Hello and welcome to the master of public health online programs faculty spotlight
webinar with Dr. Claradina Soto presented by the Keck School of Medicine
at the University of Southern California my name is Kijuana Carter and I am the
enrollment advisor here for the Master of Public Health OInline program and I'd
like to thank you for taking time out of your busy schedule to join us before we
begin I like to review what you can expect during the presentation so cut
down on background noise please mute your phone line so as not to disturb the
presenters if you have any questions for our speakers please type them into the
Q&A box in the lower right hand corner of your screen and hit Send feel free to
enter your questions as you think of them and we'll answer as many as time
allows at the end of the presentation a copy of this recording and slide
presentation will be available shortly after here's a quick look at what we'll
be covering today first I will share some information about the tech School
of Medicine of USC I'll give you some background information about our program
director dr. Shobha Kumar who will be available during the Q&A session for any
questions then we'll hear from William Jardel who will introduce our speaker
Dr. Claradina Soto lastly we'll end the presentation with a
brief Q&A session now let's begin about the Keck School of Medicine Keck is the
oldest Medical School in Southern California it was established in 1885
today it is a place of dynamic activity in patient care scientific discovery
medical and bioscience education and community service the department of
preventive medicine at the Keck School of Medicine of USC is known as a leader
in public health in population health sciences it is organized into six
divisions disease prevention and global health bioinformatics biostatistics
Cancer, Epidemiology and genetics I earn mental health and health behavior
research the department of preventive medicine performs pioneering research in
areas such as tobacco control breast cancer pediatric obesity global health
interaction between genes and the environment and others some key research
institutes include the Institute for Global Health and the Institute for
Health Promotion and disease prevention research now dr. Kumar is the program
director for the Master of Public Health online program here at USC she has a
background in social return on investment analysis and has successfully
led the design and oversight of several programs in health care disaster relief
and education dr. Kumar has also launched an international humanitarian
NGO for which she was the chief operating officer her recent projects
include capacity-building of healthcare
NGOs and the development and strengthening of emergency medical
systems and sub-saharan Africa now I want to hand it off to William Jardel
who will introduce our speaker hi everyone my name is William Jarnell and
I am the director online student relations for Massa or the Master of
Public Health Student Association and doing these webinars it gives us a
students a way to learn more about the amazing research our faculty is doing in
ways in which we can learn more and get involved I'm very excited to introduce
to all of you Dr. Soto as our speaker for today Dr. Claradina Soto is a
full-time assistant clinical professor at the University of Southern California
Keck School of Medicine she received her mph and PhD from the USC Keck School of
Medicine and she has over 20 years of experience working with American Indian
and Alaskan native populations in public health to collaborate on several
research projects with various organizations to reduce and prevent
mental health disparities commercial tobacco use and sub substance use
disorders to teaches courses in the master of
public health and health promotion programs at USC and mentors
undergraduate and graduate students dr. Soto is a longtime advocate for American
Indian and Alaska Native communities and other priority populations to advance
health equity and reduce health disparities I urge you to listen closely
to the great information being presented today and to take notes on any questions
you would like to ask at the end of the presentation will you please help me in
welcoming dr. Soto to the presentation
thank you and I know take the lead yes please okay good afternoon everybody
thank you so much for this opportunity to be able to share with you about
Native American culture and health this presentation is really primarily to just
give an awareness and some information about this population because oftentimes
that's not enough information in our courses even starting from elementary to
high school to undergrad unless of course you have selected some of these
historical courses right so it really is a great opportunity to provide even just
some of the additional additional perspective you may not have had on this
population and so I get really excited to be able to share some of this with
you I will share some of the projects at the end of just what's happening in
hopes there might be some opportunity for students to be able to be engaged in
but this presentation is just more about the population about some of the
historical events and giving an example about a public health environmental
justice issue that's happening at hand in the Navajo Nation but I definitely
will look forward to questions at the end of the presentation so with that I
will just say that I am very fortunate to be here at USC and I'm very happy to
be able to work with this population because there's
very much an underserved and under-resourced community we'll see here
in the next slide the number of populations that do exist and so for
myself I am full-blooded Native American I am half Navajo and half pueblos and so
I definitely learned so much and working and partnering and collaborating with a
number of tribal communities with a lot of the projects we have here housed at
USC also with that I'll go to my next slide which is just to really share how
many there are the American Indians and Alaska native populations in the US and
so according to the u.s. census there are about 5.2 million people who are
identify as such there are over five hundred and seventy plus federally
recognized tribes in the United States I do always like to mention that there of
that there were over 200 plus federally recognized tribes in Alaska and I always
call them the Forgotten group because oftentimes people don't realize there
are tribal communities up there and let alone that there are over 200 not just
and needless to say I always mentioned not the only early the forgotten group
but there are hard - some are hard to reach communities because they can be
accessed by playing or only by boat or only by snowmobile of course you can
understand the environment that which some of these folks live in and so it's
just an important to be able to recognize these communities up there and
there's definitely a lot of great work being done as well just a note here that
the Navajo Nation is one of the largest Indian reservations and that of these
groups there are over 200 indigenous languages spoken and so it's important
