On the second floor of the Native American health center center, a couple of dozen people are gathered around a table. They're getting personal about their health.
(Hi everyone, My name is...)
The Native Americans here have diabetes, and are taking part in a talking circle. It's a tradition of peer exchange of information, this one to help manage chronic disease. A dietician helps educate them about healthy living.
Jacquelyn Smith is Miwok Indian from a rancheria just outside of Sacramento. Her diabetes has been under control for several years, thanks in part to the eating advice she gets from the group. She says the discussion here helps other native people make healthier choices in an urban environment.
Some of us are coming from the rez, coming into town... Instead of being just at home you know farming and catching fish and chasing rabbits and deers, and we have to watch you know how we eat.
Besides the diabetes talking circle, the center on J street
offers medical and dental services, group counseling and cultural
programs. Britta Guerrero is CEO of the center.
GUERRERO: We are here to serve the Indian community, we belong to them. However, we definitely want to do our part to contribute to the overall community.
Staff say the number of patients the center serves has doubled since 2007.
GUERRERO: We've seen low-income and Medi-Cal populations specifically, but due to the recent unemployment rates. We've seen people who have just recently lost their insurance and are coming in to pay on a sliding fee scale. So we've seen an increase in our cash payments, which has required us to get a little more creative.
Guerrero says the center's patient make up used to be 60% native American, now it's about 50%. It's been a balancing act to make sure native patients are top priority.
GUERRERO: Traditionally Indian people take in members of their community, that's how we do … As far as being marginalized and being underserved, that has required us to be resilient and creative, and I think this program is a demonstration of that resiliency.
The centers growth comes at a time when the number of Sacramento county clinics has dropped from six to one. Dr. Glennah Trochet is the county's public health officer.
TROCHET: There's a much more important role for community clinics now than ever before. Because of the recession because governmental services have been reduced.
There are other community clinics in the Sacramento area. Trochet says being a federally qualified health center and having good management are essentials for continuing to serve the community.
TROCHET: I think the role of community clinics has only going to increase, particularly with health care reform, whatever form that takes, come 2014. Many more people will be eligible for services.
Meantime, the center remains committed to serving the regions native community, which Guerrero says has lower life-expectancy than other ethnic groups. Data show American Indians have some of the highest rates of diabetes in California. Jacquelyn Smith says being around other native people in the health care setting helps build trust in the health care system. Her diabetes is under control so now she offers herself as an example of disease management.
SMITH: And I tried to help them to do what I did too. And it's hard to get the elders to change. You can see them change a little at a time. Being able to come here and talk with other people and know that I'm not by myself.
After the talking circle, a tribal leader said a blessing before a mean, to express gratitude for the group.
(Elder says a blessing)
They will all see each other again in two weeks, with more stories to share.