For far too long, Native Americans have faced challenging economic, environmental, and political conditions that are, in many ways, similar to those experienced in poor developing countries. The Navajo tribe, about 175,000 people, is the largest in the United States and is based in Arizona, Utah, and New Mexico. The Navajo Nation is 25,000 square miles and is roughly the size of West Virginia
About 37 percent of Navajo people, or Dine' as they call themselves--literally meaning "The People," live in poverty. Access to preventive services, such as cancer screening and immunizations, is often limited and patients have to travel long distance to obtain medical services. The situation is made worse by a chronic lack of primary care physicians and specialists available to provide care to patients. As a result, the life expectancy for American Indians is about six years shorter than for the general population in the United States. Additionally, American Indians suffer disproportionately high rates of obesity, diabetes, heart disease, mental illness, and substance abuse.
The COPE Project began in 2009 with funding from the Rx Foundation and represents a five-year collaborative effort between the Brigham and Women's Hospital (BWH), the Navajo Nation Community Health Representative (CHR) Program, the Indian Health Service (IHS), and Partners In Health (PIH). The goal of the COPE Project is to strengthen the existing Community Health Representative (CHR) Program of the Navajo Nation and other American Indian / Alaska Native (AI/AN) nations with the following aims.
- To provide CHRs with the training, support, and resources needed to enhance their ability to promote the health of their community members living in Navajo Nation
- To improve the health status of high-risk patients with diabetes and other chronic conditions
- To increase efforst of prevention and early diagnosis of diabetes and other chronic conditions affecting the Navajo community and other Native American communities
Under the leadership of Sonya Shin, MD, a DGHE physician who relocated to New Mexico, the project initially focues on diabetes. American Indians have the highest rate of type 2 diabetes in the world. Without careful management, high-risk diabetes patients are more likely to suffer from heart attacks, strokes, and renal failure. The project has since expanded to include HIV/AIDS and other chronic diseases.
In 2013, COPE expanded to partner with the CHR program and health facilities in all eight service units of Navajo Nation: Gallup, Shiprock, Chinle, Fort Defiance, Crownpoint, Tuba City, Winslow, and Kayenta
In 2009 funding from the Rx Foundation made it possible to expand our collaboration with the IHS and Navajo Nation through a chronic disease initiative which builds on the BWH’s Prevention and Access to Care and Treatment (PACT) project’s experience. Since 2003, PACT has employed community health workers to improve the health of Boston’s sickest HIV/AIDS patients. Now an international model, PACT has expanded to help people with other chronic diseases.
For questions or information about additional COPE Project initiatives, contact Dr. Sara Selig, Associate Director of COPE.
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This page was last modified on 7/30/2013