to know that there's a lot of culture that there are a lot of unique
differences but a lot of similarities but it's great to know that there's a
lot of the cultural preservations that exist in many of these communities and I
wanted to just note as well that you've already probably heard different
terminology I don't have the right answer I often get asked you know what
do what what is the best way to say Native American American Indian it just
it differs them I've have learned in different communities I have gone to to
use certain terms obviously the most appropriate would be to be
calling these communities by their tribe are their tribal names that they prefer
to be called by and so even to say the Navajo Nation you know the folks like to
be called the name which means the people so you have different
terminologies terminologies or different ways that tribal communities like to be
called and so just wanted to make note of that as well much of my work is being
done in California and many often don't know that there are over 100 over 100
federally recognized tribes in the state of California and so there's a lot of
work to be done here especially because you also have the urban Indian
population you may want you may question what is an urban Indian and these are
individuals who are of American Indian ancestry that relocated to an urban area
either by to seek employment to get an education or it could have also been by
forced by forced relocation primarily by the US government
so I myself am a product I always say a vendor being an urban Indian born and
raised in the Bay Area so in Northern California in San Leandro near Oakland
and so I am an urban Indians not of a California tribe as I've mentioned my
tribes are from the southwest but this is really important in terms of when it
comes to conducting research and trying to collaborate and partner with the
urban Indian population so oftentimes that means going to different urban
Indian agencies and organizations that exist throughout different areas in the
Bay Area here in LA downtown LA has the United American Indian involvement which
services the urban Indian population with behavioral health services mental
health services medical they have programs to work with the elders and
with the youth so there's some great comprehensive programs to reach these
populations my next slide here is just to show a map of some of the more common
tribal communities that exist here in the United States and just by location
and I always like to note in the US there's only 35 states that
have tribes and so this kind of can be an indicator in terms of the
administration you know the US government and where folks may say that
they don't need to have to have this community on their radar and trying to
create better services because they don't have tribal communities in their
state but that's not needless to say that there's a lot of great efforts that
still needed for various communities that do exist with the over five hundred
seventy plus federally recognized tribes here in these another question that
always gets asked is no how can one become a register you know a member of a
particular you know community here and so this is always a big this deserves I
think you know a whole session in itself but I'll just take note here that it is
tribes to establish their own criteria for membership as this really provides
the unique character and traditions of each tribes and so each tribe does are
able to establish their own membership criteria and so typically this could be
more of the general piece here where a tribe may say they have to show that
they are a fourth tribal blood a descendant of a tribal member and so
usually if you already have your parents or grandparents as an enrolled member to
a tribe it's pretty you just can indicate that and then the tribe will
see that lineage for you to get your tribal membership it is important to
note though as well that you can only enroll in one tribe and so I myself
being full-blooded I can only enroll in either the Nabal side of the Pueblo side
and so I actually am an enrolled member in the Navajo Nation but actually my
children are enrolled in the pueblos and those are for various reasons but in any
event these just gives you an idea of just kind of that process of what
happens and how this membership is actually also important in terms of
resources being made available to convent American Indian community the
other important that's important to make students aware
of and even just the general population is about tribal sovereignty as the
federal recognition American Indian tribes can self-govern themselves as
sovereign nations and so they're maintaining their own government of
government to government relationship with the United States and so I'd like
to try and see it as how California is its own state what each tribe is kind of
its own state as well because they are able to govern and govern their own
tribal members their own tribal land and provide their own infrastructure for
their own community but we do have to abide by federal laws in many ways just
as other US states have to do that same thing but this part is very important
especially in just the work that I do with some of our research projects
because we want to be able to respect the tribal sovereignty of these
communities and so this comes into this is a very important piece because when
we comes to laws and policies though some of my work is in tobacco control
and California has done an excellent job in trying to reduce tobacco commercial
tobacco use in the general population which has reduced but that has not been
the case for our populations here the Native American population because
there's a lot of work to still be done and so so the communities here the
tribes don't have to abide by state laws meaning that they don't so a lot of the
casinos here in California they allow smoking and they rightfully should have
that right to do so because they have the right and their government and their
laws to be able to do that is so that does take extra effort for us to make
sure that they understand you know the education and the implications on some
of these policies here but we have to respect that that's their their laws
that they governed by but the other piece that is important is that any work
that's being done is you have to have the tribe be a part of that process
because they had to have to be in collaboration and in partnership in any
work trying to especially when it comes to public health and health promotion so
I often times have to start with the tribal leaders and get tribal approval
for any work that's being done and collaboration so that they know that
that partner is happening so this is just a really
important piece to be able to highlight here especially when trying to work with
various tribal communities just throughout the United States so with
that I just like to highlight again when working with tribal communities that you
want to be able to respect the sovereignty develop a relationship that
is so important because you want to be able to nurture that and so oftentimes
when we have these grants and different projects these property grants we need a
