Knowledge Celebration #1

Question 1

Four Worlds

Answer 1

i. Tokpela
ii. Tokpa
iii. Kuskurza
iv. Tuwaquachi

Question 2

Number of Migrations

Answer 2

4 in the fourth world

Question 3

How did the America’s become populated?

Answer 3

a. Crossed to the Americas, into what is now Alaska and Canada, via a land (ice) bridge called Beringia
b. Believe that some people migrated using boats from Asia, and even the Pacific Islands, to the Americas via the Pacific coast of North and South America (costal route)

Question 4

Hopi Legends:

Answer 4

i. Spider Woman gathered earth in four colors – yellow, red, white, and black – and mixed them with her saliva; molded them, and covered them with her white-substance cape which was the creative wisdom itself.
ii. She sang the Creation Song over them, and when she uncovered them, they were human beings in the male form. She then created four other beings, female partners, for the four male beings.
iii. The time of the dark purple light; the first phase of the dawn of Creation, which reveals the mystery of mankind’s creation;
iv. The time of the yellow light; the second phase of the dawn of Creation, when the breath of life entered mankind;
v. The time of the red light; the third phase of the dawn of Creation, when mankind, fully formed, proudly faced the Creator and was filled with warmth and love.
vi. The people were given speech, a different language to each color, with respect for each other’s difference.
vii. They were given wisdom and the power to reproduce and multiply.
viii. But they were also told to respect and love the Creator at all times – and to remember and observe the three phases of your Creation: the time of the three lights – the dark purple, the yellow and the red reveal the mystery, the breath of life, and the warmth of love.

Question 5

How many migration streams were there?

Answer 5

3

Question 6

According to the U.S. Census, how many races are there?

Answer 6

5

Question 7

Which U.S. State has the highest poverty rate for American Indians?

Answer 7

South Dakota

Question 8

Which U.S. City has the largest population of American Indians/Alaska Natives?

Answer 8

New York

Question 9

What are the largest American Indian (alone) and Alaska Native (alone) Tribal groups?

Answer 9

a. American Indian
i. Navajo
b. American Native
i. Yup’ik

Question 10

What four directions does the Medicine Wheel represent?

Answer 10

North, South, East, West

Question 11

What do cultural health beliefs influence?

Answer 11

a. Understanding cultural values and beliefs can facilitate better health care interactions and outcomes;
b. Can be used to increase cultural proficiency among health and mental health providers;
c. Can be used to motivate people to reduce risk behaviors implicated in disease causation;
d. Can potentially reduce health disparities.

Question 12

What is Historical Trauma?

Answer 12

a. According to Brave Heart (1999) historical trauma is defined as the cumulative trauma over both the life span and across generations that results from massive cataclysmic events;
b. The historical trauma response is the constellation of characteristics in reaction to the traumatic history of indigenous populations in the Americas.
c. The trauma response includes depression and self-destructive behavior, substance abuse, identification with ancestral pain, fixation to trauma, somatic symptoms, anxiety, guilt, and chronic bereavement.
d. Intergenerational transmission of historical trauma is an important element of the theory
e. Dominant group subjugates a population;
f. Resulting in Segregation/Displacement, Physical/Psychological Violence, Economic Destruction, and Cultural Dispossession;
g. Eliciting a “Trauma Response” in the first generation or primary generations.

Question 13

What is the Historical Trauma Response?

Answer 13

a. Physical Response
b. Social Response
c. Psychological Response

Question 14

What was the “Indian Intercourse Act” of 1832?

Answer 14

a. This act made it illegal to sell liquor to an American Indian anywhere in the United States.
b. “Drunken Indians”

Question 15

What was the “Indian Citizenship Act” of 1924?

Answer 15

a. To respond to current and projected demographic changes in the U.S.;
b. To eliminate long-standing disparities in the health status of people of diverse racial, ethnic, and cultural backgrounds;
c. To improve the quality of services and health outcomes;
d. To meet legislative, regulatory, and accreditation mandates;
e. To gain a competitive edge in the market place;
f. To decrease the likelihood of liability and malpractice claims.

Question 16

What does the provision of culturally competent services to American Indians/Alaska Natives include?

Answer 16

a. Understanding the beliefs, values, traditions, and practices of the culture;
b. Understanding the culturally-defined, health-related needs of individuals, families, and communities;
c. Understanding the culturally-based belief systems of the etiology of illness and disease and those related to health and healing; and,
d. Understanding the attitudes toward seeking help from health care providers.

Question 17

What does the term “mestizo” mean?

