Dena Wilson, MD, FACC: Bringing CV Services to Native American Populations
A member of the Oglala Sioux Tribe, Dena Wilson, MD, FACC, has always been involved with the Indian Health Service (IHS) – an agency within the U.S. Department of Health and Human Services responsible for providing federal health services to American Indians and Alaska Natives – first as a patient and now as a physician.
Prior to 1960, coronary artery disease was uncommon in Native Americans. Today, cardiovascular disease is the number one killer of the American Indian and Alaskan Native population. Changes in diet, economics and lifestyle have resulted in increased obesity, diabetes, high blood pressure and kidney failure. Consequently, this had led to increased rates of coronary disease, myocardial infarctions and cardiac deaths.
Since it is important for the Native American and Alaskan Native population to receive specialized care, the IHS provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 567 federally-recognized tribes in 35 states. “Because many reservations are located in rural areas, it can be a challenge to recruit and retain physicians, and there is an inability to access specialty care. I saw this ‘shortage’ of physicians and knew that I wanted to serve as a physician in the Agency,” says Wilson, who is currently the Agency’s chief clinical consultant for cardiology, as well as an officer with the U.S. Public Health Service Commissioned Corps.
Wilson grew up on the Pine Ridge Indian Reservation in South Dakota and first became involved the Native American Cardiology Program as a medical resident at the University of Arizona in Tucson, where the program was first established. She was recruited to come on board as permanent staff after she completed her fellowship. “At that time there were three other cardiologists to help but, as change is imminent, I was the only cardiologist from 2010 to 2015,” she says.
The program – originally called the Southwest Native American Cardiology Program – was first established in 1993 by the Tucson, Phoenix and Navajo Indian Health Service Areas to provide cardiac services to the rural and underserved communities throughout Arizona. Because the Southwest Native American Cardiology Program did not have sufficient resources alone, the program partnered with non-government associates, which at the time was the University of Arizona. By sharing mutual resources-supplies, equipment and personnel, the partners were able to provide a culturally-sensitive system of care for the Indian population.
Today, the Native American Cardiology Program, which is funded by the IHS and tribal facilities in Phoenix and Northern Arizona, is located in Flagstaff. It partners with Flagstaff Medical Center and the Heart and Vascular Center of Northern Arizona to provide emergency consultations, inpatient services, outpatient services, cardiology clinic services and echocardiography interpretations. “The collaboration with outside agencies to assist in providing care to the rural, underserved, Native American population is a successful approach, particularly when served by a regional specialty medical center,” she explains.
In October 2015, Wilson transferred to the Phoenix Indian Medical Center (PIMC), which is also a part of the IHS, located in Phoenix. The tribal identity of eligible beneficiaries receiving care at PIMC is representative of 67 percent of the 567 federally-recognized tribes. “Although I no longer live in the rural areas of Arizona, I am now able to provide a broader spectrum of cardiology services and continue to serve the Native American population of Arizona, Utah and Nevada, as well as many other tribes from throughout the U.S.,” she says.
An active member of the College since she was a Fellow in Training, Wilson has represented the Public Health Service on ACC’s Board of Governors since 2014.
"I would like to give a voice to the cardiovascular needs of a population that has been underrepresented in medical research and health policy," she adds.
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