A 10-Year Summary of Health Fair Data from Lakota, Powwows, and Red Shawl Events in the Rural Midwest

Abstract

Objectives—Health screening data were collected from participants at Native American community and celebratory events to evaluate their health status and identify common health concerns. These results will form the basis for developing community-based health care interventions to address health inequalities. Design—A descriptive, observational design was used to gather data in line with STROBE guidelines. Results—The screening data revealed that this population was largely obese, had low bone mass, and were in various states of dehydration. These characteristics can lead to major health risks and morbidities including diabetes, hypertension, cancer, hormone and neurotransmitter imbalances, bone fractures, and psychological disorders such as depression and anxiety. Conclusions—Professional and community efforts are essential to meet the health care needs of this population and avoid the repercussions of obesity, low bone mass, and dehydration. By incorporating collaborative input from the Native American community, we intend to develop partnerships for goals of promoting effective, culturally appropriate interventions to meet these health inequalities and promote good health and well-being.

1. Introduction

To promote good health and well-being, as well as better understand the health status and health care needs of underserved populations, the author hosts health screening booths at multiple ethnic events each year with the assistance of community health professionals and health care students and faculty. These data will inform the development of community-based health care interventions to address unmet health care needs and result in reduced inequalities.

This report summarizes data from community-based Native Americans, primarily Lakota, living in the rural Nebraska Panhandle. Data were collected by the author and her team at health screening booths at the Lakota Lutheran Center, Powwows, and Red Shawl events. The latter were cardiovascular health events targeting Native American women. Data were collected on 61 dates between June 2011 and April 2021. These data contain 548 records from 188 individuals (Appendix A).

2. Materials and Methods

Health fairs at these Native American events were for community outreach; therefore, limited sociodemographic data (age, race/ethnicity) and no health history data were collected. Attendees voluntarily approached the booth to receive screenings and discuss the results. Although Native Americans were targeted for this outreach, any attendee, regardless of race/ethnicity, was welcome to participate in the screenings. Only data for Native American participants are reported here. An IRB determined this data collection did not require consent as it was a public event offered to all present. The data is reported as a group and entirely de-identified.

Participants’ height was measured with a Seca 217 stadiometer. Body composition data were collected using a Tanita Body Composition Analyzer model SC-250. Participants removed shoes and socks as well as any additional layers of clothing, such as jackets, prior to measurements. Data collected included body mass index (BMI), percent body fat (categorized as underfat, healthy, overfat, and obese, corresponding to underweight, normal weight, overweight, and obese, respectively), fat mass, fat free mass, visceral fat rating, percent body water, body water, muscle mass, bone mass, muscle score, and basal metabolic rate (BMR). Descriptive statistics were performed using the Statistical Package for the Social Sciences (SPSS) Version 25.

3. Results

We obtained data from 65 Native Americans; 80% of those were females. Their average age was 41 years (range = 17–73). Both the mean BMI (30.3 kg/m², range = 18.4–44.8 kg/m²) and mean percent body fat (34.2%, range = 9.0–54.9%) were in the overfat/obese category (BMI ≥ 30 kg/m², percent body fat >33%). Mean percent body water was 46% (range = 34–62%), which indicates dehydration. Normal hydration ranges at 48–70% body water. Mean bone mass was 4.9 lbs (range = 1.9 lbs. to 8.4 lbs), which is low for women and more so for men (

Table 1. Native American.

Variable	N	Minimum	Maximum	Mean	Std. Dev.
Age	65	17.00	73.00	40.7538	17.30610
BMI	65	18.40	44.80	30.2554	6.95421
Percent Body Fat	64	9.40	54.20	34.1555	10.89952
Fat Mass	64	10.40	142.20	55.7438	34.18467
Fat Free Mass	64	37.10	171.20	97.8555	32.02821
Visceral Fat Rating	64	1.00	21.00	9.1406	4.87581
Percent Body Water	64	34.00	62.00	46.4742	6.92852
Body Water (lb)	64	25.50	121.80	69.4242	23.13480
Muscle Mass	64	35.20	162.80	92.9320	30.43026
Bone Mass	64	1.90	8.40	4.9266	1.59486
Muscle Score	64	8.00	24.00	15.9688	4.24626
BMR	64	1129.00	2764.00	1665.1641	329.35140

).

4. Discussion

Both BMI and body fat percentage being high in this population indicate that obesity is a common issue. Individuals in this community-based Native American population tend to be of low socioeconomic status with over 1/4 living below the poverty level [1]. Many do not have access to transportation, which impacts their access to healthy foods and health care. Common approaches to treating obesity focus on diet and exercise; however, the level of exercise for individuals in this population is unknown. Similarly, the influence of soup kitchen meals and food pantries on diet has not been explored. Partnerships for goals will be critical. Partnerships to set and meet goals in addressing these issues will be essential to the success of the interventions developed. Soup kitchens may be one of the key collaborators.

Body water percentage was low and tends to be inversely related to body fat percentage [2], so this finding was expected. Overall, bone mass values were quite low. Qualitative questioning regarding hydration revealed that nearly 100% of participants consumed carbonated drinks (soda pop) as their main beverage. Consumption of carbonated drinks has been linked to obesity, low bone density, and early onset of osteoporosis [3,4,5,6,7], suggesting that carbonated drinks may, in part, contribute to the low bone masses observed and the levels of obesity.

The above characteristics (obesity, low bone mass, dehydration) can lead to major health risks and morbidities including diabetes, hypertension, cancer, hormone and neurotransmitter imbalances, bone fractures, and psychological disorders such as depression and anxiety [8].

5. Conclusions

Therefore, effective, culturally appropriate, community-based interventions using community partnerships are needed to prevent or address these health concerns. Thus, our next step is to discuss with members of the population if they want assistance in developing programs to improve their health and, if so, to gather input from the Native American community to help develop and evaluate interventions to reduce obesity, increase hydration, and lower consumption of carbonated drinks. Good health and well-being is the goal, as well as reduced health care inequalities. Developing trusting partnerships for goals will be the key to successful interventions.