Article Text

  1. E. R. Van Dyke
  1. University of Washington School of Medicine, Seattle, WA


Purpose To address high rates of diabetes mellitus and obesity on the Swinomish Indian Reservation in Washington State, a Rural/Underserved Opportunities Program Independent Investigative Inquiry community project was designed to increase awareness of chronic illness, health maintenance, and disease prevention in a culturally appropriate format.

Methods Information about local health services, disease prevalence and prevention, and nutrition was gathered through a MEDLINE literature search, meetings with local physicians and public health officials, and on-site clinical experience. The Swinomish Indian Tribal Clinic sponsored a medical fair and “fasting and feasting” event to allow fasting community members to check their blood pressure, blood glucose, and cholesterol levels and subsequently to partake in a heart-healthy feast. On-site diabetes counseling was provided to all patients with abnormal results. Through flyers, newsletters, radio announcements, and word-of-mouth, Swinomish children were particularly encouraged to attend the health fair in addition to visiting the clinic for their yearly sports physicals. Each child who attended the health fair received a backpack filled with school supplies and was fitted for a personalized sports mouth guard made by the dental clinic staff. In addition, children were invited to learn to use stethoscopes and blood pressure cuffs, to explore the affects of tobacco and alcohol on human vital organs, to wear doctors' white coats, and to hear about higher education opportunities available through the University of Washington.

Results Seven of the eight community members screened for hyperglycemia and hyperlipidemia were at risk for developing diabetes, and one clinic practitioner had hyperlipidemia. Thirteen children received sports physicals, personalized mouth guards, backpacks, and Polaroid photographs of their participation in the health fair.

Conclusion The health fair supplied a vehicle through which to provide counseling and follow-up clinic appointments for all “Fasting and Feasting Day” participants at risk for developing diabetes, offered tangible community education about the effects of alcohol and tobacco on vital organs, empowered young people on the Swinomish Reservation to seek higher education opportunities, and fostered a closer working relationship between the Swinomish Indian Tribal Clinic and the Native American Center of Excellence at the University of Washington.

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