ZUNI HEALTH INITIATIVE-PILOT STUDY

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 健康差距是指种族/族裔少数群体经历的不利健康后果。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。低移民率和低移民率导致了以大家庭为特征的相对内婚制人口。这些社会经济上处于不利地位的人口面临着日益扩大的健康差距带来的重大公共卫生挑战。生活方式的改变导致体力活动减少，卡路里摄入量增加，大量食用快餐、汽水和酒精。因此，祖尼人正在经历肥胖、糖尿病、高血压、肾脏疾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，很可能还存在一种不明原因的CVD流行。减少这些流行病的影响因独特的历史、经济和文化障碍而变得复杂，这些障碍限制了卫生保健的利用，从而扩大了健康差距。 缩小祖尼人和更富裕人群之间的健康差距是一个重大的公共卫生挑战。为了应对这一挑战，我们将利用考虑到祖尼人口统计、家庭结构、文化和传统、卫生保健需求和现场印度卫生服务(IHS)利用的慢性护理模式来制定和试点祖尼卫生倡议(ZHI)。当全面实施ZHI时，它将有可能显著缩小健康差距。我们已经建立了一个由祖尼部落委员会、祖尼部落委员会、IHS、透析诊所公司(DCI)和新墨西哥大学(UNM)组成的教育和卫生保健联盟，以建立ZHI。该财团建立在国立卫生研究院资助的Zuni肾脏项目(ZKP)创建的基础设施基础上，将在NM-INBRE计划内开发和试点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.