The Great Plains Tribal Leaders' Health Board is committed to improving health outcomes in Indian Country. Through advocacy, public health education, direct care, and epidemiological support we provide tribal nations and tribal citizens the tools they need to improve the lives of the people. 

Every woman and girl should make their health a priority.

We must encourage our relatives to find safe ways to stay active and healthy. Below are some ways you can improve your physical and mental health:

• Get active 
• Eat a healthy and balanced diet
• Talk with your doctor or primary care provider 
• Prioritize your mental health; positive mental health is associated with "improved overall health and well-being"
• Daily decisions influence your overall health; practice healthy behaviors 

Follow these links to resources at the Centers for Disease Control (CDC) 

• Celebrate Women's Health Week
• Women, Caregiving, and COVID-19
• Health Matters for Women Newsletter

Women's Health Programs

Great Plains Good Health and Wellness

GPTLHB’s Great Plains Good Health and Wellness (GPGHW) program use evidence-informed, culturally rooted health promotion and disease prevention initiatives to help Great Plains area tribes combat obesity, commercial tobacco use, diabetes, heart disease, and stroke.

Read more

The Opioid Problem 

In 2016, opioid overdose deaths increased to more than 42,000 Americans. This shows that opioid overdose is still a major public health problem in the United States.

What Are Opioids? 

Opioids fall into three main groups: 

A prescription medicine used to treat and reduce physical pain.

Illegal drugs like heroin.

Illegal opioids like fentanyl analogs (e.g., carfentanil).

There are several prescription medication opioids, but some of the well-known ones you may have heard of before include: 

• Morphine
• Codeine
• Methadone
• Oxycodone
• Hydrocone
• Fentanyl
• Hydromorphone
• Buprenorphine

Opioid Overdoses 

An opioid overdose can happen for many different reasons. Some of the most common causes include:

Individual

• When a patient misuses a prescription on purpose.
• When someone uses an illegal drug like heroin. 
• When someone uses an opioid contaminated with an even stronger one like fentanyl.
• When a patient using prescription opioids misunderstands the directions for use.
• When someone mixes opioids with other kinds of medication.

Provider

• When the person prescribing an opioid miscalculates the dosage amount.

Pharmacist 

• When the pharmacist providing medication makes a mistake.

Overdose Risk Factors 

Anyone who uses heroin, prescription opioids long-term to manage chronic pain, or abuses prescription pain relievers is at risk of an overdose. Other, more specific examples include people who:

• Receive a rotating opioid medication regimen.
• Have been discharged from emergency medical care after an opioid overdose.
• Need opioid pain relievers, but have a suspected or confirmed substance use disorder or history of non-medical use of prescription or illegal opioids.
• Have completed opioid detoxification or haven’t used opioids in a long time.
• Have recently been released from jail and have a history of opioid use disorder or misuse.

Learn more about opioid addiction across the Great Plains region | Opioid Data Hub

Overdose Prevention 

The good news is that we can use strategies to help avoid deaths from opioid overdoses. Five important ones to remember are:

1. Encourage medical providers, people at high risk, family members, and others to learn how to prevent and manage opioid overdose.
2. Push for ensured access to treatment for people who are misusing opioids or have a substance use disorder.
3. Support ready access to naloxone. For more information on naloxone, visit drugabuse.gov.
4. Encourage people to call 911 in an emergency.
5. Encourage prescribers to use state prescription drug monitoring programs (PDMPs). For more information on PDMPs, please visit http://www.pdaps.org/.

Opioid Overdose Response 

What to do if you suspect an overdose: 

• An opioid overdose requires immediate medical attention. An essential first step is to get help from someone with medical expertise as soon as possible. Call 911 immediately if you or someone you know exhibits any of the signs. All you have to say is "someone is unresponsive and not breathing." Give a specific address and/or description of your location. Administer naloxone if possible. 

Signs of OVERDOSE, which is a life-threatening emergency, includes the following: 

• The face is extremely pale and/or clammy to the touch.
• The body is limp.
• Fingernails or lips have a blue or purple cast.
• The person is vomiting or making gurgling noises.
• The person cannot be awakened from sleep or cannot speak.
• Breathing is very slow or stopped. 
• The heartbeat is very slow or stopped. 

Conversation Starters 

Are you worried about your friend? 

