Joining to fight a health disparity

The national Prevent Cancer Foundation selected Minnesota as the site to hold a Dialogue for Action Summit to address the high incidence and mortality rates of colorectal cancer among American Indians in the Northern Plains and in Minnesota. Representatives from numerous groups, including tribal health administrators, urban Indian communities, the Minnesota Department of Health, the American Cancer Society, and the University of Minnesota Cancer Center, are all partners in this coalition and participated in the summit, which took place at Grand Casino Mille Lacs.

“It’s been a tremendous effort by the group to make this happen,” says Marva Bohen, outreach director for the Cancer Center and co-coordinator of the summit.

According to the Indian Health Service, colorectal cancer mortality rates in the Bemidji Service Unit (which includes Minnesota, Michigan, and Wisconsin) are 130 percent higher than other populations as a whole, including other American Indian populations. And colorectal cancer incidence among American Indians in Minnesota is 60 percent higher than in non-Indian populations.

“By holding this summit and giving presentations, we’ve created a greater awareness of the prevalence of colorectal cancer in these tribal communities,” says David Perdue, a Cancer Center member who also is a gastroenterologist at the University of Minnesota and a co-chair of the Minnesota Dialogue for Action project. Perdue is a member of the Chickasaw Nation of Oklahoma.

The summit opened with a drum ceremony and a prayer. The keynote speakers was Linda Burhansstiponov, a cancer expert and director of Native American Cancer Initiatives, Inc. Burhansstipanov is a member of the Western Cherokee Tribe and has been actively involved in Native American health and wellness initiatives nationwide. At the summit, she addressed culturally respectful programs on colon health.

The remaining sessions at the summit consisted of a series of conversations. The three major conversation themes that participants were asked to discuss:

• finding resources for colorectal cancer prevention and early detection in Indian communities;
• ways to create tribal and urban Indian health care systems that make colorectal cancer prevention a priority; and
• steps to engage Indian communities to participate in colorectal cancer prevention and screenings.

Perdue described the conversations as an essential first step toward better understanding and bridging health disparity gaps. The conversations helped community leaders learn about the cultural and financial barriers to colorectal cancer prevention and treatment and the resources needed to overcome those barriers.

The purpose of the conversations was to engage key tribal members and cancer experts in setting priorities for the next steps in combating colorectal cancer in these communities. The conversations at the summit served as the foundation for developing culturally sensitive colorectal cancer control strategies. Ultimately, Minnesota Intertribal Colorectal Cancer Council hopes these conversations will be the start to reducing the rate of colorectal cancer among Native Americans in the Northern Plains and Minnesota.

“We want to assail the issue of colorectal cancer from a community-based perspective,” says Perdue. “We wanted to know from the community where they think we need to put our efforts.”

--Reprinted with permission from the University of Minnesota Cancer Center 2007 Annual Report