ZUNI HEALTH INITIATIVE-PILOT STUDY

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 健康差异是指少数种族/族裔经历的不良健康结果。 祖尼普韦布洛位于新墨西哥州的农村地区，是大约11,000名祖尼印第安人的家园。移民和迁出率低，导致人口以大家庭为特征的相对同族通婚。 这一社会经济弱势群体面临着健康差距日益扩大的重大公共卫生挑战。生活方式的改变导致体育活动减少，热量摄入增加，快餐、汽水和酒精消费量增加。因此，祖尼人正在经历肥胖、糖尿病、高血压、肾病和中间表型的相互关联的流行病。由于这些情况也是心血管疾病（CVD）的危险因素，因此可能还存在未识别的CVD流行病。 历史、经济和文化障碍的独特组合使减少这些流行病的影响变得复杂，这些障碍限制了保健利用，从而扩大了健康差距。 缩小祖尼人和较富裕人群之间的健康差距是一项重大的公共卫生挑战。 为了应对这一挑战，我们将采用一种慢性病护理模式，该模式考虑到祖尼人的人口统计、家庭结构、文化和传统、医疗保健需求以及现场印度卫生服务（IHS）的利用情况，以制定和试行祖尼人健康倡议（ZHI）。当全面实施ZHI时，它将有可能大大减少健康差距。 我们已经建立了一个教育和保健联合体，由祖尼部落理事会、祖尼普韦布洛、IHS、透析诊所公司组成。(DCI)和新墨西哥州大学（UNM）建立了ZHI。该联盟建立在NIH资助的祖尼肾脏项目（ZKP）创建的基础设施上，将在NM-INBRE计划中开发和试点ZHI。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Health disparities refer to the adverse health outcomes experienced by racial/ethnic minorities. The Zuni Pueblo, located in rural portion NM, is home to ~11,000 Zuni Indians. Low rates of emigration and immigration have led to a relatively endogamous population characterized by large extended families. This socio economically disadvantaged population faces a major public health challenge from growing health disparities. Changing lifestyles have led to decreased physical activity and increased caloric intake with high consumption of fast food, soda pop and alcohol. Thus, the Zuni are experiencing interrelated epidemics of obesity, diabetes, hypertension, kidney disease and intermediate phenotypes. Since these conditions are also risk factors for cardiovascular disease (CVD) it is likely that there is also an unidentified epidemic of CVD. Decreasing the impact of these epidemics is complicated by a unique combination of historical, economic and cultural barriers, which limit health care utilization thereby increasing health disparities. Reducing heath disparities between the Zuni and more affluent populations poses a major public health challenge. To meet this challenge we will utilize a chronic care model that takes into account Zuni demographics, family structure, culture and tradition, health care needs and utilization of the on site Indian Health Service (IHS) to develop and pilot the Zuni Health Initiative (ZHI). When the full scale ZHI is implemented, it will have the potential to significantly reduce health disparities. We have established an education and health care consortium consisting of the Zuni Tribal Council, The Zuni Pueblo, IHS, Dialysis Clinic Inc. (DCI) and the University of New Mexico (UNM) to establish the ZHI. This consortium, built upon the infrastructure created by the NIH funded Zuni Kidney Project (ZKP), will develop and pilot the ZHI within the NM-INBRE program.