Urban Problems
More than 50% of American Indians live in urban areas; for example, in Seattle, Washington, there are over 15,000 American Indians. Although this popula- tion is not particularly dense, its rates of diphtheria, tuberculosis, otitis me- dia with subsequent hearing defects, alcohol abuse, inadequate immunization, iron-deficiency anemia, childhood developmental lags, mental health problems (including depression, anxiety, and coping difficulties), and caries and other dental problems are high. As in all dysfunctional families, problems arise that are related to marital difficulties and financial strain, which usually are brought about by unemployment and the lack of education or knowledge of special skills. The tension often is compounded further by alcoholism.
Between 5,000 and 6,000 American Indians live in Boston, Massachu- setts. They experience the same problems as American Indians in other cities, yet there is an additional problem. Few non-Indian residents are even aware that there is an American Indian community in that city or that it is in desperate need of adequate health and social services.