The California Rural Indian Health Board Inc. (CRIHB) California Tribal Epidemiology Center (CTEC) was formed as an Indian Health Service (IHS) area-wide program in 2005 to conduct disease surveillance, build public health infrastructure with Indian Health Programs (IHPs), and to meet the epidemiologic and evaluation needs of American Indian and Alaska Natives (AIAN) in California, including 109 federally recognized Tribes and AIANs living in urban areas. CRIHB CTEC is located in Roseville, California. CRIHB is a 501(c) 3 non-profit Tribal organization operating since 1969 under the Indian Self-Determination Act (PL 93-638). CRIHB CTEC provides data, lay fact sheets, and reports to support CRIHB’s policy efforts to advocate for more funding and expand AIAN chronic disease education and other health programs and services. CRIHB CTEC is a vital member of the Tribal Epidemiology Center Consortium (TEC-C), as evidenced by the large number of California AIANs served, the CRIHB CTEC staff expertise, and the CRIHB CTEC programmatic history. The programmatic history includes using culturally relevant methods to work with Tribal, regional, and national partners.
AIANs in California experience disproportionate health outcomes and issues. CRIHB CTEC’s 2021 California AIAN Community Health Profile shows that AIANs report a higher prevalence of heart disease (18.2%) when compared to Whites (6.7%) and all races combined (9.5%). AIANs also report a higher prevalence of diabetes (12.5%) than Whites (9.9%) or all races (9.9%) combined. Additionally, the infant mortality incidence rate for all causes among AIANs in California was 4.86 per 1,000 live births, higher than White’s infant mortality incidence rate (3.67 per 1,000 live births). Although the data presented highlights some health disparities among AIANs found by the CRIHB CTEC, small sample sizes in regional and state datasets, flawed data collection methods, and race misclassification may underestimate the true burden of disease among California AIANs. Thus, health disparities within the AIAN population may be greater than estimated. The 12 Tribal Epidemiology Centers that constitute the TEC-C are necessary for gathering and disseminating accurate statistics about AIAN health concerns, priorities, trends, conditions, and behaviors and identifying and promoting health prevention, intervention, and evaluation techniques to IHPs and Tribes.
As a component A awardee, CRIHB CTEC will implement a program designed to build public health infrastructure in IHP/Urban Indian Organizations/Tribes to reduce disease and related risk factors and promote health and well-being among California AIANs. CRIHB CTEC aims to strengthen the public health infrastructure and capacity of CRIHB CTEC and offer support to IHP, UIO, Tribes, rancherias, and federations in California to meet national public health accreditation standards and deliver the 10 Essential Public Health Services. Additionally, CRIHB CTEC will engage Centers for Disease Control and Prevention (CDC) funded CRIHB program sites in ongoing collaboration, sustainability, documentation of success stories, and evaluation efforts to ensure success and demonstrate the impact of the Component A award.