long-term grant to mechanism because it takes a while if you don't have an
established relationship it could take three to five years and maybe even more
just to develop a trusting relationship and working with tribal communities and
so for that to happen then you can next be able to work on some of the needs and
what are some of the areas of concern that the community wants to be able to
work with and with your project so including them in the process is
absolutely key to any type of work and so many of you probably have learned
this in your courses already with community-based participatory research
and so that means the tribe the community is being a part of that
process because we just don't want to be able to take we want to be able to have
that mutual relationship with both academic and with the community as well
so with that being that a lot of our work here is in public health and
there's a lot of unfortunate health disparities that exist in this community
I like to just kind of give a brief history of this and really get us in the
mindset of just how to be mindful of some of the traumatic events that have
occurred since the time of the so called you know lumbus had discovered America
but you know the thousands of years preceding European contact
much of our Native communities were organized in societies with their own
forms of government and their own way of life right but once you see this events
of just kind of these historical topics here that have happened from 1492 up
until the present day there's a lot of things that have occurred during that
history time that really has an impact and can show some of those correlations
into some of the unfortunate health disparities that exist in this
community and so with that colonial period you know we had the proliferation
of European colonies really creating a dominant presence you know on the east
coast of North America right so a lot of the Indian lands were forcefully
acquired by the Europeans which led into the removal of a lot of tribes and
forced migrations to these tribes to move west I mean this even came to a
point where at least 90 million acres of land that are the natives we're living
on were taken from tribes and given to settlers as a surplus was often without
compensations to the tribe unfortunately so during this time there was a lot of
removal and a lot of now putting these communities once living in their way of
life onto these reservations now and so not only have you removed them but you
place them on these lands there they now have to be able to adapt in a new
environment new culture way of life new sources of food and other things and
that's and this of course is a very resilient community but you have to
think about some of those things that they now have had to adapt to and
currently still - to this day living with some of those folks being on on the
reservation so you had all of that during that period and the big piece of
this is really this assimilation that happened with the US government trying
to assembly on the Native communities into mainstream society really trying to
not only remove them from their land but remove them from their cultural way of
life and that in itself you know really has an impact and so there's a lot of
things that have happened within that history to be able to do that but
needless to say in the 1930s you know we did have some sort of you know this kind
of Indian Reorganization to be able to give back and where the federal
government began to restore some of this Indian land and creating programs to
rehabilitate and the end of the economic life of this community but needless to
say what happened after that was this unfortunate termination period where the
government the youth the Congress decided to terminate at least 100 tribes
really creating an economic laughter for many tribal communities
again resulting in millions of acres of land being lost and of course the way of
life or for many of these communities but as of now you know so you have to
think of that time that's just not too far go you know from the 50s and 60s
then now we have here the self-determination period which is
absolutely happening you know with our communities being able to have this kind
of resurgence of tribal government involvement with Congress to be able to
that I have any additional terminations but to really provide that state
recognition in federal recognitions to to those tribes and develop more
policies for self-determination and self-governance as well so that's I just
like to kind of point out as it's important to be mindful as this does
have an impact on how this creates some of the public health issues in this
community and so with that I wanted to kind of share a little bit more about
some examples of this assimilation and how this happened and so they had back
in the day Richard general richard pratt which had he's famous for his quote of
building indian and saved the man when you think about this quote this is
trying to take away the language the culture the wave dress but to
Americanize them basically and so you can see this picture here of this navajo
gentleman and his traditional work but three years later he is now transformed
into this kind of militant looking an individual and this really had was based
on folks being part of this boarding school which the government also had
this part of their systematic way of assimilating Native children in the
school system of assimilating them into mainstream society right so just another
systematic way of the government and so this picture here is of the Carlisle
Indian boarding school that happened in the late 1880s to early 1990s and again
these boarding schools were developed to a
American Indians and so this goal is very well known in Pennsylvania which
this became the model for at least another twenty six boarding schools in
15 states and also hundreds of private boarding schools sponsored by various
religious denominations and so actually both my parents are products of boarding
schools my mother being taken away from her family at a very young age I want to
say six seven years of age and living in a boarding school being raised by non
natives and not being needle able to speak her language
her mouth being washed out with soap if she was not if she was to speak her
language when she's trying to speak to a peer of hers which none of them knew
English at the time right but that was something that they were mandated to do
and if they broke any type of rules or laws of that and within this boarding
school they were recommended so there was a lot of physical abuse verbal abuse
and even sexual abuse that happened in these boarding schools and so again this
is just another indication of some of this assimilation practices that
occurred by the government that really as a major impact on this community long
standing for sure again even me having my own parents being part of this system
a product of this system and so you can see that this new terminology that's not
new but more of this is coming into the research of this historical trauma which
really is just showing the experience of the series of traumatic events by the US