If you’ve noticed someone in your life showing signs of a mental or substance use disorder, the first thing you should do is talk to them. It’s not an easy conversation, but it could be precisely the encouragement they need to seek help. Try using a conversation starter to open the door to a judgment-free zone where they’ll feel valued, supported, and listened to.

Conversation Starter Examples

I’ve been worried about you. I’ve noticed you’ve (been drinking a lot, been using drugs, seemed down lately, etc.). Can we talk about what’s going on?

If you don’t feel comfortable talking to me, is there someone else you’d prefer to talk to, like your parents, siblings, or someone else who cares about you?

It seems like you are going through a difficult time. Is there anything I can do to help?

I care about you and want to make sure you’re okay. If you ever think about harming yourself, you know you can come to me, right?

Do you know someone who’s had an experience like yours? I can help you find someone to talk to if you don't.

I want to be here for you. Do you want to talk about it?

You can make a big difference simply by letting your friend know you’re there. Remind your friend that asking for help is a normal part of life, and they can find support at SAMHSA.gov/young-adults or call 1-800-662-HELP (4357) for treatment referral.

Content provided by SAMSHA.

Opioid Resources

There are also several available resources for communities and organizations to fight back against America’s opioid problem.

Great Plains Tribal Epidemology Center

• Naloxone Info Card
  
• Prescribing Naloxone
• Prescribing Naloxone Pt 2
• Promote Recovery
• What Are Opioids?
• Devastating Effects of Opioid Abuse
• The Cycle of Opioid Abuse Pt 1 (Video)
• The Cycle of Opioid Abuse Pt 2 (Video)
• Opioid Safe Storage (Native Reach)
• Signs of Opioid Addiction

SAMHSA

• National Helpline: 1-800-662-HELP (4357) or 1-800-487-4889 (TDD, for hearing impaired)
• Behavioral Health Treatment Services Locator (search by address, city, or ZIP Code): https://findtreatment.samhsa.gov/
• Buprenorphine Treatment Practitioner Locator (search by address, city, or ZIP Code): https://www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physician-locator
• Single-State Agencies for Substance Abuse Services: https://www.samhsa.gov/sites/default/files/ssa-directory.pdf
• State Opioid Treatment Authorities: https://dpt2.samhsa.gov/regulations/smalist.aspx
• SAMHSA Publications Ordering (all SAMHSA Store products are available at no charge): https://store.samhsa.gov; 1-877-SAMHSA-7 (1-877-726-4727)

Centers for Disease Control and Prevention

• Understanding the Epidemic: https://www.cdc.gov/drugoverdose/epidemic
• Poisoning: https://www.cdc.gov/homeandrecreationalsafety/poisoning

Association of State and Territorial Health Officials

• Preventing Opioid Misuse in the States and Territories: http://my.astho.org/opioids/home

National Association of State Alcohol and Drug Abuse Directors

• Opioids Fact Sheet (February 5, 2016): http://nasadad.org/2016/02/opioids-fact-sheet-2016/

Prevent & Protect

• Tools for conducting overdose prevention and naloxone advocacy, outreach, and communication campaigns: http://prevent-protect.org/community-resources-1/

We support our relatives. 

Opioid Response Program

The Great Plains Tribal Chairmen’s Health Board’s (GPTCHB) Great Plains Tribal Opioid Response (GPTOR) program addresses the opioid crisis and stimulant misuse in the Great Plains Area

Read more

---

Great Plains Behavioral Health & Recovery Programs

Read more

---

Great Plains Tribal Epidemiology Center

Read more

We are committed to serving the needs of mothers, children, and fathers in the Great Plains region. We understand the importance of promoting the health and well-being of American Indian families in Great Plains tribal communities. We provide direct services, research, epidemiology, and technical assistance. The Maternal and Child Health leadership and staff provide advocacy services, collaborate with local, state, and national groups and programs to represent Native families, and promote culturally responsive programs and services for families in the Great Plains. 

Programs that serve our mothers and children. 

Great Plains Healthy Start Program

GPHS utilizes Community Health Workers to deliver paraprofessional health services to women of childbearing age, their partners, and children from birth to 18 months. Services provided are free for residents in one of the eight (8) Healthy Start communities in North and South Dakota. The program improves health outcomes before, during, and after pregnancy and addresses health and social service needs to strengthen family resilience.

Read more

Indigenous Linking Actions in Unmet Needs Children's Health (ILAUNCH) Program

ILAUNCH develops safe, supportive environments for children ages 0-8 and their families living on and near Rosebud Sioux tribal communities. The project strengthens capacity and infrastructure and increases support to families through direct services that help children grow up healthy and ready to learn.

