Donald Warne | University of North Dakota (original) (raw)

Papers by Donald Warne

Research paper thumbnail of Social Determinants of American Indian Nutritional Health

Current developments in nutrition, Aug 1, 2019

Research paper thumbnail of Comparison of Body Size Measurements as Predictors of NIDDM in Pima Indians

Diabetes Care, Apr 1, 1995

OBJECTIVE-To determine and compare the abilities of various anthropometric measurements to predic... more OBJECTIVE-To determine and compare the abilities of various anthropometric measurements to predict the development of non-insulin-dependent diabetes mellitus (NIDDM) in Pima Indian men and women. RESEARCH DESIGN A N D M E T H O D S-A total of 290 male and 443 fe male Pima Indians were followed for up to 6 years for the development of NIDDM. A proportional hazards analysis was used to assess the ability of anthropometric measurements evaluated at baseline to predict NIDDM. Receiver operating characteristic (ROC) curves were used to compare individual variables in predicting NIDDM. RESULTS-In separate models controlled for age and sex, body mass index (BMI), waist circumference, thigh circumference, waist-to-thigh ratio (WTR), weight, and percentage body fat (PBF) estimated by bioelectric resistance each predicted NIDDM, which developed in 30 men and 52 women. The highest incidence rate ratios (IRRs; for 1 SD of a variable) were for WTR in men and for PBF in women, although the confidence interval (CI) for PBF was wide. In step wise analyses, WTR was the most significant predictor in men (IRR for 1 SD = 1.58, 95% CI = 1.20-2.07), and BMI was the most significant predictor in women (IRR for 1 SD = 1.65, 95% CI = 1.29-2.11). However, by ROC analyses, thigh circumference was the only variable significantly worse than WTR in men or BMI in women at predicting NIDDM. CONCLUSIONS-Measurements such as waist circumference, WTR, weight, and BMI may be as useful as more complicated measurements, such as PBF by bioelectric resistance, for identifying groups of individuals whose body habitus places them at high risk of developing NIDDM.

Research paper thumbnail of Alcoholismo y abuso de sustancias

Research paper thumbnail of Tribal Tobacco Policy Roadmap: White Earth Nation Promising Practices

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 19, 2014

Research paper thumbnail of Tribal Health Departments and the Academic Health Department: Approaches to Creating Synergy

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 17, 2014

Research paper thumbnail of Alcoholism and Substance Abuse

Research paper thumbnail of AmericanIndianHealthPolicy:HistoricalTrendsand ContemporaryIssues

Indian health expenditures per capita compared with other federal health care expenditures per ca... more Indian health expenditures per capita compared with other federal health care expenditures per capita.

Research paper thumbnail of Regional Differences In Coverage Among American Indians And Alaska Natives Before And After The ACA

Health Affairs, Sep 1, 2019

Understanding regional variation in the effect of the Affordable Care Act (ACA) on health insuran... more Understanding regional variation in the effect of the Affordable Care Act (ACA) on health insurance coverage among vulnerable populations such as American Indian and Alaska Native adults has important policy implications. We used American Community Survey data for the period 2010-17 to examine unadjusted trends in health insurance coverage among American Indians and Alaska Natives across ten US regions. In each region we also used multivariate regression to evaluate the effects of the ACA on insurance coverage among American Indians and Alaska Natives and differences in effects between that group and non-Hispanic whites. In the West we observed significant improvements in public insurance among American Indians and Alaska Natives, and disparities compared to non-Hispanic whites were reduced following the ACA. Although there were unadjusted increases in insurance coverage across most regions, regression analyses suggested that there were no significant post-ACA changes in public or private health insurance coverage among American Indians and Alaska Natives in the Oklahoma, Bemidji, or Alaska regions. In sum, health insurance among American Indians and Alaska Natives increased after the ACA, but improvements were not consistent across regions. More attention is needed to improve insurance coverage among American Indians and Alaska Natives in midwestern regions.