government and how this has implications to to our community in many ways because
of this listing that you see here of all these different acts that have happened
so this does now reflect you know in our communities the higher than average
rates of suicide homicide domestic violence child abuse substance abuse and
really because of these attempts to assimilate our communities and our
populations by forcing them into these boarding schools but then also thinking
of these others of putting them into reservations now which
and they have changed their diet their culture etc etc and so with that you see
a lot of these and so within the research there are questions now that we
have to indicate if folks think about these historical traumatic events what
are some of these Disqus symptoms that are now occurring and you really see a
lot of these breakdown in our families because of this forced removal of our
children or because of these other historical events that have happened and
our reasons for high rates of child abuse now you have to think if these
folks that we're taking in to these boarding schools are raised in these
boarding schools you know they their parenting style can definitely be
different and there's a lot of even just a lot of healing that needs to happen
because of the abuse and other traumatic things that have happened while being in
there and so there's a lot of higher rates now of domestic violence and I
think there's just a lot of anger issues that are still happening that need to be
dealt with and a lot of healing is mentioned that needs to happen in this
community then we also have just a lot of psychological issues happening that
are really impacting a person's well-being you know unfortunately higher
alcohol consumption substance abuse fortunately having low self-esteem and
this being because of cultural identity I'm having a lack of positive role miles
role models excuse me but then also these other physiological things that
are happening as we do have higher rates of heart disease injuries with diabetes
and other issues ten which I think are only yeah so in terms of just the health
status as well again being that there's just there's many causes of health
disparities that really span the life spectrum within this community with high
infant mortality rates high prevalence of chronic diseases mental health
disorders and substance abuse but I do give but there is a lot of resilience
that has happened in this community and culture has definitely been one way to
not only heal but also a way to promote the well-being in in the community
so here when we compare the American Indian
Kaneda population comparing them to the overall u.s. they are younger poor and
more likely to be unemployed or lack health insurance again suffer from high
rates of a number of health health related illnesses and then also to have
a lower life expectancy and then the general US population so is that there
are a number of health risk of course based on this you know and there's a lot
of issues that are related and complicate things these are just a
number of public health issues that need to be addressed and so here with some of
my work it's dealing with them trying to reduce mental health reduce substance
use tobacco use and some environmental issues as well this community but this
definitely deserves a lot more attention and oftentimes I do ask if you are
sitting in a table and there always has to have that needs the representation
needs to happen to bring the this community their issues to the table so
even if as you're just learning some of this and you are in a meeting maybe your
job is in a county or you know in some agency and there's things happening for
other communities now I do ask that you you know pose the question of how are
how how is this how are they reaching this community and how are some of the
issues being addressed especially if it may relate to some of these topics here
that you see on the slide so so that's just kind of that little piece of the
health promotion those things to keep in mind when you think about how wire why
why are there a lot of health issues and health disparities in this community and
when there's a lot of things that have happened you know through through
history that absolutely have an impact on this and so this deserves a lot of
additional attention a lot of additional work to be done and a lot of
collaboration and partnership with these communities to be able to address the
various needs within these communities and so
I'll leave it at that because my next slides are to also provide an example of
just kind of this public health issues of high rates of cancer high rates of
other illnesses due to uranium mining so I'll go ahead and go to this next slide
here this is something that I was able to do over 20 years ago and it's that
felt so long ago but this is still an issue currently on the Navajo Navajo
Nation where the community is dealing with a lot of high rates of cancer and
high rates of black lung disease other illnesses due to radiation exposure and
these aren't just folks that worked in the mines but their families and
families that live around abandoned waste sites abandoned
waste that sits on the reservation so it's always great to just increase your
awareness about current issues that are happening just here in our own backyard
in the United States and so this map here just shows where the Navajo Nation
sits in the southwest most of parts of Arizona parts of New Mexico and Utah and
so my family's from Farmington New Mexico right near the four corners and I
had an opportunity to do an internship in my undergrad years so it was a
familiar territory but living there was another interesting aspect in trying to
dis understand this issue at hand because we were trying to increase the
awareness of the community that we needed to get Congress to take action to
not only help those that were sick but to also remove a lot of the waste that
was sitting in the community but this picture here just shows of some
documentaries that have been done about this issue so this is a picture of
Justin Evelyn - to give you an idea of just their work environments because
they many of these miners were working in for $2 a day and not having much
fresh air where those that were working in the mines had no proper ventilation
and so they were being exposed is this radioactive material daily and so but
little did they know what they were being
suppose do they have no idea at that time but the companies did obviously so
this is just showing how uranium is a naturally occurring radioactive element
and so many Navajo men worked in these mines and these Mills
jobs were near their home and was one of the only jobs available at the time and
which was during the 40s and 50s there was many jobs that included different
positions again but no protective equipment was provided and so they
inhaled a lot of the dust and drink contaminated waters near these mines
this picture here also indicates how the environment has been contaminated
because a lot of the excess waste that they didn't need they would just shuffle
it over the cliff sides and so that gets into the farmland that gets into there