Read more

Tribal Maternal, Infant, and Early Childhood Home Visiting Program (GP-TMIECHV)

MIECHV provides home visiting services for SWO families with young children, from birth to kindergarten entry. The program assesses community needs and service integration while developing community capacity and enhancing systems of care. This home visiting service will support healthy development by addressing maternal and child health, early learning, family support, and promote positive child and family outcomes.

Read more

The Rural Communities Opioid Response Project for Neonatal Abstinence Syndrome (RCORP-NAS)

The Rural Communities Opioid Response Project for Neonatal Abstinence Syndrome (RCORP – NAS) is a project that serves Indigenous women, mothers, and women of childbearing age who are at risk of Neonatal Abstinence Syndrome (NAS), Opioid Use Disorder (OUD), and other Substance Use Disorders (SUD) on the Crow Creek Sioux Reservation community.

Read more

Tribal Injury Prevention Cooperative Agreement Program (TIPCAP) & Great Plains Injury Prevention Program (GPIPP)

TIPCAP focuses on community awareness of and education on appropriate child car seat usage and child safety restraint in vehicles for 17 tribal communities and one service unit in the Great Plains Area. The program assesses and identifies current child passenger safety capacity, resources and needs; increases community Child Passenger Safety Technician capacity; and distributes seats to families who lack resources to purchase them.

Read more

Maternal & Child Health (MCH) Resources

Resources - Maternal & Child Health

The Great Plains Maternal & Child Health department gathered resources for indigenous families in the great plains region. 

Read more

Teen Pregnancy

The Centers for Disease Control (CDC) reported that from 2018 to 2019 the teen pregnancy rate among Natives was higher (29.2) than all other races/ethnicities. During the same time, period teen birth rates declined for several racial groups (Hispanic females, non-Hispanic white females, and non-Hispanic black females). The teen pregnancy rate among Natives was more than two times higher than non-Hispanic white teens. 

Risk Factors for Teen Pregnancy 

The CDC found that "social determinants of health, such as low education and low-income levels of a teen's family, may contribute to high birth rates". Certain settings or environments can put teens at higher risk of teen pregnancy than other groups. For example, foster care can cause a young woman to be two times more likely to become pregnant than young women who do not live in foster care. 

Teen Pregnancy Prevention 

There are evidence-based teen pregnancy prevention programs that can be implemented in different settings. Beyond implementing a teen pregnancy prevention program teens should have access to the following: 

• Youth-friendly reproductive health services 
• Support from parents and other trusted adults 
• Efforts at the community level 

Source: CDC | Teen Pregnancy 

Learn More

Sexually Transmitted Infections / Teen Pregnancy Prevention Initiative Program

If you are sexually active, you need to be informed. Follow this link to learn how to protect yourself from sexually transmitted infections. 

Read more

Great Plains Tribal Epidemiology Center

The Great Plains Tribal Epidemiology Center provides support to tribal nations across the Great Plains to help diagnose health disparities and the presence of diseases and disorders in our communities. 

Read more

Oyate Health Center

The Oyate Health Center is a tribally-owned and operated walk-in primary care clinic located in Rapid City, South Dakota. The facility is under the management of the Great Plains Tribal Leaders’ Health Board.

Read more

Get the Facts About Sexually Transmitted Infections Among Natives 

HIV 

According to the Centers for Disease Control (CDC), the rate of HIV among adult and adolescent Native males was great than the rate for white males. The rate of HIV among Native females was greater than white females. 

HIV | American Indians and Alaskan Natives 

Sexually Transmitted Diseases 

•  Chlamydia: According to the CDC, in 2018 the rate of reported chlamydia among Natives in the United States was 3.7 times higher than the rate among whites 
• Gonorrhea: The CDC reports that in 2018, gonorrhea cases among Natives was 4.6 times higher than the rate among whites
• Congenital Syphilis: According to the CDC, congenital syphilis cases among Natives was 5.9 times higher than the rate among whites

Learn More About STDs

Syphilis 

According to the South Dakota Department of Health, Syphilis cases have increased by 1,286% compared to the five-year median number of cases in South Dakota. 3/4 of the syphilis cases are among Natives. Most of the cases are in western South Dakota. There has been an increase in congenital syphilis cases and deaths. View our emergency resources. 

