic whites infants. Sudden infant death syndrome and unintentional injuries were more common. AI/AN infants were four times more likely to die from pneumonia and influenza.

· By region, the greatest death rates were in the Northern Plains and Southern Plains. The lowest death rates were in the East and the Southwest.

“The new detailed examination of death records offers the most accurate and current information available on deaths among the American Indian and Alaska Native populations,” said David Espey, M.D., acting director of CDC’s Division of Cancer Prevention and Control. “Now, we can better characterize and track the health status of these populations – a critical step to address health disparities.”

The studies address race misclassification in two ways. First, the authors linked U.S. National Death Index records with Indian Health Services registration records to more accurately identify the race of AI/AN people who had died. Second, the authors focused their analyses on the Indian Health Services’ Contract Health Service Delivery Area counties (CHSDA) where about 64 percent of AI/AN persons live. Fewer race misclassification errors occur in CHSDA data than in death records.

The authors reviewed trends from 1990 through 2009, and compared death rates between AI/AN people and non-Hispanic whites by geographic regions for a more recent time period (1999-2009).

The report concludes that patterns of mortality are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and health-harming social determinants. Many of the observed excess deaths can be addressed through evidence-based public health interventions.

“The Indian Health Service is grateful for this important research and encouraged about its potential to help guide efforts to improve health and wellness among American Indians and Alaska Natives,” said Yvette Roubideaux, M.D., M.P.H, acting IHS director. “Having more accurate data along with our understanding of the contributing social factors can lead to more aggressive public health interventions that we know can make a difference.”

For more information, the articles from the report will be in the AJPH “First Look” early online section at 4:00 pm EST today. Visit: http://ajph.aphapublications.org/toc/ajph/0/0

For information on CDC’s efforts in cancer prevention and control, visit http://www.cdc.gov/cancer/.

The Affordable Care Act (ACA), also known as the health care law, was created to expand access to coverage, control health care costs, and improve health care quality and coordination. The ACA also includes permanent reauthorization of the Indian Health Care Improvement Act, which extends current law and authorizes new programs and services within the Indian Health Service. Visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more.

Isadore Boni: AIDS Stigma Holding Back Progress in Indian Country

Courtesy Wellbound StorytellersIsadore Boni, San Carlos Apache, was diagnosed with HIV and hepatitis C in May 2002. After his disease escalated to AIDS in November 2004, he was cured of hepatitis C in 2013. Now he is an advocate for HIV prevention and HIV/AIDS treatment and care. — Courtesy Wellbound Storytellers
Isadore Boni, San Carlos Apache, was diagnosed with HIV and hepatitis C in May 2002. After his disease escalated to AIDS in November 2004, he was cured of hepatitis C in 2013. Now he is an advocate for HIV prevention and HIV/AIDS treatment and care.

Isadore Boni, Indian Country Today Media Network

According to the Center for Disease Control (CDC), of persons diagnosed with HIV, more than 38 percent of American Indians and Alaskan Natives progressed to an AIDS diagnosis in less than 12 months, which is the highest percentage among all racial/ethnic groups.

Many question why American Indians and Alaskan Natives progress so fast to an AIDS diagnosis, which also contributes to Natives having the shortest survival time among all racial/ethnic groups. AIDS/HIV awareness activist Isadore Boni blames the stigma attached to the disease.

“Stigma in Indian country in general is still very very strong,” Boni said. “Stigma prevents people from getting tested, prevents people from accessing the care they need and it stops people who are positive from going through the process of acceptance. That is more important than anything. Stigma to me in my opinion, is the reason, that Native people, have the highest death rates, among all other people according to the CDC.”

Boni, a San Carlos Apache tribal member, spoke to college students at Haskell Indian Nations University for their AIDS Awareness event.

Native AIDS Survivor Finds Empowerment Through Honesty, Fights for HIV Confidentiality Law

Apache AIDS Survivor Runs Fifth Half-Marathon

Regardless of the statistics, Boni has gone on to lead a healthy and productive life. Since being diagnosed with HIV, he recently finished his fifth P.F. Chang’s half marathon this past January in Phoenix, Arizona, where he resides.

“I want the students to know, even the most educated and most successful people have HIV and it doesn’t necessarily mean it’s a death sentence,” he said. “The sooner you get tested, the longer you can live.”
According the CDC, Native Hawaiians/Other Pacific Islanders and American Indians/Alaska Natives had the 3rd and 5th highest rate of new HIV infections, respectively.

One concern of Boni is making sure when someone does find out they are positive for HIV that they have support.