Research paper thumbnail of Chokeberry reduces inflammation in human preadipocytes

Journal of Functional Foods, 2024

Chokeberry, Aronia melanocarpa, is an indigenous fruit from North America used as food and to pre... more Chokeberry, Aronia melanocarpa, is an indigenous fruit from North America used as food and to prevent chronic disease by Indigenous Peoples. The objective of this study was to test anti-inflammatory effects of anthocyanin on palmitic acid (PA)-induced IL-6 gene expression, IL-6 DNA methylation, and histone (H3) acetylation. Additionally, we examined effects of anthocyanins Cyanidin-3-O-galactoside (C3Gal) and Cyanidin-3-glucoside (C3G) on IL-6 gene expression. Human primary pre-adipocytes were treated with chokeberry juice extract (CBE), C3Gal or C3G in the presence or absence of PA or lipopolysaccharide (LPS). CBE inhibited LPS-and PA-induced IL-6 mRNA expression (p < 0.0001), while C3G and C3Gal had smaller effects. Human IL-6 promoter DNA methylation was increased (p = 0.0256) in CBE treated cells compared to control. Histone H3 acetylations were not affected by CBE or PA treatment. These data indicate that CBE epigenetically reduced PA-induced inflammation by regulating IL-6 DNA methylation without affecting histone modifications in human preadipocyte cells.

Research paper thumbnail of The 2019 Partial Government Shutdown and Its Impact on Health Care for American Indians and Alaska Natives

Journal of Health Care for the Poor and Underserved, 2020

Th e 2018-9 partial government shutdown created a 35-day gap in federal appropriations for the In... more Th e 2018-9 partial government shutdown created a 35-day gap in federal appropriations for the Indian Health Service and tribal health programs. With ongoing challenges for American Indian and Alaska Native health systems, including clinician shortages and poor health outcomes, the funding gap engendered substantial health risks. Other federal health systems have been sheltered from this and past shutdowns through receiving their appropriations in advance. Several approaches exist to implementing advance appropriations, including instituting advance appropriations across Bureau of Indian Aff airs and Indian Health Service programs; or by moving Indian Health Service funding to the same appropriation as the Department of Health and Human Services. Furthermore, building and strengthening health partnerships with non-federal institutions, such as academic medical centers, may help distribute fi nancial risk and strengthen care systems.

Research paper thumbnail of Oral Health Advocacy in North Dakota: Lessons Learned and Next Steps

2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015), Nov 2, 2015

Research paper thumbnail of American Indian adverse childhood experiences disparities in South Dakota: Results of the South Dakota Health Survey

2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015), Nov 3, 2015

Research paper thumbnail of American Indian public health as an academic discipline

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 4, 2013

ABSTRACT

Research paper thumbnail of Investing in Native Community-Led Strategies to Improve Physical Activity

NAM perspectives, Apr 6, 2015

Research paper thumbnail of The State of Indigenous America Series: Ten Indian Health Policy Challenges for the New Administration in 2009

Research paper thumbnail of Integration of the preventive medicine specialty in the rural and Tribal public health workforce

Preventive Medicine, Oct 1, 2020

Smith et al., 2019). American Indian and Alaska Native populations have substantially higher mort... more Smith et al., 2019). American Indian and Alaska Native populations have substantially higher mortality rates due to largely preventable issues, including alcohol, chronic liver disease and cirrhosis, diabetes mellitus, unintentional injuries (including motor vehicle accidents), assault (homicide),(Indian Health Service, 2019) and infant mortality (Danielson et al., 2018). 3. The public health imperative Health professional shortages in Indian country are well

Research paper thumbnail of Health insurance coverage among American Indians and Alaska Natives in the context of the Affordable Care Act

Ethnicity & Health, Jun 10, 2019

Objectives: American Indians and Alaska Natives (AI/AN) have a unique healthcare system uniquely ... more Objectives: American Indians and Alaska Natives (AI/AN) have a unique healthcare system uniquely interwoven with the Affordable Care Act (ACA). The aim of this study is to document changes in health insurance among AI/AN adults before and after implementation of the ACA.

Research paper thumbnail of American Indian Health Policy: Historical Trends and Contemporary Issues

American Journal of Public Health, Jun 1, 2014

The United States has a trust responsibility to provide services to American Indians and Alaska N... more The United States has a trust responsibility to provide services to American Indians and Alaska Native (AI/AN) persons. However, a long-standing history of underfunding of the Indian Health Service (IHS) has led to significant challenges in providing services.Twentieth century laws, including the Snyder Act, Transfer Act, Indian Self-Determination and Education Assistance Act, and Indian Health Care Improvement Act (IHCIA) have had an effect on the way health services are provided. IHCIA was reauthorized as part of the Patient Protection and Affordable Care Act (ACA). Several provisions in ACA allow for potential improvements in access to services for AI/AN populations and are described herein.Although policy developments have been promising, IHS underfunding must be resolved to ensure improved AI/AN health.

