American Indians and Alaska Natives
Crude birth rate per 1,000 population by race of mother, 2007
14.3 15.3
Percentage of live births of women receiving prenatal care first trimester, 2007
67.5 53.2
Percentage of live births of women receiving third-trimester or no prenatal care, 2007
8.4 14.0
Percentage of live births to teenage childbearing women—under 18, 2007
3.4 6.1
Percentage of low birth weight per live births >2,500 grams, 2007
8.22 7.46
Infant mortality per 1,000 live births, 2006 6.7 8.3 Cancer—all sites per 100,000 population, 2007 446.7 332.0 Lung cancer incidence per 100,000 Men: 65.4 Men: — population, 2007 Women: 47.4 Women: — Breast cancer incidence per 100,000, 2007 122.5 83.4 Prostate cancer incidence per 100,000, 2007 158.3 77.9 Male death rates from suicide, all ages, age adjusted per 100,000 resident population, 2007
11.3 18.1
Male death rates from homicide, all ages, age adjusted per 100,000 resident population, 1999/2003
9.6 9.2
Source: National Center for Health Statistics. Health, United States (2010). With Special Feature on Death and Dying. Hyattsville, MD. 2011: Author, pp. 102, 106, 107, 110, 124, 137, and 204.
Mental Illness
The family in this population is often a nuclear family, with strong biologi- cal and large extended family networks. Children are taught to respect tradi- tions, and community organizations are growing in strength and numbers. Many American Indians tend to use traditional medicines and HEALERS and are knowledgeable about these resources. People may frequently be treated by a traditional medicine man or woman. The sweat lodge and herbs are frequently used to treat mental symptoms. Several diagnostic techniques include the use of divination, conjuring, and stargazing.
“Ghost sickness” is a culture bound syndrome that affects some Ameri- can Indians. This mental health problem involves a preoccupation with death, an intense fear of ghosts and the deceased and is associated with witchcraft. It is thought to be caused by the touch of a ghost. The ghosts of the recently departed may cause illness or even death among the living. Symptoms include bad dreams, weakness, feelings of danger, loss of appetite, and confusion (Admin., 2011).
Methamphetamine (meth) abuse and suicide are 2 top concerns in Indian country. Methamphetamine is a low-cost, highly addictive stimulant drug. Its
HEALTH and ILLNESS in the American Indian and Alaska Native Population ■ 225
Table 9–3 Mortality Disparities Rates Between American Indians and Alaska Natives (AI/AN) in the IHS Service Area 2004–2006 Age- Adjusted Rates per 100,000 Population
AI/AN Rate 2004–2006
U.S. All Races Rate—2005
Ratio: AI/AN to U.S. All Races
All Causes 980.0 798.8 1.2 Alcohol-Induced 43.0 7.0 6.1 Breast Cancer 21.0 24.1 0.9 Cerebrovascular 46.6 46-6 1.0 Cervical Cancer 3.3 2.4 1.4 Diabetes 68.1 24.6 2.8 Heart Disease 206.2 211.1 1.0 HIV Infection 3.0 4.2 0.7 Homicide (Assault) 11.7 6.1 1.9 Infant Deathsa 8.0 6.9 1.2 Malignant Neoplasm 176.2 183.8 1.0 Maternal Deaths 16.9 15.1 1.1 Pneumonia/Influenza 27.1 20.3 1.3 Suicide 19.8 10.9 1.8 Tuberculosis 1.2 0.2 6.0
Source: U.S. Department of Health and Human Services, Indian Health Service. (2011). Facts on health disparities. Retrieved from http://info.ihs.gov/. aInfant deaths per 1,000 live births.
Note: Rates are adjusted to compensate for misreporting of American Indian and Alaska Native race on state death certificates. American Indian and Alaska Native death rate columns present data for the 3-year period specified. U.S. all races columns present data for a 1-year period. ICD-10 codes were introduced in 1999; therefore, comparability ratios were applied to deaths for 1996–1998. Rates are based on American Indian and Alaska Native alone; 2000 census with bridged-race categories.
introduction to Indian Country has destabilized and disrupted entire health and social systems. Meth is a synthetic artificial stimulant with a number of ef- fects on the brain and the rest of the body. People who use this chemical may display high levels of aggression and may injure or kill themselves and others. Meth also causes significant physical complications including neurological/or- ganic brain changes. Hand in hand with meth abuse is the high suicide rate. There are a wide range of general risk factors, such as “getting into trouble,” that have been shown to contribute to suicide in adolescents. AI/AN young people face, on average, a greater number of these risk factors and/or the risk factors are more severe in nature. Research suggests that factors that protect Native youth and young adults against suicidal behavior are their sense of be- longing to their culture, strong tribal spiritual orientation, and cultural conti- nuity (Grenier & Lockjer, 2007).
Alcoholism is a major mental health problem among American Indians. A comparison of the 10 leading causes of death among American Indians/ Alaska Natives and the general population reveals that unintentional injuries (#3), chronic liver disease and cirrhosis (#4), and suicide (#6) rank higher as