Why does a trip to South Dakota qualify as Global Health?
Because certain populations within the United States have health outcomes that are as poor as those in the developing world. With average life expectancy five years lower than the average American, (72.6 years vs. 77.8 years), American Indians & Alaska Natives (AI/AN) suffer from significant disparities in health. Major medical centers, specialty care, and even primary care are frequently multiple hours away, effectively making this population as isolated and underserved as those observed in other parts of the world.
Cancer is one aspect of health where American Indians fare especially poorly. While cancer death rates for other Americans have been declining in recent years, AI/AN death rates have remained the same. In particular, American Indians in the Northern Plains (North and South Dakota, Nebraska and Iowa) have cancer mortality rates that are 30% higher than the rest of the US population.
My project is working to quantify these disparities for American Indians in South Dakota with head and neck (H&N) cancer via a chart review. Stage at presentation is one of the most important factors for cancer survival, and AI/AN historically present with later-stage cancers. To help understand why, I am also administering a survey at two large community events to gauge knowledge of the risk factors and early signs and symptoms of H&N cancer. Alongside the survey, we are offering a free head and neck screening examination.
Sunshine Dwojak, MD, MPH
Harvard Program in Otolaryngology
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| Landscape near the Pine Ridge and Rosebud Sioux Indian Reservations |
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