Research paper thumbnail of HIV care and treatment of American Indians/Alaska natives with diagnosed HIV infection – 27 states and the District of Columbia, 2012

International Journal of Std & Aids, Nov 21, 2016

The objective of this study was to measure linkage to care, retention in care, and suppressed vir... more The objective of this study was to measure linkage to care, retention in care, and suppressed viral load (VL) among American Indians/Alaska Natives (AIs/ANs) aged 13 years with diagnosed HIV infection. We used national HIV case surveillance data to measure linkage to care, defined as 1 CD4 or VL test 1 month after HIV diagnosis during 2013; retention in care, defined as 2 CD4 or VL tests 3 months apart during 2012; and suppressed VL, defined as <200 copies/mL at the most recent VL test during 2012. In 2013, 74.1% of AIs/ANs were linked to care. At year-end 2012, 46.9% of AIs/ANs were retained in care and 45.1% were virally suppressed. A lower percentage of females (41.3%), compared with males (46.5), were virally suppressed. By age group, the lowest percentage of virally suppressed AIs/ANs (37.5%) were aged 13-34 years. To improve individual health and to prevent HIV among AIs/ANs, outcomes must improve-particularly for female AIs/ANs and for AIs/ANs aged 13-34 years. Screening for HIV infection in accordance with Centers for Disease Control and Prevention's testing recommendations can lead to improvements along the continuum of HIV care.

Research paper thumbnail of American Indian health disparities: psychosocial influences

Social and Personality Psychology Compass, Oct 1, 2015

The American Indian (AI) population suffers from significant health disparities. Death rates from... more The American Indian (AI) population suffers from significant health disparities. Death rates from diabetes, cancer, infant mortality, and other causes are higher among AIs. Numerous psychosocial inf luences, including a history of genocide and boarding school experiences, have led to unresolved historical trauma and its associated poor health outcomes. Adverse childhood experiences are also a strong predictor of risk for numerous chronic and behavioral health conditions. Food programs for impoverished populations historically have led to high rates of formula feeding of infants and intake of high-calorie, low nutritional value foods. Adverse adulthood experiences, including poverty, racism, and substance abuse, lead to depression, anxiety, and poor health outcomes. These social circumstances can have an impact on the quality of parenting skills for the next generation, leading to continued intergenerational health disparities. Additional research into the psychosocial inf luences and social determinants of health is needed to ensure improved policy and program development.

Research paper thumbnail of Social Determinants of American Indian Nutritional Health

Current developments in nutrition, Aug 1, 2019

Research paper thumbnail of Comparison of Body Size Measurements as Predictors of NIDDM in Pima Indians

Diabetes Care, Apr 1, 1995

OBJECTIVE-To determine and compare the abilities of various anthropometric measurements to predic... more OBJECTIVE-To determine and compare the abilities of various anthropometric measurements to predict the development of non-insulin-dependent diabetes mellitus (NIDDM) in Pima Indian men and women. RESEARCH DESIGN A N D M E T H O D S-A total of 290 male and 443 fe male Pima Indians were followed for up to 6 years for the development of NIDDM. A proportional hazards analysis was used to assess the ability of anthropometric measurements evaluated at baseline to predict NIDDM. Receiver operating characteristic (ROC) curves were used to compare individual variables in predicting NIDDM. RESULTS-In separate models controlled for age and sex, body mass index (BMI), waist circumference, thigh circumference, waist-to-thigh ratio (WTR), weight, and percentage body fat (PBF) estimated by bioelectric resistance each predicted NIDDM, which developed in 30 men and 52 women. The highest incidence rate ratios (IRRs; for 1 SD of a variable) were for WTR in men and for PBF in women, although the confidence interval (CI) for PBF was wide. In step wise analyses, WTR was the most significant predictor in men (IRR for 1 SD = 1.58, 95% CI = 1.20-2.07), and BMI was the most significant predictor in women (IRR for 1 SD = 1.65, 95% CI = 1.29-2.11). However, by ROC analyses, thigh circumference was the only variable significantly worse than WTR in men or BMI in women at predicting NIDDM. CONCLUSIONS-Measurements such as waist circumference, WTR, weight, and BMI may be as useful as more complicated measurements, such as PBF by bioelectric resistance, for identifying groups of individuals whose body habitus places them at high risk of developing NIDDM.