Answer 17

Spaniard and Native American mixed

Question 18

Currently, how many federally recognized American Indian/Alaska Native Tribes exist in the U.S.?

Answer 18

566 Tribes

Question 19

What is race?

Answer 19

White” refers to a person having origins in any of the original peoples of Europe, the Middle East, or North Africa. It includes people who indicated their race(s) as “White” or reported entries such as Irish, German, Italian, Lebanese, Arab, Moroccan, or Caucasian.

b. “Black or African American” refers to a person having origins in any of the Black racial groups of Africa. It includes people who indicated their race(s) as “Black, African Am., or Negro” or reported entries such as African American, Kenyan, Nigerian, or Haitian.
c. “Asian” refers to a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. It includes people who indicated their race(s) as “Asian” or reported entries such as “Asian Indian,” “Chinese,” “Filipino,” “Korean,” “Japanese,” “Vietnamese,” and “Other Asian” or provided other detailed Asian responses.
d. “Native Hawaiian or Other Pacific Islander” refers to a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. It includes people who indicated their race(s) as “Pacific Islander” or reported entries such as “Native Hawaiian,” “Guamanian or Chamorro,” “Samoan,” and “Other Pacific Islander” or provided other detailed Pacific Islander responses.
e. “American Indian or Alaska Native” refers to a person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. This category includes people who indicated their race(s) as “American Indian or Alaska Native” or reported their

Question 20

How many sovereign American Indian communities are there in Arizona?

Answer 20

22 Sovereign AI communities

Question 21

What are the major reasons for misclassification of American Indians?

Answer 21

a. Systems Level:
i. No electronic medical records available;
ii. Unable to link to other registries;
iii. No patient query or lack of race/ethnicity field in data collection;
iv. Inadequate definitions of AI/AN identity.
b. Policy Level:
i. Spanish surnames – people automatically classified as Hispanic;
ii. Physical appearance of individual;
iii. Decreasing blood quantum;
iv. Younger and older people more likely to be classified as White on death certificates.
c. Individual Level:
i. Refusal to answer race/ethnicity questions;
ii. Not able to identify with a particular ethnic or racial identity;
iii. Forced to identify as one race in forms;
iv. Previous generation did not enroll in tribe.

Question 22

10. What are some of the pre-Columbian health conditions experienced by American Indians/Alaska Natives?

Answer 22

a. Parasitic Diseases (Giardia and Amebic Dysentery)
b. Infectious Diseases (TB, Tularemia, Rabies, Hepatitis-A, Herpes, Pertussis, and Poliomyelitis)
c. Musculoskeletal Diseases (Osteoarthritis and trauma)
d. Nutritional Diseases (Iron-Deficiency Anemia)

Question 23

What are some diseases that were foreign to American Indians/Alaska Natives?

Answer 23

a. Bubonic plague
b. Measles
c. Smallpox
d. Mumps
e. Chickenpox
f. Influenza
g. Cholera
h. Diphtheria
i. Typhus
j. Malaria
k. Yellow Fever
l. Leprosy

Question 24

What are some key elements and healing rituals in American Indian Medicine?

Answer 24

a. Traditional healing among the indigenous peoples of the Americas was holistic.
b. The mind, body and spirit are seen as interconnected;
c. Healing combines religion, spirituality, herbal medicine, and ceremonial rituals that are used to treat people with physical and emotional conditions;
d. From the Native American perspective, medicine is more about healing the person and restoring balance than curing a disease.
e. Native American healing is based on the belief that everyone and everything on earth is interconnected, and every person, animal, and plant has a spirit or essence;
f. Diseases are more likely to invade the body of a person who is imbalanced, has negative thinking, or lives an unhealthy lifestyle;
g. Some of the most common aspects of Native American healing include the use of healers, herbal remedies, purifying rituals, and symbolic healing rituals to treat illnesses of both the body and spirit.

Question 25

What is the socio-demographic and economic profile of American Indians/Alaska Natives?

Answer 25

a. High rates of poverty
b. 1 in 5 families are headed by women
c. Unsafe and unhealthful working conditions
d. About 12% of housing lack adequate water supply and waste disposal systems

Question 26

Why is there a need for Cultural Competence?

Answer 26

a. To respond to current and projected demographic changes in the U.S.;
b. To eliminate long-standing disparities in the health status of people of diverse racial, ethnic, and cultural backgrounds;
c. To improve the quality of services and health outcomes;
d. To meet legislative, regulatory, and accreditation mandates;
e. To gain a competitive edge in the market place;
f. To decrease the likelihood of liability and malpractice claims.

Question 27

Where does Arizona rank in terms of American Indian population size?

