Sudden Infant Death Syndrome remains a mystery
TAHLEQUAH, Okla. – Cherokee Nation citizen Angela Garrett remembers the cold day in January 1993 as one that began like a normal day.
She had just per her 2-month-old son, Blaine, down for a nap in his crib. She checked on him frequently, but despite that, one hour later Blaine died in his sleep. The cause was Sudden Infant Death Syndrome.
October is Sudden Infant Death Syndrome, or SIDS, Awareness Month. SIDS occurs at a rate of about 0.5 per 1,000 births. However, in American Indian and African American populations, the rate is around one per 1,000 births.
SIDS is considered the death of a child less than 1 year old that remains “unexplained” after a thorough investigation including an autopsy, review of clinical history and investigation of the scene of death, said Dr. Tom Kincade, chief of Pediatrics at the Cherokee Nation Three Rivers Health Center in Muskogee.
“I think it is important for our communities to know abut SIDS due to the increased rates in Native Americans and also to be aware of the factors that can help prevent SIDS,” Kincade said.
SIDS remains a leading cause of death in healthy infants less than 1 year old, and approximately 2,100 infants in the United States die of SIDS per year, he said.
Parents can reduce the risk of SIDS by placing babies on their backs to sleep.
“Studies show that over 90 percent of infants that died from SIDS were not sleeping on their backs,” he said. “Most were sleeping on their stomachs.”
Garrett said she put Blaine on his back for his nap, but when she found him, he was on his stomach and his face was in the crib mattress.
“Somehow, at 2 months old he rolled over,” she said. “He was already gone when I found him. I didn’t even call 911(immediately.) I called my mom because he was already gone.”
She said afterward she was in a state of shock, and since then she’s blocked out most of the memory of losing Blaine to SIDS.
“I don’t even remember them taking him out,” she said. “I thought he was still in the room after the ambulance got there and everything. It was a couple of hours later and I thought he was still there.”
Even now, 14 years later, Garrett said she’s stilly trying to understand SIDS.
“From the moment I found him, I don’t remember too much of anything else,” she said. “He wasn’t sick. He didn’t have a cold. There wasn’t anything wrong with him.”
Studies have also shown that letting babies use pacifiers while sleeping can reduce the SIDS risk, Kincade said. He added that infants should sleep on a firm sleeping surface, should not be overdressed while they sleep and stuffed animals, excess bedding and blankets should be avoided.
“When babies leave the hospital nursery they should be able to maintain a normal body temperature which means if parents feel comfortable in shorts and a tee shirt, their babies will too,” he said.
Educational materials about SIDS have been placed in the clinic and exam rooms at the Three Rivers Health Center, and other tribal clinics have been encouraged to do the same, Kincade said.
OKLAHOMA CITY – For May, the Oklahoma City Indian Clinic, a nonprofit that provides services to Native Americans in central Oklahoma, is bringing awareness to mental health issues.
“It is important to understand early symptoms of mental illness and know when certain behaviors are potential signs of something more,” Summer Welcher-Duke, OKCIC Behavioral Health director, said. “We need to speak up early and educate people about risky behavior and its connection to mental illness, and do so in a compassionate, judgment-free way.”
According to an OKCIC press release, approximately 43.8 million adults in the United States, or 18.5 percent, experience mental illness in a given year.
The release states that specific populations of people, such as Native Americans, experience mental health concerns at a higher rate than the general population.
According to the American Psychiatric Association, Native Americans experience serious psychological distress 1.5 times more than the general population, experience post traumatic stress disorder more than twice as often as the general population and use and abuse alcohol and other drugs at younger ages and at higher rates than all other ethnic groups.
OKCIC offers counseling for a range of mental health and substance abuse issues through its Behavioral Health Department, which is a multi-faceted department of licensed mental health professionals that address the physical as well as mental, emotional and spiritual needs of the Native community.
“Prevention, early identification, early intervention and integrated services work,” OKCIC CEO Robyn Sunday-Allen said. “When we engage in prevention and early identification, we can help reduce the burden of mental illness by identifying symptoms and warning signs early.”
For more information, visit <a href="http://www.okcic.com" target="_blank">www.okcic.com</a>.