to the animals that graze and so sheep is a staple in this community where many
come families when I would go home to visit grandma she would butcher a sheep
and we would have a wonderful family feast but these animals are ingesting
contaminated things within the environment and again and it's getting
into a lot of the farming of the communities that farm as well the
picture on the bottom indicates a lot of the abandoned sites that still sit in
the community EPA has done some work the Environmental Protection Agency where
some places have been considered more hazard than others but there's still a
lot of abandoned sites that have not been touched because they don't quite
meet that criteria that need does it say there's a lot of exposure still
happening in this community especially for those them with this picture here
shows an abandoned mine so you see how fast they open this is and this is from
some of the work that I did over 20 years ago and I was very thankful to
these folks because they told me to stay away if I wanted to have children to
stay away from these abandoned sites because we the question was home how
much exposure do you need is could get you sick and so I definitely kept my
distance but there is a lot of children that we're playing in these
minds not knowing or in tiles of the mill tellings and oftentimes some of the
families are taking these chunks of the or the leftover sites to build their
bread ovens or even have at their own home foundations or build fireplaces I'm
not knowing that they are being exposed to radioactive elements on a daily basis
and so this picture here if you could see kind of that there's a dark mountain
in the back but the lighter one in front of that is the actual meal telling some
waste that sits in the middle of the reservation near to the city and so this
is uncovered with cement but needs us to say once this has been dug up and put
out there's still that exposure can exist so no matter how thick that that
cement is that exposure is still radiating out into the community with
the beta gamma alpha rays I don't know which one of those but you get my point
I'm sorry I'm not the scientist here on this piece but this just kind of gives
you an idea of this how long and how much of this waste is in this community
is still being exposed where they've picked up and collected some of it but
again it still sits in a community exposing a particular community there
and the the part about this is that you know you have over time this seepage
that's this is now getting into the groundwater and so there's a lot of
research actually being done by the University of New Mexico which I'm
really thankful for and they're really identifying a lot of contaminated areas
and sites and really I think this is also helpful
to ensure that future mining is not going to happen because there's still a
lot of high rich deposits of uranium that sits on the Navajo Nation that the
government wants their hands on and we want to make sure that the Navajo Nation
government again who is sovereign entity and they can make that decision to say
yes will allow you but being more informed and knowing how much harm this
has caused this community and the environment that hopefully it will keep
the the additional mining from happening in this community and so again there's
just a lot of diseases now that are happening in this community with higher
rates of lung cancer
all because of these exposure to byproducts you know again in the soil
air and water this is something that has been happening in terms of the knowledge
of knowing that correlation of being exposed to radiation and the outcomes of
cancer and other illnesses that that are because of this exposure and so this
really has really created an unfortunate peace for the community and so real
quickly just what's happening now is that the community has really fought
hard in the past 20 years with some good leadership taking it back to Congress to
at least get compensation so those miners former miners their
family their wives the children are able to apply for compensation of up to one
hundred and fifty thousand dollars which folks say is such an insult because this
barely pays for their medical bills and so it's really a challenge to get that
money because you have to you have to approve show documentation that you
worked with one of these companies or that you were married to a miner to out
to be able to help pay off those medical bills there's just a lot of loops and
barriers to this and it's a very big challenge but there's people that are
helping people get compensated but there's a lot of Appeals that have to
happen because you get rejected the first time and then you have to continue
to reapply but it is reaching some but it has missed a lot because there's been
a lot of losses due to this and a lot of because of the illnesses and deaths
related to the cancer from being exposed to all of these deadly materials and so
that's just something at hand that's happening in this community that again
wanted to raise your awareness about this because many of us have no idea
that this is happening and it's still being fought till to this day and folks
trying to remove this contaminated stuff in their in their community but also
help those that are sick shifting gears a little bit I just like to share this
other story because this is kind of a part of the resilience that still
happens to this day and this is the story of culture it is quick story but
this is the puddle revolt that happened in 1680 and so again this not this is
not included in our history books and it absolutely should because this is where
the Pueblo is a new mexico revolted against the Spaniards who were trying to
acquire them and so this picture here shows the different pueblos in this and
New Mexico and famous is mine which is je em easy right above Zia Pueblo but
all of these puzzles were organized by a leader a Taos Pueblo leader named po'pay
and so he's the one that is well known for organizing a rebellion against the
Ruth the the Spaniards and so you see a picture of Statue here that they have up
in New Mexico and in his hand he has a rope of not so he had every Pablo he
made sure that every public got this rope of not because he had said that
every morning that the Sun comes up to remove a knot and when that when we get
to that last knot then that day is when we're going to revolt against the
Spaniards and so that was a way of them reuniting getting together and
organizing this themselves which they of course had a great victory against the
Spaniards which is great so a victory for the puzzles I should say is why a
story of how they still exist today this next picture is just because I love to
share a little bit about famous Pablo and so that is a picture of myself my
father and my two children I do need to update this because my son al dances as
well so my daughter and I are both dressed in our regalia for our
traditional day it is open to the public it's always on August 2nd and so we
dance and it's a time for our community to come together and for prayer for
growth for well-being and so there's a lot of preparation that happens for this
feast day which one is baking bread because that's our main soul or I guess
