|
CALS
Alum
JoAnn Allen Holland: Helping Indian Nations
Conquer Diabetes
"What works best is empowering our clients".
By Amanda Vander Meer
When JoAnn Allen Holland was driving a grain truck for an Idaho rancher in 1973, while finishing her UI food science degree, she could never have imagined a career helping more than a dozen Indian nations, from Oklahoma to California, in their battles against diabetes.
Native Americans throughout the United States face a diabetes epidemic. They are 10 times more likely to develop diabetes than are white people. The Indian Health Service (IHS), the U.S. Department of Health and Human Services arm responsible for the health of 1.5 million Native Americans in 35 states, currently treats more than 107,000 tribal members for diabetes. Complications are a major cause of blindness, amputations, kidney failure, and death in Indian populations.
Today Holland, a registered dietitian and a commissioned officer with the United States Public Health Service (USPHS), works at the Parker Indian Hospital, Colorado River Indian Service Unit, addressing health issues for five tribes living along the Colorado River in both Arizona and California. Holland set up the diabetes clinic soon after the new $22 million Parker Indian Hospital opened in 2001. Since the PHS is one of seven uniformed services in the United States, "like the Marines," Holland wears a uniform to work and is a captain-equivalent to an Army colonel. It is the highest rank a public health dietitian/nutritionist officer can earn. The surgeon general is her highest ranking officer. "What works best," she finds, "is empowering our clients."
Empowering people to make lifestyle changes
"As a dietitian," observes Holland, "it's hardest to see people make changes, because food is so private. Change is hard. However, if you let THEM make the choice, diet change is more likely to occur." Often her clients come from dysfunctional families and struggle with drug and alcohol abuse. "Food is their least concern. Also, most of the time, after they are diagnosed with diabetes, they don't feel bad, so why should they exercise and change their diet? Yet, most of them will tell you, 'Mom died on dialysis,' or 'had an amputation.' So there are definite challenges."
Holland designed a "team" approach at Parker, so when people come to see her about diabetes, they also meet with their eye doctor, foot doctor, pharmacist, and social worker and get overall health evaluations. She greets new outpatients at the door and talks individually or with families about options for healthier eating and ways to control diabetes before guiding her clients to related appointments. This personal attention, she hopes, will build rapport and trust.
"When we were starting up, there was a lot of trial and error. Our team would meet every noon after clinic-optometrist, pharmacist, social workers. How do we bring people in? How satisfied are our patients? What comments had we all heard? So we could try to deliver the care people wanted; we could meet their standards."
Time at the mother lode of diabetes research
Holland's role is highly specialized. In 1994, she began a 19-month assignment at Sacaton, Arizona, headquarters for Pima Indians, or "O'Odham," on the Gila River Indian Reservation. It had one of two model diabetes education programs in PHS recognized by the American Diabetes Association. After gaining additional experience working with patients with diabetes, Holland passed the national test for Certified Diabetes Educator (CDE).
The Pimas' huge diabetes rate-some 50 percent of their population-drew the attention of researchers in the 1960s. For some 30 years, Pima volunteers helped scientists seek both genetic and practical answers to diabetes, its origins, and ways to combat it. It was here that scientists working for the National Institutes of Health learned that diabetes and insulin resistance does run in families, that children born of diabetic and obese mothers are much more likely to have diabetes and be obese, and that exercise and diet can help.
Starting a model program for Oklahoma nations
Holland's longest assignment, from 1995 to 2002, was in Lawton, Oklahoma. As director of the Lawton Diabetes Program, she served seven southwest Oklahoma Indian tribes. In 1998, she collaborated with the tribes, implementing grants for Special Diabetes Program for Indians, which helped revive a program that was so short on funds it couldn't provide the needed supplies to its patients. Under her guidance, the program invested an additional $2.7 million to hire diabetes educators and a psychologist, purchase glucose meter supplies and medications, develop a comprehensive podiatry department, and design prevention activities for Head Start and Senior Nutrition centers.
She also designed seven model diabetes programs-one unique to each tribe-and helped train 14 community members as fitness trainers. Under her direction, glucose figures improved dramatically, blood pressures improved, and many more patients were seen and integrated into diabetes programs. It is no surprise she won numerous national awards, including, in 2002, the USPHS Commendation Medal, "for noteworthy contributions as director of the Lawton Service Unit Diabetes Program." That same year the UI recognized her as "one of the Centennial 100 individuals who, through their lives and work, illuminated the breadth, diversity, culture, and spirit of the School of Family and Consumer Sciences."
UI memories; life with burros, London Bridge
Holland's favorite UI memories, while earning her 1974 B.S. degree in food science and a second B.S. degree in food and nutrition in 1982, involve working with her professors. "So many of them were willing to help me one on one! That really made a difference," recalls Holland. One professor even opened his home for student study groups. Food science students learned about milk processing at a creamery in the basement of the Food Research Center near Morrill Hall. As part of the Food Science Club, Holland helped make smoked cheese, which the club sold at Christmas.
Now the Hollands enjoy life in Lake Havasu City, Arizona, a 40-mile commute north of Parker. They own two horses and recently adopted three burros from the Bureau of Land Management. When she's not judging a 4-H contest or county fair entries for La Paz County, she and husband Ron enjoy walks within view of Havasu's famous London Bridge, marinas, and shops.
"I recommend this career for any nutrition students," says Holland. "You get to travel, and a special benefit is learning tribal traditions and making friendships that still fill our mailbox, come holiday time."
top
|