TAHLEQUAH, Okla. – The Oklahoma Osteopathic Association recently awarded Cherokee Nation Dr. Jeffrey Gastorf the 2017 A.T. Still Award of Excellence.
It is given to one osteopathic physician statewide in honor of A.T. Still, who was the founder of osteopathy and osteopathic medicine that focuses on total body health and the ability for the body to heal itself.
Gastorf, 41, is a general physician at the Vinita Health Center.
“Dr. Gastorf embodies the teachings of Dr. A.T. Still and seeks out opportunities to share his knowledge with residents and students. His patient-centered approach is the foundation of osteopathic medicine and benefits the lives of his patients,” Kenneth E. Calabrese, president of the Oklahoma Osteopathic Association, said.
Gastorf completed his medical school training at Oklahoma State University and his residency training at Durant Family Medicine Residency.
He is the former director of the Durant Family Medicine Residency Program, where he served for eight years before joining the tribe’s Vinita Health Center in January.
“I wanted to focus more on patient care, and I appreciate that Cherokee Nation is truly concerned about providing care and having resources to help patients,” Gastorf said. “The most rewarding thing is when patients are appreciative of the care they receive and thank you for your help.”
Gastorf also serves on the Graduate Medical Education committee for the Oklahoma Osteopathic Association and previously served as president of the Oklahoma chapter of the American College of Osteopathic Family Physicians.
CN Health Services operates the largest tribally run health system in the country, with more than a million patient visits per year. It consists of eight health centers and W.W. Hastings Hospital in Tahlequah.
A record number of Oklahomans died from drug overdoses in 2016, and for the first time in years, methamphetamine was the single biggest killer, preliminary data shows.
An Oklahoma Bureau of Narcotics and Dangerous Drugs Control analysis shows 952 people died from overdoses, and the number is likely to rise as pending autopsies are finalized. The total number of overdose deaths is well above the 862 recorded in 2015 and the previous record of 870 in 2014.
Meth was involved in 328 of the deaths, climbing steeply from 271 in 2015 and surpassing the total combined deaths involving much-abused opioids hydrocodone and oxycodone.
Opioids remain a potent threat, however. As a group, they were involved in more fatal overdoses than meth in 2016.
Fatal heroin overdoses continued to surge, with the drug involved in 49 deaths in 2016, up from 31 in 2015. Other states have seen larger increases in deadly heroin abuse.
The Narcotics Bureau said its numbers derive from its running collection of autopsy results from the Office of the Chief Medical Examiner.
Narcotics Bureau spokesman Mark Woodward attributed the meth-related deaths partly to the growing use and continued availability of the drug.
Oklahoma’s high rates of mental illness and addiction, along with crackdowns on opioid prescribing, have made the state a ready market for a form of meth, called “ice,” provided by Mexican cartels.
The living-room meth labs of the previous decade are less common now, with discoveries of labs decreasing dramatically, Woodward said. Instead, meth comes from “super labs” in Mexico and along the U.S.-Mexico border. People who once would have cooked small amounts of meth to sell and use now steal or barter to feed their habits.
“It’s cheap, it’s accessible and someone in your circle will have it if you’re using drugs,” he said.
Changes in law have helped decrease opioid overdoses, health officials say. A 2015 law requires doctors to check the state’s Prescription Monitoring Program database before prescribing opioids and benzodiazepines, such as Xanax, to new patients. A 2014 reclassification of combination opioids, such as Lortab, which includes hydrocodone and acetaminophen, into Schedule II controlled dangerous substances, prohibits doctors from writing prescriptions for more than 90 days and phoning them in to pharmacies.
Jeff Dismukes, spokesman for the Oklahoma Department of Mental Health and Substance Abuse Services, said the declining number of opioid-related deaths also corresponds with lives saved from administering opioid-blocking Naloxone.
“It’s pretty darn close,” he said. “You can see how we’re really making a difference in bringing that number down.”
However, prescription drug overdoses remain a scourge.
“We’ve made a little progress with opioids but we’re nowhere near that not being a problem,” Dismukes said. “That’s still the biggest issue in the state”
Jessica Hawkins, prevention director for the Mental Health Department, cautioned against oversimplifying potential links between meth and prescription drug abuse. A drop in one doesn’t necessarily lead to an increase in the other, she said.
