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Cross Cutting : Tribal Epidemiology

The Tribal Epidemiology Subcommittee consists of epidemiologists and others working with American Indians/Alaska Natives (AI/AN) in state, local, territorial, and tribal health agencies and epidemiology centers. For the past 10 years, CSTE has been successful in bringing together key players for public health surveillance, health data sharing, and public health authority in Indian Country despite more complex issues surrounding the responsibility for public health services for AI/AN populations.

CSTE has conducted assessments of tribally-operated and urban Indian health care facilities to assess their case reporting practices and to identify barriers to tribe and provider participation in public health surveillance. The 2009 assessment of epidemiology capacity included questions on tribal epidemiology; a brief summary of the tribal epidemiology results also includes recommendations for improvement.

In 2012, CSTE released a report entitled "Legal Issues Concerning Identifiable Health Data Sharing Between State/Local Public Health Authorities and Tribal Epidemiology Centers in Selected US Jurisdictions," which assessed selected states’ laws regarding data sharing, identified state-specific laws that authorize or limit the sharing of identifiable public health activities, and illustrated the precedence of data-sharing agreements. This report provides a foundation for examining potential privacy issues and solutions for current and potential tribal epidemiology centers’ (TECs’) partners for privacy implications of state and laws in selected jurisdictions as well as to facilitate public health data sharing.

A workgroup of this subcommittee conducted a study during the 2009 H1N1 Influenza pandemic to develop a better understanding of mortality risk factors in the AI/AN population that could lead to improved prevention and control of influenza. Both national influenza vaccination and antiviral use recommendations have been changed to reflect the increased risk to these populations, partly as a result of this study’s December 2009 MMWR. The workgroup continues their efforts to understand this disparity in mortality risk among AI/AN in a case-control study.

CSTE has also collaborated with TECs to host several meetings. CSTE and the Northern Plains and Great Lakes Tribal Epidemiology Centers hosted a Tribal Epidemiology Liaison Training. CSTE and the United Southern & Eastern Tribes hosted a meeting to develop recommendations on collaborating to improve AI/AN disease surveillance and to introduce the production of tribal specific reports for public health decision making. A third meeting for the western region focused on improving data linkages and reducing racial misclassification among AI/AN populations.

CSTE members compiled a Tribal Data Linkage Toolkit for epidemiologists interested in data linkage and comparing AI/AN data to improve the quality of race coding.

For more information about the Tribal Epidemiology Subcommittee and its activities, please contact Jessica Arrazola. Click here to view other Cross Cutting Steering Committee activities.

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