“Sharing with people makes me stronger,” Boni said. “It is also medicine, whether it’s words or a hug, that to me is medicine. That support, is more stronger than any medication that I have been taking.”

The National Native HIV/AIDS Awareness Day is March 20. Organizers are looking for tribal communities to host events to help increase awareness. Anything from hosting talks, walks, runs or by going with someone to take a test as a form of support, National Native HIV/AIDS Awareness Day has materials ready for anyone at their website at www.nnhaad.org.

This article was originally published by Wellbound Storytellers. Read more blogs about healthy living written by Natives throughout Indian country at WellboundStorytellers.com.

How a cup of nettle tea changed my life

A member of the Muckleshoot tribe, Valerie Segrest knew something was missing from her diet, but she wasn’t expecting the change it would bring.

By Valerie Segrest, Crosscut.com

Four years ago, when I was studying nutrition at Bastyr University in Seattle, I came to class to find a cup of tea waiting for me. My instructor said we would be doing a meditation: We would sit in silence for three minutes and drink tea. She instructed us to pay attention to how this warm beverage made us feel.

I was already immersed in an environment that preached the benefits of a good diet. My diet was pristine. On certain days, I was obsessed with eating the right things, like leafy greens and organic, whole carrots, which I cut myself rather than risk buying the baby-cut varieties that are washed in chlorinated water. But I was still sick quite often and couldn’t put my finger on what was lacking.

I am a Muckleshoot Indian, but other than the occasional seafood dish, little of what I ate then bore much connection with the landscape I lived in, which had fed my ancestors for many generations.

My body immediately responded to this tea. It was as if I were remembering what it was like to feel well. I was rooted and energized. When our three-minute silence ended, the instructor circled around the room and asked us to describe how we felt. Some people said they felt calmed, some said comforted.

Still stunned, I continued to sit in silence. The teacher announced we had just experienced wild stinging nettle tea.

I proceeded to drink nettle tea instead of water every day. I walked around with jars of nettle-tea infusions and talked to anyone who asked about how amazing this plant was. I began to visit patches of nettles in the woods near my house and everywhere else I could find the plants.

I read everything I could on the nettle. I drew it. I sat with it. I stung myself with it. I harvested and ate it. I bathed in its beautiful, rich juice. I had never felt so strong, energized, and healthy.

I call nettle my first plant teacher. From the moment I drank the juices of this plant, I became an advocate, passionate about the native foods of the Pacific Northwest. Currently, my work as a nutrition educator takes me to tribal communities throughout Washington state. Everywhere I go, I hear stories about the ways native foods heal people. Elders remind me that problems like diabetes and heart disease were almost nonexistent in our communities until we began to lose access to foods like salmon, huckleberries, elk and wild greens. These foods are nutrient-dense, and they bless us with a true sense of place.

From Muckleshoot oral traditions, I have learned that plants and animals teach us how to live. How can we be like salmon, who return each year to their ancestral rivers and give their lives in order to feed the land, plants, animals and humans? How can we transform our behaviors and habits to fit our natural surroundings, like the 20 different varieties of huckleberries that grow wild from the seashore to the mountaintops?

Since that moment with the cup of nettle tea, I have become committed to sharing the abundance of wild foods, praying for their return and celebrating their presence in the world.

Forage Fish Important to Salmon Diet

Point No Point Treaty Council biologists are counting forage fish eggs so they can get a better idea of what food is available for salmon.

Source: NWIFC

Shannon Miller and John Hagan keep a close eye on the phases of the moon so they can determine the best time of the month to collect samples of pinhead-sized translucent forage fish eggs.

“We found that the moon phases may be a potential spawning cue,” Miller said. “There are more eggs around the new moon and full moon phases during the fall and winter months, so we schedule our surveys around that and the tides. That makes for an interesting work schedule.”

Miller and Hagan are Point No Point Treaty Council (PNPTC) biologists who are studying the spawning rates of surf smelt and pacific sand lance, both important food sources for salmon. The PNPTC is a natural resources management agency for the Port Gamble and Jamestown S’Klallam tribes.

Past studies have focused on the presence or absence of eggs in the intertidal zone but have not necessarily tracked egg densities,” Miller said. “We’re trying to build a better quantitative data set to see if they’re reproducing enough offspring for salmon to eat. They’re an important part of the food chain and an indicator of the health of the sound’s ecosystem.”