our instead of using a fork and spoon you know our bread is used to dip in the
red chili stew and the green chili students so this is our oven here
it's a fire that's made and once that's out we remove all the ashes and put all
the seventy plus loaves of bread in there cover it up and bread is nice and
done in an hour but you see here just my children riding their bikes out in the
dirt areas which is just great for the kids to roam because here living in the
city it's a little bit more difficult and letting them allow to just roam
around free so I love showing this picture and just sharing a little bit
about the Hema sculpture because I often do ask students you know what do you
picture when you're thinking of Native communities and so it's great to just
share even just a regalia of our community here I have a few more minutes
but this here is just a little a slide just showing some of these common values
among native Native communities and it's about sharing generosity you know no
matter how much has happened in this community or in the communities I should
say there's oftentimes just a lot of sharing and generosity and oftentimes
it's great going to different conferences that are needed specific
because there's just a lot of sharing in a lot of generosity and just being
thankful for for the thanksgivin family is very important community and tribes
and I always keep that in mind especially with all the work that we
have done because everything we do and at lease with our projects is for the
community and for these families and and the tribes having respect for elders as
I'm sure this is very much a common value for many folks in different
communities but we often want to make sure that we respect our elders and go
to them for guidance and making sure that we are doing things in the most
respectful way and again orientation to present time you know it's great that us
here in modern day life we're always worried about time and this and that but
it's always orientation to present time is just in the moment and so if I have a
2:00 o'clock appointment but I'm meeting with the community we could be talking
for another two hours and you just got to be in that present moment and at that
present time and be with that for this community the other piece
as interesting as communication and I wish I had more time because I have so
much that I have learned with communication with this community in
terms of trying to introduce myself and getting part being a part of different
projects and collaborating and partnering but it is absolutely
important to have FaceTime to be able to introduce yourself to the community
because a phone call is just not going to work
you definitely want to be able to always these are very general of course I want
to say that you know but speak slowly and pause while telling a story because
I overall with this communication I've learned that not all communities but is
that that direct eye contact is important where they don't necessarily
look sometimes that the context the eye contact is looking somewhere else and
people can think of it as being rude and so when I train others to go and help
out in the community when we're trying to gather information oftentimes we'll
let them know that it's not you know it don't if they're not looking at you
don't take it as being rude that's just how it is that they are the they're
still listening those and still paying attention to things but these are just
some of those things that I like to bring up but it doesn't mean that it's
for everybody but these are things that I have absolutely learned along the way
as well and that of course they don't there's a lot of distrust of outsiders
and so again that's part of building that relationship with these communities
as well the other that I like to provide is just again with your with your work
being in health promotion there's health promotion messages as this is just an
example of how trying to reach a specific community with a specific
message that absolutely resonates for this community and so being in tobacco
control and all of this great anti tobacco messaging that has happened out
for the general population we have to be careful because some of that doesn't
quite resonate with us where you're telling our communities our native
communities that all tobacco is bad well it's not because tobacco is very sacred
to us and it's used in traditional ceremonies
and medicinal ways and so how do we give back to give that message to show that
we must preserve that a great part the sacred tobacco but also knowing that if
using tobacco in an abusive way using recreationally that this can be harmful
to your health and that's not we definitely want to provide that message
as well so back in my work this was made over ten years ago but it's great that
we'll still see this poster in various clinics and other native agencies
throughout California this was put together where we were only allowed to
provide to create one Pete one health promotion message and how difficult was
that knowing that we have a beautifully diverse communities throughout the state
of California so how are we going to try and reach all and so we did it to the
best of our ability which then we had to ensure that we were using peripheral
strategies matching the surface characteristics meaning the community
that you're trying to reach right and absolutely having the number four
constituent involving strategies wherein you're involving the community involving
those that can provide that guidance and so this really had with that guidance
they said let's create let's try and create something with just four
directions in mind the north south east and west and so with that in mind the
woman is reflective of the Northern California tribes Yurok basket is
representative of how Southern California tribes weave their baskets
and for the east and west are the tobacco plants that grow to the east and
to the west side and so then you have the messaging that has to be clear right
I can't quite read it from here but hopefully you guys are able to with that
message that is supposed to resonate with this community where it's saying
you know that the Creator gave us tobacco to bless our families in our
community right but if you smoke commercial tobacco and abuse it
you know that's it's going to create harm so we want to keep tobacco as a
gift and not to be abused and so I just wanted to provide that example of how
use some of those strategies and try to create public health messaging for
for this community so with that that ends some of the stuff that I wanted to
share with you all but I also wanted to share some of the funded grants like we
have in hoping that if you have an interest in working with some of the
projects that I have going on currently we are looking for students to help with
data entry maybe literature reviews and so folks
knowing that many of you are online students and may not necessarily be here
some some maybe it'll come through the office but others might be able to work
remotely we are searching for folks for students for some student help it could
either be volunteer it could also be for credit and I forget what those class