“They’re concurrently problematic,” she said. “What we don’t want to do is switch attention from another serious epidemic, which is the opioid epidemic we’re in, and move attention away from that.”
Hawkins said potential causes include increased strength of methamphetamine, manner of taking the drug (IV users are more likely to suffer an overdose), using meth with other substances, and multigenerational use in some families.
Woodward said there is no way to know if the hundreds of Oklahomans who died from meth overdoses were regular users or were shifting from prescription opioids to meth. Autopsies and medical examiner reports only determine what was in a person’s body at the time of death, or if responders found drugs or paraphernalia nearby. Also, many people who die from drug overdoses have taken multiple drugs, although the Narcotics Bureau counts them according to the main drug found in their systems.
“When you’re an addict, you’ll take what you can get. … They all have their drug of choice, but they’re not exclusive to that drug,” he said.
<strong>Oklahoma Watch is a nonprofit, nonpartisan media organization that produces in-depth and investigative content on public-policy issues facing the state. For more Oklahoma Watch content, go to <a href="http://www.oklahomawatch.org" target="_blank">oklahomawatch.org</a>.</strong>
OKLAHOMA CITY (AP) — A Republican plan to overhaul the nation's health care system shows health care could become unaffordable for many poor Oklahomans and the state could be forced to subsidize health care costs for Native Americans, according to an early analysis of the plan prepared for Gov. Mary Fallin.
A document obtained Tuesday by The Associated Press shows state health officials also project the proposed new law would result in the state immediately losing $9.3 million in public health funding for programs such as immunizations and chronic disease funding.
The three-page document prepared last week by state health officials and policy analysts in Fallin's office outlines some of the pros and cons of key provisions in the plan.
Among the top concerns is the proposal to replace income-based subsidies that help people pay for premiums with age-based tax credits.
"This creates a huge subsidy cliff between Medicaid and the individual market that could cause people on Medicaid to not go to work or earn more income because the cost of insurance would be unaffordable," the analysis states. "The subsidy should be based on income and age."
Anna Holloway, a 60-year-old Norman resident who received tax subsidies to purchase health insurance on the federal exchange, said she's fearful the new GOP plan could price her out of the market for health insurance.
"If I didn't have subsidies, I couldn't have insurance," said Holloway, who works part-time at a Tulsa seminary and takes medication every day because of an auto-immune disease.
"I am conscious of just how desperate this is," she said, fighting back tears. "I try not to let myself feel this way, but to live this way with real terror, real fear that the universe is going to fall apart around me."
The analysis also suggests there is no indication that the federal government intends to adhere to a previous obligation to pay for tribal members' health care costs, "shifting that burden to the states."
Among the benefits cited in the report is that the age rating change should lower the cost of insurance for young people, who also could be attracted by their ability to buy catastrophic coverage.
Oklahoma has one of the highest uninsured rates in the nation, with about 14 percent of residents with no coverage, compared to the national rate of about 9 percent. Oklahoma also is among the poorer states, with about 16 percent of residents earning below the federal poverty level of $24,250 for a family of four in 2015.
An analysis of the plan by the nonpartisan Congressional Budget Office released this week predicts 14 million Americans would lose coverage next year under the GOP proposal, and that number would balloon to 24 million by 2026.
A separate analysis of the bill by the left-leaning Center for American Progress shows Oklahoma would experience among the highest premium increases by 2020, averaging more than $5,000 per individual. Those annual premium increases are even more dramatic for low-income residents, who would see their premiums increase by about $7,385 by 2020, and Oklahomans aged 55-64, who would see average increases of $12,032.
Fallin said in a statement she's optimistic that Republicans members of Congress are planning to repeal, replace and reform the Affordable Care Act, but described the GOP proposal as a "first step."
"I look forward to seeing what will evolve from this proposal," she said. "I hope the plan will offer strong flexibility to the states to reform Medicaid and the system surrounding it."
OKLAHOMA CITY (AP) — State health officials say Oklahoma County is in the midst of the largest syphilis outbreak in recent state history.
The state Health Department's manager of HIV and sexually transmitted disease services, Kristen Eberly, said this is the largest number of cases connecting to the same infection she's seen in her 13 years with the department.
