SIOUX FALLS: Sioux Falls-based Sanford Health has begun new efforts in research and medical programs in hopes of narrowing the vast disparities in health care on American Indian reservations in South Dakota and elsewhere. A portion of a $400 million donation to the hospital system by Sioux Falls businessman T. Denny Sanford last year will be dedicated to tribal health as part of its expanded research efforts.

``We're taking an approach that is research-based,'' said Sanford Chief Executive Kelby Krabbenhoft. ``It's about fundamentally understanding what the problem is.'' At a meeting by The Center for Health Disparities at Sanford Research/USD, representatives from seven South Dakota tribes discussed health issues with Sanford officials and former US House speaker Newt Gingrich. The research center works with 27 different tribes in the Midwest and West.

Sanford officials also met recently with Rep. Stephanie Herseth Sandlin, D-SD, to discuss their commitment to Native American health in the region. Herseth Sandlin lamented the situation in South Dakota. ``Right here in our own state, we are the microcosm of disparities of health between Natives and non-Natives,'' the congresswoman said. As part of treaties signed by the Sioux Nation in the late 1800s, the federal government agreed to provide medical care on Indian reservations _ care that generally matched the nation's accepted standards.

The government-run Indian Health Service today runs hospitals and clinics on most reservations. But critics long have complained of insufficient financial support that has led to constant turnover among IHS doctors and nurses, understaffed hospitals, sparse specialty care and long waits to see a doctor. The disparities in health between Indians and other Americans are clear. Indians in the South Dakota area are 40 percent more likely to die of cancer than people in the general population of the United States, according to federal statistics. Also, Native Americans are twice as likely to be diagnosed with diabetes.

The infant mortality rate for Indians in South Dakotan is almost twice the rate of non-Native South Dakotans, according to the state Health Department. Gingrich, who has acted as an adviser to Sanford, said he's interested in more talks with tribal leaders to potentially develop programs addressing the interaction between work, education and the health of Indians. Gingrich has made tribal health one focus of his Center for Health Transformation, a think-tank group of health-related businesses and organizations.

``I hope it is the continuation of a long interest, that we might develop programs,'' he said. ``Clearly, the focus on preventive health and wellness is very important.'' Sanford already is working with tribes to conduct basic research in the areas of diabetes, infant mortality and fetal-alcohol syndrome. Ben Perryman, Sanford's vice president of research, decried what he calls the lack of stability in federally funded tribal health research efforts. ``We do these grant projects and while we have the grant dollars things work really well,'' he said.

``But when the grant's gone, it all disappears.'' The health system also is reaching out in a consulting role to help tribal organizations keep projects going after direct research funds end. Sanford is working with the Rosebud Sioux Tribe to develop a business plan for dialysis services on the reservation.

The services are contracted through a national dialysis firm, and tribal leaders are looking for a better way to serve people who need blood cleansing. That may involve the tribe eventually taking over the service, said Rodney Bordeaux, Rosebud chairman. Sanford would ``not necessarily run it for us, but they could help us administer it and run it ourselves,'' Bordeaux said. ``They have centers of their own; they run their own programs.''

Bordeaux said more federal money without a lot of red tape is needed for Indian health programs. ``We need direct services at the reservation level,'' Bordeaux said. ``We need to make sure that every cent comes down to the hospitals and clinics where it's really needed.'' Republican U.S. Congressional candidate Chris Lien said he's recently visited with people on reservations in South Dakota to discuss health issues.

``I am in favor of allowing them to have the tools to have the health care we need,'' Lien said. ``What I'd rather see in Congress, though, is instead of all of these large bills lumped together, have them out on a stand-alone basis so the American people can see what's being spent and where it's being spent.''