The mission of Denver Indian Health and Family Services is to provide culturally competent services that promote quality health for American Indian and Alaskan Native adults, children, and families in the Denver metropolitan area. The United States Census Bureau defines the area as 8,345 square miles in ten Colorado jurisdictions: City and County of Denver, Arapahoe County, Jefferson County, Adams County, Douglas County, the City and County of Broomfield, Elbert County, Park County, Clear Creek County, and Gilpin County. In the Denver service area, there are 106,602 individuals who identified as AI/AN alone or in combination, which has doubled since the 2010 census.
In 2020 there were 1,926 total patients seen at DIHFS. A total of 141 tribal nations were represented among all patients. There were also 984 visits among 350 non-Indian patients and 234 visits among 106 Indian non-tribal members. Social determinants of health are important aspects that can lead to healthy lives and AI/AN’s face disproportionate rates of unemployment, poverty, educational attainment, insurance coverage, and housing compared to Non-Hispanic Whites (NHW). AI/AN communities face higher rates of preventable chronic health conditions including obesity, diabetes, substance use disorders, tobacco addiction, and cancer than the national average. Data from the Healthy Kids Colorado 2019 survey results show that AI/AN youth are less physically active (at least 60 mins/day on five or more days in the past week) compared to NHW youth at 44.6% and 52.1% respectively. AI/AN youth who are overweight or obese (i.e., at or above the 85th percentile for body mass index, by age and gender) is close to double that of NHW at 16.4% and 30.6% respectively. The percentage of DIHFS adult patients (age 19+) who were appropriately vaccinated per age recommendations was lower than the Albuquerque service area at 45.8% and 67.5% respectively. According to the Colorado Office of Behavioral Health, AI/AN’s make up approximately 1.91% of the state’s population but account for 3.49% of the total percentage of individuals in SUD treatment services. Among adults living in urban areas, 6.7% of AI/ANs experienced unmet needs for mental health services, compared to 5.4% of NHW’s (UIHI, 2016).
The DIHFS 4in1 programs shall address the needs of each of the four categories through culturally competent care, direct services, outreach services, and health education promotion. The Behavioral Health department will conduct mental health and substance abuse/misuse assessments, provide referrals to treatment, and conduct follow up services for outpatient care. The Health and Wellness Department will conduct individual and group fitness activities, personal training classes, and incorporate activities from the IHS Physical Activity Kit and the Smoke Free Txt initiative into current programming. Immunization services will be provided to children, adolescents, and adults. Information technology such as electronic health record messaging, email list serve communication, website, and contracted services will be used to provide health education, appointment reminder messaging, and health promotion materials.