Learn More About Syphilis in Indian Country 

Viral Hepatitis 

 According to the CDC, in 2018 Natives in the United States had the "highest hepatitis C related death rate among all race/ethnic groups, at 9.05 deaths per 100,000 population". 

Learn More About Viral Hepatitis 

Tuberculosis (TB)

 In 2018, the CDC reported that the rate of TB disease among Natives was over eight times higher than the rate of TB disease among non-Hispanic whites. 

Learn More About Tuberculosis

 STD statistics sourced from CDC | Health Disparities in HIV, Viral Hepatitis, STDs, and TB

STD Prevention Programs 

Sexually Transmitted Infections / Teen Pregnancy Prevention Initiative Program

If you are sexually active, you need to be informed. Follow this link to learn how to protect yourself from sexually transmitted infections. 

Read more

Great Plains Tribal Epidemiology Center

The Great Plains Tribal Epidemiology Center provides support to tribal nations across the Great Plains to help diagnose health disparities and the presence of diseases and disorders in our communities. 

Read more

Oyate Health Center

The Oyate Health Center is a tribally-owned and operated walk-in primary care clinic located in Rapid City, South Dakota. The facility is under the management of the Great Plains Tribal Leaders’ Health Board.

Read more

HIV Among Natives 

According to the Centers for Disease Control (CDC), among Natives HIV (Human Immunodeficiency Virus) has been increasing since 2014. 

HIV Risk Factors

The risk of getting or spreading HIV varies depending on the type of exposure and behavior. The common places people get or spread HIV is through anal or vaginal sex, or sharing needles, syringes, or other drug-injection equipment - for example, cookers. 

HIV Prevention

The best way to prevent HIV is to educate the public about the disease (including transmission, risk factors and prevention methods). Both North Dakota and South Dakota have many resources available for HIV prevention, with specifics for each listed below.

HIV Prevention Challenges 

HIV stigma negatively affects the health and well-being of all people with HIV. 

Educational Materials and Training

Additional education and training materials, resources, and opportunities available at the national and state levels that Tribes can take advantage of are listed below.

National Level

The AIDS Education and Training Center (AETC) offers a wide array of free resources, webinars, and training on its website: http://aidsetc.org/resources. Websites that provide free educational materials and printable handouts:

• CDC's Act Against AIDS includes free and printable posters, banners, and brochures
• AIDS InfoNet contains numerous free fact sheets with information on HIV-related topics
• Greaterthan.org offers educational materials and state-specific information and advocacy
• Kaiser - HIV/AIDS includes a compilation of HIV-related materials, including its global impact
• The National Native American AIDS Prevention Center provides resources, data, and other information specific to HIV among American Indian populations

North Dakota

HIV/AIDS prevention materials and condoms can be ordered from the North Dakota Department of Health through a form that can be obtained by following this link. The North Dakota Department of Health also expressed interest in partnering with Tribes to produce culturally-sensitive prevention materials and conduct outreach to promote testing events. Contact Lindsey VanderBusch at 701-328-4555 for more information.

South Dakota

The South Dakota Department of Health occasionally offers trainings at the state-level, many of which are pre-recorded and regularly available. Those interested should contact Susan Gannon at 605-773-4785 or visit  http://www.effectiveinterventions.org.

South Dakota also has an HIV Prevention Planning Group (PPG), which makes decisions about HIV prevention in the state. The PPG’s meetings are open to the public and offer time for public comments. Contact April Ivey at 605-773-4785 for more information.

Sundance Supplies

Since the late 1980s, the Great Plains Area Indian Health Service recognized the possibility of HIV transmission during the Sundance ceremonies that occur annually on many of the reservations. With this possibility in mind, it is recommended that education about HIV be provided to Sundance leaders and dancers and that precautions be taken to ensure their safety while respecting the sacredness of these ceremonies. 

HIV Counseling, Testing, and/or Referral Sites

Getting tested, understanding risk factors, receiving comprehensive counseling, and referral to services are crucial steps between the prevention and treatment of HIV/AIDS.

HIV.gov also offers a very convenient way to locate testing sites and other HIV services near you. Simply go to the HIV Testing Sites and Care Services Locator on their website and enter your location.

Supporting our relatives with HIV.

Sexually Transmitted Infections / Teen Pregnancy Prevention Initiative Program

If you are sexually active, you need to be informed. Follow this link to learn how to protect yourself from sexually transmitted infections. 