Answer 27

3rd

Question 28

Where did Syphilis originate?

Answer 28

New World- Americas

Question 29

According to Dr. Carlos Gonzales, what is the healer’s primary role?

Answer 29

a. Facilitate

Question 30

Can Traditional Indian Medicine be generalized to other tribal groups?

Answer 30

No

Question 31

What do health belief systems do?

Answer 31

a. Define and categorize health and illness;
b. Offer explanatory models for illness;
c. Are based upon theories of the relationship between cause and the nature of illness and treatments (physical, magical, supernatural);
d. Defines the specific “scope” of practice for healers.

Question 32

What was the “Long Walk” of the Navajo?

Answer 32

a. Navajos were forced to walk up to thirteen miles a day at gunpoint from their reservation in what is now Arizona to eastern New Mexico. Some 53 different forced marches occurred between August 1864 and the end of 1866.

Question 33

Surviving Columbus Summary

Answer 33

About the Pueblo tribe and how they were forced off their land by the government and their adaptation to the changes in the modern world

Question 34

Hozho Women Summary

Answer 34

These women had traditional role of preparing meals and staying at home but are starting to branch out to other roles like the sweat lodge preparation

Question 35

What are some traditional roles of American Indian/Alaska Native women?

Answer 35

dentity rooted in her spirituality, extended family and tribe;

b. Highly valued as harmonizing influence;
c. Biological role as mother’s who raise healthy families;
d. Spiritual role as the extension of the Spirit Mother, essential for the tribes’ continuation.
e. Repository for cultural knowledge – educate and care for her family;
f. Economic role in contributing to subsistence of family and tribe;
g. Status increased with age;
h. Many tribes were matrilineal.

Question 36

What is the incidence of breast cancer among American Indian/Alaska Native women?

Answer 36

a. High: Alaska

b. Low: East

Question 37

What is the incidence of cervical cancer among American Indian/Alaska Native women?

Answer 37

a. High: Southern Plains

b. Low: East

Question 38

40. What are the breast and cervical cancer mortality rates among American Indian/Alaska Native women?

Answer 38

a. Breast Cancer Mortality:
i. High: Southern Plains
ii. Low: Southwest
b. Cervical Cancer Mortality:
i. High: Northern Plains
ii. Low: East

Question 39

Are the rates higher or lower compared to non-Hispanic White women?

Answer 39

a. Higher

Question 40

What is the definition of Microaggressions?

Answer 40

a. Chronic, everyday injustices that Native Americans endure—the interpersonal and environmental messages that are denigrating, demeaning or invalidating
b. These verbal and non-verbal encounters place the burden of addressing them on the recipient of the encounter – creating stress

Question 41

What are the three types of Microaggressions?

Answer 41

a. Microinsults: Behaviors that convey rudeness, insensitivity, or reflect unfair treatment or demean identity or heritage (e.g., eye-rolling);
b. Microinvalidations: Communications that that nullify the experiential reality or identity of Native persons (e.g., are you a “real Indian?” );
c. Microassaults: Characterized by explicit racial derogatory attacks or purposeful discriminatory actions – intentionality more clear (e.g., “don’t go on the war path now”)

Question 42

According to Healthy People 2010, what is the largest health disparity among American Indians/Alaska Natives?

Answer 42

Fetal Alcohol Syndrome

Question 43

What are some health disparities found among American Indians/Alaska Natives?

Answer 43

a. Fetal Alcohol Syndrome
b. Women Smoking During Pregnancy
c. Alcohol-Related MVH Crash Deaths
d. Gonorrhea among Women 15-44 years of age
e. Cirrhosis Deaths
f. Drug-Induced Deaths
g. Deaths from Poisoning
h. Gonorrhea
i. Tuberculosis
j. Sudden Infant Death Syndrome
k. Higher rates of obesity and overweight;
l. Higher rates of Diabetes Mellitus;
m. Higher rates of Cardiovascular Disease;
n. Higher rates of frequent mental distress;
o. Higher rates of fair/poor health status.

Question 44

What is the Cultural Competence Continuum?

Answer 44

a. Developing an awareness of one’s own beliefs, sensations, and thoughts without letting them have an undue influence on those from other cultural backgrounds;
b. Demonstrating knowledge and understanding of the client’s culture;
c. Accepting and respecting cultural differences;
d. Adapting care to be congruent with the client’s culture.

Question 45

Why is there a need for Cultural Competence?

Answer 45

enrolled or principal tribe, such as Navajo, Blackfeet, Inupiat, Yup’ik, or Central American Indian groups or South American Indian groups