Matching Items (2)
Description
The overarching purpose of my dissertation is to offer one Pueblo perspective about research and health education to contribute to critical dialogue among Pueblo people so that relevant research and health education approaches grounded in Pueblo thinking can emerge. Research was a pebble in my shoe that caused me great discomfort as I walked within academia during the many years I worked as a health educator at a university, and continues to bother me. The purpose of my journal article is to discuss why much mainstream research is problematic from a Pueblo Indian standpoint and to explore considerations for research with Pueblo people. The purpose of my book chapter is to reflect on my experiences as a Pueblo Indian health educator to add to the discussion about the importance of grounding Pueblo health education in local Pueblo knowledge systems and to discuss the limitations of delivering health education primarily grounded in a western biomedical disease model. Finally, my policy brief is an urgent call to action for tribal leaders regarding a recent change to the New Mexico Department of Health's race and ethnicity presentation in health data standard. This change resulted in 39,636 American Indians and Alaska Natives in New Mexico being reclassified as Hispanic. It is my intention to connect my ideas about research and health education with the work of other Pueblo scholars to add to the growing body of Pueblo informed writing to contribute to current and future scholarship that will ultimately benefit Pueblo people.
ContributorsSuina, Michele (Author) / Sumida Huaman, Elizabeth (Thesis advisor) / Brayboy, Bryan (Thesis advisor) / Gomez, Alan (Committee member) / Arizona State University (Publisher)
Created2015
Description
The health situation of indigenous peoples is comparable to that of the world's poorest populations, but with the additional burdens of social and cultural marginalization, geographic and cultural barriers to accessing health services, and, in some areas, appropriation of land and natural resources. Cultural transmission (the transfer of beliefs, ideas, and behaviors from one culture to another) from outsider health institutions should presumably aid in closing this health gap by transferring knowledge, practices, and infrastructure to prevent and treat disease. This study examines the biosocial construction of the disease ecology of tuberculosis (TB) in indigenous communities of the Paraguayan Chaco with varying degrees of cultural transmission from outside institutions (government, religious, and NGOs), to determine the influence of cultural transmission on local disease ecologies. Using a biocultural epidemiological framework for the analysis of human infectious disease ecology, this study employed an interdisciplinary, mixed methods approach to examine the interactions of host, pathogen, and the environment in the Paraguayan Chaco. Three case studies examining aspects of TB disease ecology in indigenous communities are presented: (1) The effective cultural transmission of biomedical knowledge to isolated communities, (2) Public health infrastructure, hygiene, and the prevalence of intestinal parasites: co-morbidities that promote the progression to active TB disease, and (3) Community-level risk factors for TB and indigenous TB burden. Findings from the case studies suggest that greater influence from outside institutions was not associated with greater adoption of biomedical knowledge of TB. The prevalence of helminthiasis was unexpectedly low, but infection with giardia was common, even in a community with cleaner water sources. Communities with a health post were more likely to report active adult TB, while communities with more education were less likely to report active pediatric TB, suggesting that healthcare access is the major determinant of TB detection. More research is needed on the role of non-indigenous community residents and other measures of acculturation or integration in TB outcomes, especially at the household level. Indigenous TB burden in the Chaco is disproportionately high, and better understanding of the mechanisms that produce higher incidence and prevalence of the disease is needed.
ContributorsVansteelandt, Amanda (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Stone, Anne (Thesis advisor) / Hruschka, Daniel (Committee member) / Rojas de Arias, Antonieta (Committee member) / Arizona State University (Publisher)
Created2014