Read more

Great Plains Tribal Epidemiology Center

The Great Plains Tribal Epidemiology Center provides support to tribal nations across the Great Plains to help diagnose health disparities and the presence of diseases and disorders in our communities. 

Read more

Oyate Health Center

The Oyate Health Center is a tribally-owned and operated walk-in primary care clinic located in Rapid City, South Dakota. The facility is under the management of the Great Plains Tribal Leaders’ Health Board.

Read more

Mental Health Basics

According to a report from the Centers for Disease Control and Prevention (CDC), suicide rates among American Indians have increased since 2003. Suicide rates disproportionately affect American Indians; in 2015, the rate of suicides among American Indians was 3.5 times higher than other ethnic/racial groups with the lowest rates. 

What is mental health? 

Our emotional, psychological, and social well-being make up our mental health. Our mental health can affect how we think, feel, and act. It can even determine how we deal with stress, related to others, and make healthy choices. From childhood, adolescence, and through adulthood mental health is important at every stage of life. 

Why is mental health important for your overall health? 

Our mental health is just as important as our physical health. They are both equally important components of health. For example, a person experiencing depression is at an increased risk for many types of physical health problems - usually chronic or long-lasting conditions like diabetes, heart disease, and stroke. Physical chronic conditions can also increase the risk for mental illness. 

Can your mental health change over time? 

 Yes, a person's mental health can change over time, due to many factors. A person's mental health can be impacted when the demands placed on that person exceed their resources and coping skills. For example, a person working long hours, experiencing economic hardship, or caring for a relative may experience poor mental health. 

How common are mental illnesses? 

In the United States, mental illness is one of the most common health conditions.

• 1 in 5 Americans will experience a mental illness in a given year. 
• 1 in 5 children, currently or at some point during their life, have had a seriously debilitating mental illness. 
• More than 50% of Americans will be diagnosed with a mental illness or disorder at some point in their lifetime. 
• 1 in 25 Americans lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. 

What causes mental illnesses? 

There is no one cause for mental illness or poor mental health. There are a number of factors that may increase the risk for mental illness, such as: 

• Trauma or a history of abuse, adverse life experiences for example generational trauma, child abuse, sexual assault, witnessing violence, etc. 
• Experiences caused by or related to other chronic medical conditions, like cancer or diabetes 
• Biological factors or chemical imbalances in the brain
• Use of drugs or alcohol 
• Having feelings of loneliness or isolation 

Information about mental health was gathered from the CDC. 

We support our relatives' behavioral health.

Behavioral Health Programs 

Connecting With Our Youth

Connecting With Our Youth (CWOY) is a values-based initiative to reduce the rate of suicide for Native American youth in the He Sapa catchment area. CWOY is informed by Lakota culture values of caring and compassion for all (Waúŋšila) and youth are sacred (Wakȟáŋyeža) to strengthen connections between American Indian youth and their culture.

Read more

---

Native Connections - Suicide Prevention

The Native Connections Program provides information on suicide prevention and substance use disorder for the Crow Creek Sioux Reservation.

Read more

---

Opioid Response Program

The Great Plains Tribal Chairmen’s Health Board’s (GPTCHB) Great Plains Tribal Opioid Response (GPTOR) program addresses the opioid crisis and stimulant misuse in the Great Plains Area

Read more

---

Circles of Care

The Community Support Groups, offered by OHC at the Lacrosse location, serve as training for friends and family members concerned about loved ones who live with a substance use disorder. The program is based on the Community Reinforcement and Family Training (CRAFT) model, a highly effective, evidence-based, motivational program that impacts communities and families in multiple areas of their lives.

Read more

What is mental health?

Mental health is more than just the absence of mental disorders. Our people have a holistic view of wellness. We believe wellness is more than physical health. Wellness includes your mental, emotional, physical, and spiritual health. You can take steps to improve your wellness.

Suicides Among Natives in South Dakota 

• Suicide is the 7th LEADING CAUSE of death among Natives.
• Suicide rates among Natives are 2.5x HIGHER than White rates.
• Males account for 63% of suicides, Females 37%.
• The rate of suicide is highest among YOUNG ADULTS (20-29).

Warning Signs

A change in behavior or the presence of entirely new behaviors is something to look out for when concerned that a person may be suicidal. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who take their lives exhibit one or more warning signs, either through what they say or do.

