Reducing the burden of cardiovascular disease and its risk factors in Navajo population through food stores on Navajo Nation

Cardiovascular disease (CVD) and its risk factors are increasing at an alarming rate among the adult Navajo population, who are also suffering from the rising challenge of food insecurity. Changes over the past few decades in the food environment of Navajo population, and their increasing consumption of unhealthy foods and beverages link to the prevalence of CVDs. It is of urgent public health concern to address the burden of CVDs among the Navajo population, as inaction can lead to worsening morbidity, mortality and healthcare costs in decades to come. Access to healthier food options is the first and foremost area where bringing a change in the health environment, can improve outcomes for CVDs. Navajo Nation, on account of being a food desert, faces significant barriers to the availability of healthy food and beverage options. Food policy development process for Navajo Nation is an interplay among federal, state and tribal laws. For the Navajo Nation, interventions to reduce the burden of CVD and its risk factors are best suited at the community level as cultural contexts will need to be included and it will be important to gain the support of local leaders and elders. A community level intervention for the Navajo Nation will not only help improve overall health by influencing societal norms towards healthy behavior but will also be strengthening the community mediating structures towards tailored health policy development. This paper proposes adopting a policy intervention at the community level which will lead to behavior modification towards healthy eating and reduce risk of CVDs and its risk factors among Navajo population. The proposed intervention is increasing the number of food stores on Navajo Nation and providing healthy food and beverage choices in food stores of all sizes along with nutrition education, through provision of small business loans to local entrepreneurs.Master of Public Healt