Research paper thumbnail of Alcoholismo y abuso de sustancias

Research paper thumbnail of Tribal Tobacco Policy Roadmap: White Earth Nation Promising Practices

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 19, 2014

Research paper thumbnail of Tribal Health Departments and the Academic Health Department: Approaches to Creating Synergy

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 17, 2014

Research paper thumbnail of Alcoholism and Substance Abuse

Research paper thumbnail of AmericanIndianHealthPolicy:HistoricalTrendsand ContemporaryIssues

Indian health expenditures per capita compared with other federal health care expenditures per ca... more Indian health expenditures per capita compared with other federal health care expenditures per capita.

Research paper thumbnail of Regional Differences In Coverage Among American Indians And Alaska Natives Before And After The ACA

Health Affairs, Sep 1, 2019

Understanding regional variation in the effect of the Affordable Care Act (ACA) on health insuran... more Understanding regional variation in the effect of the Affordable Care Act (ACA) on health insurance coverage among vulnerable populations such as American Indian and Alaska Native adults has important policy implications. We used American Community Survey data for the period 2010-17 to examine unadjusted trends in health insurance coverage among American Indians and Alaska Natives across ten US regions. In each region we also used multivariate regression to evaluate the effects of the ACA on insurance coverage among American Indians and Alaska Natives and differences in effects between that group and non-Hispanic whites. In the West we observed significant improvements in public insurance among American Indians and Alaska Natives, and disparities compared to non-Hispanic whites were reduced following the ACA. Although there were unadjusted increases in insurance coverage across most regions, regression analyses suggested that there were no significant post-ACA changes in public or private health insurance coverage among American Indians and Alaska Natives in the Oklahoma, Bemidji, or Alaska regions. In sum, health insurance among American Indians and Alaska Natives increased after the ACA, but improvements were not consistent across regions. More attention is needed to improve insurance coverage among American Indians and Alaska Natives in midwestern regions.

Research paper thumbnail of Chokeberry reduces inflammation in human preadipocytes

Journal of Functional Foods, 2024

Chokeberry, Aronia melanocarpa, is an indigenous fruit from North America used as food and to pre... more Chokeberry, Aronia melanocarpa, is an indigenous fruit from North America used as food and to prevent chronic disease by Indigenous Peoples. The objective of this study was to test anti-inflammatory effects of anthocyanin on palmitic acid (PA)-induced IL-6 gene expression, IL-6 DNA methylation, and histone (H3) acetylation. Additionally, we examined effects of anthocyanins Cyanidin-3-O-galactoside (C3Gal) and Cyanidin-3-glucoside (C3G) on IL-6 gene expression. Human primary pre-adipocytes were treated with chokeberry juice extract (CBE), C3Gal or C3G in the presence or absence of PA or lipopolysaccharide (LPS). CBE inhibited LPS-and PA-induced IL-6 mRNA expression (p < 0.0001), while C3G and C3Gal had smaller effects. Human IL-6 promoter DNA methylation was increased (p = 0.0256) in CBE treated cells compared to control. Histone H3 acetylations were not affected by CBE or PA treatment. These data indicate that CBE epigenetically reduced PA-induced inflammation by regulating IL-6 DNA methylation without affecting histone modifications in human preadipocyte cells.

Research paper thumbnail of The 2019 Partial Government Shutdown and Its Impact on Health Care for American Indians and Alaska Natives

Journal of Health Care for the Poor and Underserved, 2020

Th e 2018-9 partial government shutdown created a 35-day gap in federal appropriations for the In... more Th e 2018-9 partial government shutdown created a 35-day gap in federal appropriations for the Indian Health Service and tribal health programs. With ongoing challenges for American Indian and Alaska Native health systems, including clinician shortages and poor health outcomes, the funding gap engendered substantial health risks. Other federal health systems have been sheltered from this and past shutdowns through receiving their appropriations in advance. Several approaches exist to implementing advance appropriations, including instituting advance appropriations across Bureau of Indian Aff airs and Indian Health Service programs; or by moving Indian Health Service funding to the same appropriation as the Department of Health and Human Services. Furthermore, building and strengthening health partnerships with non-federal institutions, such as academic medical centers, may help distribute fi nancial risk and strengthen care systems.

