Health studies show Indian Country disparities
Friday, August 1, 2003

American Indians and Alaska Natives suffer the highest rates of diabetes, injury-related death and respiratory infections in the United States, federal health officials reported on Thursday.

In a series of studies published this week, the Indian Health Service (IHS) and the Centers for Disease Control and Prevention (CDC) documented health disparities in Indian Country. Researchers found that Native Americans, old and young, are disproportionately affected by disease and death problems that are entirely preventable.

"American Indians and Alaska Natives, at least since the turn of the 20th century, have experienced great disparities in health," W. Craig Vanderwagen, acting chief medical officer for IHS, said yesterday in a conference call.

But by applying public health principles, improvements can be made, officials noted, stressing the need to change behaviors, create locally-driven solutions and develop tribal-federal partnerships to combat the problems seen among Native Americans.

"We believe that by addressing local practices and cultures, each of us can help develop future prevention measures to narrow the injury disparity gaps," said Dr. Christine Branche, director of CDC's Injury Center.

IHS and CDC worked together to present data on diabetes, injury mortality among youth, cancer mortality and bronchiolitis, a respiratory tract infection. They also documented the vaccination levels among Alaska Native children.

The diabetes study showed that 15.3 percent of American Indian and Alaska Native adults suffer from the disease. This was twice as high as the national rate of 7.3 percent.

The injury study found that the death rate for Native youth is twice the rate for all ethnic and racial groups in the United States. While gains were made in preventing drowning and fire-related deaths over a ten-year period examined, homicide rates increased and suicide rates stayed the same.

Overall, cancer mortality among American Indians and Alaska Natives was actually lower than the general population. But the rates for Indians in the Northern Plains and for Alaska Natives was actually higher. Also, rates for lung cancer, associated with high tobacco use in some parts of Indian Country, surpassed the nation.

In the bronchiolitis study, researchers found that rates for Native youth was twice that for the general population of all other children. Outpatient visit and hospitalization data was examined for children under 5.

The studies did not examine the reason for the disparities. But Vanderwagen said the root cause was the breakdown of tribal culture.

"We think there has been a real fragmentation of the community and family support structures, and this is reflected in behaviors that really influence people's health," he said.

The high rate of poverty among American Indians and Alaska Natives -- 26 percent versus the national average of 13 percent -- also contributes, officials said. Vanderwagen cited anecdotal evidence that gaming and economic development will make a positive impact in the long run.

The vaccination study showed that successful programs can be developed to improve Native health. Through public-private partnerships, researchers found that vaccination coverage among Alaska Native children is higher than the national average. "This achievement, despite the presence of barriers to vaccination, demonstrates the commitment of [Alaska Native] communities, tribal corporations, and state public health authorities to address health concerns and exemplifies the effectiveness of using multiple strategies," the CDC report stated.

All five studies appear in the Morbidity and Mortality Weekly Report (MMWR), a publication of the CDC.

Get the Studies:
Health Disparities Experienced by American Indians and Alaska Natives
Injury Mortality Among American Indian and Alaska Native Children and Youth --- United States, 1989--1998
Diabetes Prevalence Among American Indians and Alaska Natives and the Overall Population --- United States, 1994--2002
Cancer Mortality Among American Indians and Alaska Natives --- United States, 1994--1998
Bronchiolitis-Associated Outpatient Visits and Hospitalizations Among American Indian and Alaska Native Children --- United States, 1990--2000
Vaccination Coverage Levels Among Alaska Native Children Aged 19--35 Months --- National Immunization Survey, United States, 2000--2001

Full MMWR Report:
August 1, 2003

Conference Call Transcript:
Health Disparities Experienced by American Indians and Alaska Natives (July 31, 2003)

Other Resources:
IHS: Facts on Indian Health Disparities | IHS: Health Disparities Trends

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