Native elders are at greater risk for numerous acute as well as chronic illnesses. Native elders suffer more frequent comorbidity of such conditions, thereby compounding the adverse health effects. In addition, they have less access to needed services, and are slower to seek available care, which leads to more serious, complicated presentations. Despite recognizing these circumstances, relatively few inroads have been made in altering the individual-, familial-, community-, and system-related factors that contribute to them. Barriers to advancement in this area include the following:
The Administrative Core provides varying levels of direction and support--both day-to-day and long-term--to each of the other cores. This consists of the following levels of support: full range of logistical operations (e.g., scheduling, communication, personnel matters, expenditures, and monitoring functions); coordination of activities across all cores through a Center Coordinating Committee comprised of the core leaders; key strategic decisions (e.g., selection and periodic evaluation of Native Investigators, approval of Pilot Studies); and program planning as well as review.
The Community Liaison Core provides formal linkage of the other core components to the participating communities through the four field offices and facilitates broader participation of local consumers, providers, and planners in NERC efforts. In addition, the core builds upon existing collaborations with community-based, advocacy, and professional organizations to disseminate the programmatic outcomes of NERC activities.
The Investigator Development Core weaves together didactic, experiential, and mentored instruction as well as specialized seminars to equip Native Investigators to function as independent scientists working at the interface of aging, health, and culture, with special emphasis on Native elders.
The Measurement Core provides varying levels of direction and support to each of the Native Investigators and supporting faculty in the development and course of the Pilot Studies and related research. NERC's Measurement Core is comprised of four components: a data management/analysis sub core, an ethnographic sub core, a clinical sub core, and a statistical sub core. The staff assists in calculating power analyses to determine sample sizes, in tailoring analyses to the data available, in supervising data analysts, in reviewing manuscripts, and in demonstrating new analytic procedures.