Talk

If a person talks about:

• Killing themselves
• Feeling hopeless
• Having no reason to live
• Being a burden to others
• Feeling trapped
• Unbearable pain

Behavior

Behaviors that may signal risk, especially if related to a painful event, loss, or change:

• Increased use of alcohol or drugs
• Looking for a way to end their lives, such as searching online for methods
• Withdrawing from activities
• Isolating from family and friends
• Sleeping too much or too little
• Visiting or calling people to say goodbye
• Giving away prized possessions
• Aggression
• Fatigue

Mood 

People who are considering suicide often display one or more of the following moods:

• Depression
• Anxiety
• Loss of interest
• Irritability
• Humiliation/Shame
• Agitation/Anger
• Relief/Sudden Improvement

If you need help right now:

• 988 Suicide & Crisis Lifeline
  • Call or text 988 or chat 988lineline.org
• National Suicide Prevention Lifeline
  • 1-800-273-TALK (8255)
• Text OYATE to 741741
  • Download & use the Connecting With Our Youth Mobile App to talk to an Okijupi (safe, local volunteer)

Mental Health Facts and Myths

Here are common myths with facts to debunk those myths about mental health.

Myth: Children do not experience mental health problems.

Fact: Half of the people who experience mental health disorders show signs before the age of 14. Young children can also show warning signs of mental health concerns. Early mental health support can help your child before problems interfere with other development needs.

Myth: Mental health problems are caused by weakness or character flaws. If a person is facing a mental health issue, they can snap out of it if they try hard enough.

Fact: Many people need help to get better. Life is hard sometimes. People who have mental health problems can get better and most completely recover.

Overcoming Stigma

Mental health stigma is common across all populations, even native communities. For Native communities, this may correlate with the loss of traditional belief systems and practices.

Across Indian County, we have seen that when Native communities return to using traditional healers, ceremonies, and rituals, some Native persons experiencing mental health problems are more likely to seek traditional forms of healing.

Yoga for Wellness 

Every day, 100 people die in the United States from opioid abuse. To fight this surging epidemic, the Great Plains Tribal Opioid Response Team is working to provide tribal citizens with the tools they need to prevent and overcome opioid addiction. Starting on February 14, 2022, the Great Plains Tribal Opioid Response Team will unveil a series of online Yoga Classes free to the public that will supplement other prevention programs working to educate the community about the dangers of opioids. To prevent opioid use disorder and support those in recovery in our community, Great Plains Tribal Opioid Response offers three tracks of Yoga. All these classes are free, between 30 – 45 minutes, and online!  Everyone is welcome!

Read More

Suicide Prevention Programs

Great Plains Native Connections Program

The Native Connections Program provides information on suicide prevention and substance use disorder for the Crow Creek Sioux Reservation.

Read more

Connecting With Our Youth Program

Connecting With Our Youth (CWOY) is a values-based initiative to reduce the rate of suicide for Native American youth in the He Sapa catchment area. CWOY is informed by Lakota culture values of caring and compassion for all (Waúŋšila) and youth are sacred (Wakȟáŋyeža) to strengthen connections between American Indian youth and their culture.

Read more

"Heart disease" is a term used to describe a few different heart conditions. Cardiovascular disease (CVD) has been increasing among Natives. CVD has been a leading cause of death among Natives over the last 50 years. 

Symptoms 

Heart disease causes about 659,000 deaths in the United States each year - that is equal to about 1 in every 4 deaths. Heart disease can be "silent" and undiagnosed until a person experiences serious signs and symptoms of a heart attack, heart failure, or arrhythmia. Symptoms of these serious conditions may include: 

• Heart attack: chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath 
• Arrhythmia: fluttering feelings in the chest (palpitations) 
• Heart failure: shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins 

Risk Factors for Heart Disease

• High blood pressure
• High cholesterol
• Diabetes
• Smoking or drinking alcohol
• Overweight or obesity
• Unhealthy diet

Sources CDC | Heart Disease & Cardiovascular Disease in American Indians and Alaskan Natives | Professional Heart Daily

We help our relatives with heart disease. 

Great Plains Good Health and Wellness

GPTLHB’s Great Plains Good Health and Wellness (GPGHW) program use evidence-informed, culturally rooted health promotion and disease prevention initiatives to help Great Plains area tribes combat obesity, commercial tobacco use, diabetes, heart disease, and stroke.

Read more