Minneapolis Star Tribune, July 8

U's innovative workforce training will help address American Indian health gaps

New program responds to need for providers, staff with cultural knowledge.

American Indians and Alaskan Natives bear what experts call a "disproportionate disease burden." Here's how that euphemistic term translates to real life:

They're at higher risk of heart disease than the general population and more than twice as likely to develop diabetes. They're also more likely to die from diabetes, chronic liver disease and cirrhosis, cancer, stroke, kidney disease, suicide, assault and drug-related causes.

These tragic gaps aren't a new medical challenge, but they remain a particularly stubborn and shameful one. That's why a new initiative from the University of Minnesota's School of Public Health is timely and needed.

In Minnesota and across the nation, there is growing acknowledgment of the value of having caregivers who are not only aware of American Indians' unique health needs and but familiar with their cultural values. This foundation can strengthen the caregiver-patient relationship, which in turn can serve as a foundation for improved medical outcomes.

At the same time, there is a shortage of health care providers and staff with the cultural knowledge needed to strengthen care in Indian communities. The new School of Public Health program, which was announced in June, aims to help meet this workforce demand.

The school is now offering its graduate students a chance to minor in American Indian health. The pathway is believed to be the first of its kind in the nation. It also complements the work done at the University of Minnesota Medical School's Center of American Indian and Minority Health.

There's no need to be American Indian to enroll. Subjects will include Indian culture and provide an in-depth look at tribal law, the federally run Indian Health Service and the complicated interaction between Indian nations and the federal government.

The knowledge will augment traditional public health graduate majors, which include biostatistics, community health promotion, epidemiology, environmental health, and public health administration and policy.

Those who complete the minor will be better prepared to work "within the unique world of tribal public health and wellness," said Linda Frizzell, an assistant professor and nationally recognized expert on Indian health care policy and administration.

Dr. Mary Owen, the director of the University of Minnesota Medical School's Center of American Indian and Minority Health, applauded the program's debut. Building a culturally aware workforce can improve outcomes in many ways, she told an editorial writer. It can strengthen one-on-one patient interactions. It can also help lay the foundation for large-scale community-based interventions tailored to the community's needs.

Owen said an example of a program like this is the American Indian Special Diabetes Program, which is credited with decreasing the rate of kidney failure from type 2 diabetes in Native Americans by 54% from 1996 to 2013.

"So, yes, Native American specific programming within the School of Public Health is critical, both to increase the pool of culturally aware health care workers but also to expand awareness of the existing and successful public health programming that has long been integral to Native American health care."

It reflects well on Minnesota that its flagship university is taking a smart, practical approach — better workforce training — to address health disparities. Academic institutions elsewhere should follow its lead.

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St. Cloud Times, July 5

We've celebrated. Now it's time to live the ideals

The fireworks have exploded, the flags have been flown and John Philip Sousa music has again beat out a rhythm of patriotism and pride.

As we spent the Independence Day holiday with family and friends, we hope you enjoyed it with yours as well.

Now, as the work week is set to begin and the second half of 2019 unfolds, we issue a challenge: Carry that spirit forward.

We live in a great nation — one that has been a beacon to other countries since we had the chutzpah to tell King George III to get lost back in 1776.

How do we know it's a great nation? Our power, courage and determination have been demonstrated on the battlefield. Our scientific achievements have helped spur humanity to the stars.

And we know it by the generosity and challenge presented in the precise words of our founding documents.

Quite obviously, there is this statement, the second sentence in the Declaration of Independence: "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

All men are deserving of liberty and the equal chance to strive for success. That was the first argument made in favor of founding the United States of America — that every person has rights equal to others.

While our founders may have been flawed in executing this principle in their own time, they minced no words in expressing the ideal.

But dig deeper and the founders commitments to that principle are deepened and expanded.

The 14th Amendment makes a precise description of a citizen, then a sweeping, expanded statement of protection for all people of due process and equal protection under the law.

"All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws."

And this, in Article 6 of the U.S. Constitution: "... no religious Test shall ever be required as a Qualification to any Office or public Trust under the United States."

The founders then immediately doubled down on the intended exclusion of religious homogeneity (or religion entirely) from American government — not American life — in the very first clause of the very first amendment in the Bill of Rights: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

But that wasn't even the first time religious freedom was called out in our nation's formative documents.

Months earlier, in January 1776, Thomas Paine wrote this in "Common Sense," a foundational publication of the revolution: "For myself, I fully and conscientiously believe, that it is the will of the Almighty, that there should be diversity of religious opinions among us: It affords a larger field for our Christian kindness. Were we all of one way of thinking, our religious dispositions would want matter for probation; and on this liberal principle, I look on the various denominations among us, to be like children of the same family, differing only, in what is called, their Christian names."

We live in a great nation. You can see it in the words of freedom and tolerance written by men who risked a traitor's death to write them.

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The Free Pres of Mankato, July 9

Subsidies: Close loopholes that allow big farms to skirt caps

When President Trump tore up trade agreements and slapped tariffs on farm products, America's farm economy suffered. To mollify farmers, a big part of his base, the president announced billions of dollars in aid to farmers.

There were supposed to be caps on how much each farm could collect in subsidies, but an Associated Press analysis shows big farm operations easily skirted the caps.

It's a gaping loophole that does a disservice to the taxpayers funding the subsidies.

The program sets a $125,000 cap in each of three categories of commodities: one for soybeans and other row crops, one for pork and dairy, and one for cherries and almonds. But each qualified family member or business partner gets their own $125,000 cap for each category. Farmers who produce both soybeans and hogs, for example, would have separate caps for each and could collect $250,000. But there are legal ways around those caps, and the data show that farmers are using them, according to the AP.

One Missouri soybean farm got $2.8 million in subsidies by using a number of family members who were "actively involved" in the operation. Thousands more big farms collected more than the cap.

While Americans support "family farms," the ever larger mega-farms often look and operate more like corporations rather than what Americans would view as a family business. In fact virtually every farm in the country is considered a family farm under USDA guidelines.

While the AP analysis pointed out problems in the trade war subsidies, the loophole on caps has been routinely abused in other farm programs. Farms, getting subsidized crop insurance under the farm bill, can make claims if their production is lowered by weather or other conditions. When collecting those payments, big farms also use multiple family member applications to go above caps.

Republican U.S. Sen. Charles Grassley of Iowa has long railed against the loopholes, saying the largest farm operations are using "underhanded legal tricks" to get more "while young and beginning farmers are priced out of the profession."

More subsidies are on the way from the White House, with $16 billion more coming this year. The USDA should tighten requirements for the next round of payouts and Congress should close subsidy loopholes in the next farm bill.

Copyright 2019 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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