The outbreak comes as Oklahoma is also seeing a rising number of residents dying from heroine and methamphetamine overdose.
Health officials said drug abuse is one of the main contributing factors for the syphilis outbreak. Other risk factors associated with the outbreak include exchanging sex for money or drugs, and having multiple sex partners.
Eighty residents between the ages of 14 and 47 have been infected over the past few months, The Oklahoman reported. The majority of those identified used drugs, including heroin and methanphetamine.
Health officials said it's important for residents to get tested for syphillis.
"We just want to help everybody, regardless of whether you're on drugs or not, we don't care," Eberly said. "We want to help get you treated and make you as healthy as we can."
Syphilis is a sexually transmitted disease passed through direct contact with a syphilitic sore, known as a chancre.
ATLANTA, Ga. – Community-based and individual-level prevention strategies are effective ways to reduce alcohol use among American Indian and other youth living in rural communities, according to a new study supported by the National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health.
The National Institute on Drug Abuse also provided support for the study.
“This important study underscores our commitment to finding evidence-based solutions for alcohol problems in American Indian and other underserved populations,” said NIAAA Director George F. Koob “This study is one of the largest alcohol prevention trials ever conducted with an American Indian population, and the first to demonstrate the effectiveness of screening and brief counseling intervention in significantly reducing youth alcohol use at a community level.”
Although American Indian teens drink at rates similar to other United States teens, they have early onset alcohol use compared to other groups and higher rates of alcohol problems. Rural youths, including those who are a racial minority relative to their community, are also at increased risk for alcohol misuse. Early prevention is critical in these populations, but both American Indians and rural communities have been underrepresented in studies aimed at finding effective solutions for underage drinking.
To address this gap, researchers led by Kelli A. Komro of the Rollins School of Public Health at Emory University in Atlanta worked with the Cherokee Nation, the second-largest tribe in the U.S., to implement a rigorous research trial of two distinct strategies to reduce underage drinking and its consequences.
Communities Mobilizing for Change on Alcohol is a community-organizing intervention designed to reduce alcohol access, use and consequences among underage youths. The second strategy, called CONNECT, is an individually delivered screening and brief intervention delivered in schools. The study was conducted within the 14 counties of northeastern Oklahoma that comprise the CN jurisdictional area, which is home to about 40 percent of the tribe. While CN citizens constitute a significant proportion of the population, whites and other racial/ethnic minorities also live within this area. Results of the trial are reported in the March 2017 issue of the American Journal of Public Health.
“Community organizing has been used effectively in multiple other health intervention trials and appeared to be an optimal strategy to engage diverse citizens in these multicultural communities,” explained Dr. Komro. CMCA involves training teams of adults to implement policies and take actions to reduce youth access to alcohol through social and commercial sources. In the school-based intervention, a school social worker conducts a brief one-on-one health consultation with each student each semester to encourage healthy behavior change related to alcohol consumption. Students who report high risk drinking attend follow-up sessions and are referred to specialty treatment when appropriate.
Six communities, each served by a single high school, participated in the study. The student population in these communities was nearly 50 percent American Indian. The study population consisted of students who were in ninth or 10th grade when the study began and followed over three years through 11th or 12th grade.
By random assignment, students in two communities received both the community-organizing intervention and the individually delivered intervention. Students in two different communities served as controls, and received neither intervention. One of the remaining two communities used only the community-organizing intervention while the other used only the school-based individually administered intervention.
Over the course of the study, researchers found that self-reports of alcohol use, including any use and heavy drinking episodes (five or more drinks on at least one occasion) in the past 30 days, was significantly reduced among students receiving either or both interventions, compared with students in the control communities.
“The two distinct interventions alone and in combination resulted in similar patterns of effect across time,” said Komro, “but, interestingly, we found no evidence that the two interventions combined had significantly greater effects than either alone.”
Komro and her colleagues conclude that, while alcohol use among high school students remains a serious public health problem, and rural and American Indian youths are particularly vulnerable populations, the specific community and school-based interventions they examined are effective approaches for addressing alcohol problems in these diverse communities.
Additional alcohol research information and publications are available at: <a href="http://www.niaaa.nih.gov" target="_blank">http://www.niaaa.nih.gov</a>.