credits are but other folks on the line from the mph program can share with that
but we do have a couple of tobacco related programs for smoking cessation
I'm trying to help Nate obtains quit smoking or quit using many of these
other nicotine products such as e cigarettes and vaping things like that
but then we also have a social media project where we're training Native
youth to develop their own media messages with digital storytelling
Photovoice public service announcements and they are being period peer educators
back to the Native youth but also then to tribal councils to create tobacco
policy changes and then we have another that's looking at community readiness in
tribal communities throughout the state of California where we're trying to
understand if tribes are adopting state policies or state laws so for example
California just passed them a lobbying having to be the age of 21 to purchase
so our tribes also adopting that law if they are we're asking why if they are
not and choose not to we're asking why not just to kind of learn a little bit
more about some of the different policies that are in tribal communities
as it relates to tobacco control and this last one is really addressing the
opioid crisis made of Native Americans have some
highest opioid use but also opioid related deaths and this is a really
serious issue happening at hand and so there's a lot of funding being made
available to some of the tribal communities here and urban Indian
populations in California so us here at USC are tasked with the needs assessment
to learn more how this funding can be helpful to create treatment services
prevention and other services to culturally reach these communities but
also evaluation with a lot of these projects that are being funded and
making sure of showing how this is creating an impact to reduce opioid use
and opioid related to us so with that I want to say thank you and I know I went
a little bit over time but looking forward to some of your questions so
thank you everyone thank you and that's all right you went over a little bit
that was a lot of great information that you shared with us today and we are so
grateful for you being with us on this webinar I'm sure we do have plenty of
questions so we are going to open up the Q&A session I do want to remind students
that our program director dr. Kumar is also on the line available for questions
as well I'd like to go ahead and start off the Q&A session actually looking
back at you know some of the research opportunities that you have available
right now and you were talking about some of the roles that they're trying to
feel what steps do students take to participate in any of your research
opportunities what would they need to do to participate yeah so with my
information up there it would just be great to de send an email and so sending
an email it would be great for this to start in spring just to make it easier
that way so again it could be volunteer or could be for or credit and then we
can just touch base and usually I'll ask for a CD and just a statement of
interest and then we can take it from there to see how we might make this an
opportunity so just emailing me and I'll probably follow up in
november/december and then try and figure figure out how we can best get
the help or a number of these projects okay great thank you so much for sharing
that information our next question is is for you dr. Soto do tribes have their
version of public health department's internally that work with federal and
nonprofit public health workers yes they do
tribes have their own departments and not all but some and so some
infrastructures are stronger than others and so these and actually these are some
of the entities that we have to go through and so like even with our
research projects where we have our own academic IRB ensuring that we are not
putting any human subjects at risk we have to get that certification and
approval well some of the tribes else will have their own departments as such
where we have to go through their protocol and IRB process as well
insuring that we're not putting anybody at risk as well so yes they do and then
some either internally fund themselves or they get the support of government
support or that federal funding support their departments okay thank you
our next question is as a student are there grants of scholarships available
for this very important research yes there is I actually ask you well if is
that if there are opportunities I guess I can share that for the mph to share
with the list with the mph listserv that might be helpful I mean okay so this
could be both ways where students may want to work in this capacity or they
may want to get the funding so this could be either for Native students
themselves wanting that additional research experience or those that are
not native but then just wanting to see what other opportunities are they have
that available but things that I have I can definitely share your way to that
absolutely absolutely thank you so much our next question is for healthcare
workers is it hard or not an option to conduct studies from afar
since in-person interaction seems to be of great importance so meaning for
public health workers working in tribal communities am i understanding that
correctly I am going to assume that that yes we're public for public health
workers yes yeah you did yes it's important absolutely have that
interaction in-person interaction that is absolutely of great importance to
ensure that trust and that mutual respect and that continuance of mutual
relationships and building and ensuring that you're trying to meet the needs of
a community so yes absolutely okay our next question actually is are
there popular blogs that I can follow from either yourself or others
concerning awareness on sexual abuse uranium and other topics that impact
Native American culture there's a number of them out there and I think the one
I'll mention is Indian country so you can actually get a subscription to
Indian country it's very inexpensive and it really provides current event issues
I think it comes out weekly I could be wrong but it comes out often and there's
a lot of different current events that shares information about various
communities throughout the u.s. okay thank you for sharing that information
our next question actually is a three-part question so have you have how
has different eras of government been with working with Native Americans is it
worse now than it has been in the past or was there a time it was best as far
as a relationship with the federal government mmm
great question oh that's a really great question because um yeah oftentimes even
just when you think of presidents and former administration our current
administration I mean that's the part that I'm thinking about right and and
how these government's have been or not working with native Native Americans
this really has changed so I mean I even think of just currently you know with
our former President Obama and really putting a lot of first Pacific are how
am I saying that there's been a lot of positions having a first-time Native
American in that position and that happened a lot with President Obama