Since 2011, they have been collecting bags of sand from beaches on Indian Island, in areas with prime forage fish habitat, which includes sandy gravel shores. The bags are taken back to the PNPTC lab, where the eggs are separated from the sand and then individually counted. In the 2011-2012 sampling period, more than 450,000 eggs were sampled.

“We’re finding many more eggs than in past studies, but we are also sampling more intensively,” Miller said.

This five-year project will also look at the timing of incubation and emergence of forage fish embryos, as well as the environmental conditions for spawning, such as water temperature, that determine successful spawning rates.

Partners in the project include the U.S. Navy, Washington Department of Fish and Wildlife, Puget Sound Partnership and the Environmental Protection Agency.

The Great American Smokeout and the National COPD Awareness Month Team Up to Help Smokers Quit

National COPD Awareness month and the Great American Smokeout provide smokers in the U.S. with support to help them kick the habit this November.

Written by Joe Bowman, Healthline

If you are one of the nearly 44 million Americans who have yet to kick their smoking habit, November might be the perfect time to put the cigarettes out for good.

On Thursday, November 21, the American Cancer Society (ACS) will hold the 37th annual Great American Smokeout. In 1976, the California Division of the ACS encouraged nearly 1 million smokers to give up cigarettes for the day. The success of the first Great American Smokeout prompted the ACS to expand the program to the rest of the U.S. the following year, turning the third Thursday of November into a day when Americans can support one another in the fight to quit smoking.

According to the Centers for Disease Control and Prevention (CDC), cigarette smoking is the principal cause of preventable death in the U.S. It is responsible for one in five deaths—or more than 440,000 deaths annually. Tobacco use greatly increases a person’s risk for cancer, heart disease, stroke, respiratory diseases, and a host of other conditions.

The ACS reports that smoking is not only responsible for nearly a third of all cancer deaths but also for about a fifth of deaths from all causes. Changes in attitude toward tobacco usage have helped the percentage of American smokers over the age of 18 drop from more than 42 percent to close to 18 percent. Though many states now have laws that restrict smoking in public areas, it’s estimated that 1 in 5 U.S. adults still smoke.

The ACS believes that even quitting for a day is a step in the right direction toward a healthier lifestyle.

Take a Minute to See the Timeline of What Happens When You Quit Smoking »

Starting a Dialogue About COPD

November is also National COPD Awareness Month. Chronic obstructive pulmonary disease (COPD) is a disease that affects the lungs, making breathing more difficult as it progresses. COPD, which is also known as emphysema or chronic bronchitis, is characterized by three main symptoms: shortness of breath during physical activity and, as the disease worsens, while at rest; chronic coughing; and spitting or coughing mucus from the lungs.

The University of Maryland Medical Center estimates that cigarette smoking accounts for around 80 percent of all COPD cases. With more than 120,000 deaths each year in the U.S. alone, COPD moved ahead of stroke in 2010 to become the third leading cause of death in the U.S. While more than 12 million people are currently diagnosed with COPD, the more disturbing fact is that there are likely another 12 million with the disease who are unaware of it.

In an effort to educate patients and health care providers of COPD, the National Heart, Lung, and Blood Institute (NHLBI) has launched the COPD Learn More Breathe Better campaign, aimed at current and former smokers over the age of 45.

James Kiley, director of the NHLBI Division of Lung Diseases, hopes that increased awareness of the disease will encourage more patients and health care providers to discuss symptoms and treatments for COPD in the doctor’s office.

“It’s no secret that early diagnosis and treatment can improve daily living for those who have COPD, but you can’t get there without an open line of dialogue in the exam room,” Kiley said in a press release.

Although there is no cure for COPD, lifestyle changes such as smoking cessation, exercise, and a healthy diet can lessen the symptoms of the disease. You should also speak with your doctor about medications that can also help.

Not Convinced? Here Are 7 More Reasons to Quit Smoking »

Additional Tips to Keep You Smoke-Free

While the task of giving up cigarettes might seem daunting to many current smokers, the ACS offers these tips to help you stick to your goal after the clock strikes 12 during this year’s Great American Smokeout:

Seek out support in the form of smoking cessation hotlines or stop-smoking groups in your city or online.
Look into counseling to give you an additional, professional support system.
Ask your doctor about prescription medications, including Bupropion or Chantix.
If counseling or medication aren’t possible, there are many books out there that can help.
Ask your doctor or pharmacist about nicotine replacement products, like patches or gum.
Talk about quitting with friends and family. Don’t underestimate the power of positive reinforcement and encouragement from loved ones.

For more information about quitting smoking and tobacco products, call the ACS at 1-800-227-2345.