Research paper thumbnail of Oral Health Advocacy in North Dakota: Lessons Learned and Next Steps

2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015), Nov 2, 2015

Research paper thumbnail of American Indian adverse childhood experiences disparities in South Dakota: Results of the South Dakota Health Survey

2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015), Nov 3, 2015

Research paper thumbnail of American Indian public health as an academic discipline

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 4, 2013

ABSTRACT

Research paper thumbnail of Investing in Native Community-Led Strategies to Improve Physical Activity

NAM perspectives, Apr 6, 2015

Research paper thumbnail of The State of Indigenous America Series: Ten Indian Health Policy Challenges for the New Administration in 2009

Research paper thumbnail of Integration of the preventive medicine specialty in the rural and Tribal public health workforce

Preventive Medicine, Oct 1, 2020

Smith et al., 2019). American Indian and Alaska Native populations have substantially higher mort... more Smith et al., 2019). American Indian and Alaska Native populations have substantially higher mortality rates due to largely preventable issues, including alcohol, chronic liver disease and cirrhosis, diabetes mellitus, unintentional injuries (including motor vehicle accidents), assault (homicide),(Indian Health Service, 2019) and infant mortality (Danielson et al., 2018). 3. The public health imperative Health professional shortages in Indian country are well

Research paper thumbnail of Health insurance coverage among American Indians and Alaska Natives in the context of the Affordable Care Act

Ethnicity & Health, Jun 10, 2019

Objectives: American Indians and Alaska Natives (AI/AN) have a unique healthcare system uniquely ... more Objectives: American Indians and Alaska Natives (AI/AN) have a unique healthcare system uniquely interwoven with the Affordable Care Act (ACA). The aim of this study is to document changes in health insurance among AI/AN adults before and after implementation of the ACA.

Research paper thumbnail of American Indian Health Policy: Historical Trends and Contemporary Issues

American Journal of Public Health, Jun 1, 2014

The United States has a trust responsibility to provide services to American Indians and Alaska N... more The United States has a trust responsibility to provide services to American Indians and Alaska Native (AI/AN) persons. However, a long-standing history of underfunding of the Indian Health Service (IHS) has led to significant challenges in providing services.Twentieth century laws, including the Snyder Act, Transfer Act, Indian Self-Determination and Education Assistance Act, and Indian Health Care Improvement Act (IHCIA) have had an effect on the way health services are provided. IHCIA was reauthorized as part of the Patient Protection and Affordable Care Act (ACA). Several provisions in ACA allow for potential improvements in access to services for AI/AN populations and are described herein.Although policy developments have been promising, IHS underfunding must be resolved to ensure improved AI/AN health.

Research paper thumbnail of HIV care and treatment of American Indians/Alaska natives with diagnosed HIV infection – 27 states and the District of Columbia, 2012

International Journal of Std & Aids, Nov 21, 2016

The objective of this study was to measure linkage to care, retention in care, and suppressed vir... more The objective of this study was to measure linkage to care, retention in care, and suppressed viral load (VL) among American Indians/Alaska Natives (AIs/ANs) aged 13 years with diagnosed HIV infection. We used national HIV case surveillance data to measure linkage to care, defined as 1 CD4 or VL test 1 month after HIV diagnosis during 2013; retention in care, defined as 2 CD4 or VL tests 3 months apart during 2012; and suppressed VL, defined as <200 copies/mL at the most recent VL test during 2012. In 2013, 74.1% of AIs/ANs were linked to care. At year-end 2012, 46.9% of AIs/ANs were retained in care and 45.1% were virally suppressed. A lower percentage of females (41.3%), compared with males (46.5), were virally suppressed. By age group, the lowest percentage of virally suppressed AIs/ANs (37.5%) were aged 13-34 years. To improve individual health and to prevent HIV among AIs/ANs, outcomes must improve-particularly for female AIs/ANs and for AIs/ANs aged 13-34 years. Screening for HIV infection in accordance with Centers for Disease Control and Prevention's testing recommendations can lead to improvements along the continuum of HIV care.

Research paper thumbnail of American Indian health disparities: psychosocial influences

Social and Personality Psychology Compass, Oct 1, 2015

The American Indian (AI) population suffers from significant health disparities. Death rates from... more The American Indian (AI) population suffers from significant health disparities. Death rates from diabetes, cancer, infant mortality, and other causes are higher among AIs. Numerous psychosocial inf luences, including a history of genocide and boarding school experiences, have led to unresolved historical trauma and its associated poor health outcomes. Adverse childhood experiences are also a strong predictor of risk for numerous chronic and behavioral health conditions. Food programs for impoverished populations historically have led to high rates of formula feeding of infants and intake of high-calorie, low nutritional value foods. Adverse adulthood experiences, including poverty, racism, and substance abuse, lead to depression, anxiety, and poor health outcomes. These social circumstances can have an impact on the quality of parenting skills for the next generation, leading to continued intergenerational health disparities. Additional research into the psychosocial inf luences and social determinants of health is needed to ensure improved policy and program development.