because he really believed in trying to support on this community who again as
mentioned very underserved very under-resourced and so really working
even with youth and having this great gosh I want to say it was called
Generation X and I could be wrong but he and some of it was great that some of my
family was part of this where there was just thousands of Native youth that were
put together to meet with President Obama and Michelle Obama at that time
and and things progressed from there because students were able to share the
needs of their community of the things that they would wanted you know to be
successful individuals and in not only their own communities but just in in
them in in our own and just here today to be successful I'm contributing
individuals to society is what I'm trying to say so it has changed
constantly I mean just that quick little history of events of where you know
things we're trying to go good and then all of a sudden you terminate a hundred
tribes that again is based on the types of treble or the types of government or
who was in government and at that time and so that definitely is scary of where
we are currently and how that is potentially you know making more
harm than good to these communities and so you know one example is funding
there's a lot of funding that has been taken in a way that really unpreserved
not only the cultural way of life but education opportunity for youth but then
also for other segments of the population and so we're seeing a lot of
that unfortunate things happening because of our current administration
mostly that answers the question I'm trying to think of current past and all
that works with our relationship with the federal government I mean there's a
lot that I've learned even in our own work here because I think of a huge
graph that we got here to learn about the retail environment on tribal lands
and trying to learn about a tribal tribal Lee manufactured tobacco products
so tribes are making their own tobacco products for their own economic
infrastructure right and so anyways we have some of that work being done to
learn more about the retail environment to learn and we learned that our own
community is not using these products which is a good thing but we had this
federal funding from FDA and from the National Institute of Health and so when
our communities were learning that we had this funding from the federal
government they definitely did not want many of them were reluctant in working
with us because now that's with the federal government who was trying to put
a lot of these retail retailers trying to make sure that they were in
compliance with the federal rules meaning that they should not be selling
to minors which means that they should not be having a vending machine of
cigarettes which means they should not be selling loosies so part of our work
was to and to educate tribes of this happening because again you know they
have to abide by federal laws so then the tribes were worried that federal
governments we're going to come into their community and make them do certain
things but and so you've had some tribe I've had their own tribal police shoo
away federal federal folks that have come on to their own tribal land so it
gets really tricky it gets really that relationship is
definitely not a trusted one as you can see just with this example I gave but
there's just a lot of different things that happen and occur that again that's
why it's important to understand a little bit about tribal sovereignty and
then what does that mean with that federal government relationship but I'll
leave it at that I could go on and on all right well
thank you so much our next question is what are your thoughts on current
efforts regarding opioids in Native communities yes well so I only know of
this current a bit so I'm really happy that a lot of funding is coming out from
Samsa to address the opioid crisis in Native communities and populations and
so I'm hoping that folks our tribes and communities are applying for those for
those funds to be able to address it in their own communities I'm really happy
with the state here in California I've worked with a number of State
Department's before and so this Department of Health Care Services has
to be one of the most progressive in the sense that they're providing funds to
Indian country here in California to tribal communities the urban Indian
populations to address this and being
allowing them to have these funds to provide some services so medication
assisted treatment services these met programs that they have that they are
trying to address how to best promote training others with naloxone because
many folks have overdoses and so how can we try to prove them you reverse that
right so by providing the locks onto folks that have overdosed we can save a
life so they're doing a lot of training without end or doing a lot of with
suicide prevention as well so the funding is great and I hope that tribal
communities are applying for this because I know just here in California
it's a big issue and I know it's a big issue in other in other states as well
that have the population that are dealing with this issue right now so
that that I know in itself and there's a lot of work to be done and figuring out
what's what's the best way to reach these communities in in the most
appropriate and most cultural way in meeting their needs wonderful well thank
you so much for sharing that we're a little short on time so I'm going to ask
one more question for you dr. Soto it's actually another three-part question but
what online courses do you teach do you teach about this topic in your online
course and what other topics do you cover so online course I used to th the
P the PM 501 right the theory course but it's been a while because it's all of
this great funding that we have less time to teach so more I just do more
guest lectures in terms of just trying to address certain topics like these um
oh yeah so I mean we are trying to I'd love to have our own class
you know that's related to this topic and the Masters in public health but I
also know that I'm working with the School of Social Work and so we have a
course there I don't know if anybody is a dual degree with the mph and MSW but
we have an immersion program that takes graduate students to the Cheyenne River
Sioux Indian Reservation and then giving them the opportunity to make an impact
in this population so so that's where a lot of other topics are definitely
addressed and you get a whole semester of different issues regarding and how to
best reach these communities in public health efforts all right well thank you
so much again dr. Soto for sharing with us today I definitely want to thank our
speaker dr. Soto dr. Kumar who was also on the line as well as William Jardel
and I want to thank everyone who participated
pated in today's webinar I do want to let you know a copy of this recording
and slide presentation will be available shortly after this concludes today's
webinar thank you again everyone and have a wonderful rest of the day
great thank you have a wonderful day
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