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Friday, September 19, 2003

Native American children who were abused or attended boarding school are more likely to have problems with alcohol as adults, according to a study being published this month.

In what was said to be the first study of its kind, researchers found that men who suffered a combination of physical and sexual abuse as children were almost twice as likely to abuse alcohol. Women who were sexually abused or sent away to school were twice as likely to have alcohol problems, researchers said.

"The findings suggest that childhood exposures are highly relevant to Native American communities," the study authors wrote.

Published in the September issue of the American Journal of Preventive Medicine, the study aims to understand why alcohol affects Indian Country disproportionately. From 1994 to 1996, the alcohol death rate among Native Americans was over seven times the rate for all other Americans, a figure considered conservative.

In studies among non-Natives, childhood experiences have been shown to correlate with alcohol problems later in life. But similar information about Natives was inconsistent, researchers said, because the studies were limited to one tribe.

By looking at seven tribes, researchers were able to get a wider view of alcohol abuse among different Native communities. Members of three tribes from the Phoenix area of the Indian Health Service (IHS), and one each from the Minnesota, Oklahoma, Portland and Nashville areas participated in face-to-face interviews with other Indians from 1998 to 2001.

The 1660 men and women subjects were asked about five childhood "maltreatment" categories: physical abuse, physical neglect, sexual abuse, emotional abuse and emotional neglect. They were also asked about parental alcoholism, education and cultural characteristics like language use, participation in tribal ceremonies and proximity to tribal homelands.

According to the study results, lifetime prevalence of alcohol dependence was high in all but one tribe. Similarly, parental alcoholism was reported by more than half of tribal members in all but one tribe.

Overall, 9 percent of men involved in the study had been diagnosed with alcohol abuse and 30 percent with alcohol dependence. Among women, 5 percent had been diagnosed with alcohol abuse and 18 percent with alcohol dependence.

Men and women were affected differently by other childhood maltreatment, researchers found. Combined physical and sexual abuse trigged higher alcohol abuse rates for men while sexual abuse and boarding school attendance were determining factors for women.

"The boarding school findings suggest that the removal from home for educational purposes has an independent negative consequence above that of maltreatment for women, but not for men," the study authors wrote.

The cultural and tribal influences on alcohol dependence were harder to discern for researchers, in part because of the diversity of the subjects. But they found that "relationships between cultural factors and alcohol dependence were not significant among men."

On the other hand, women who knew more of their language were had a higher risk of alcohol problems. Women who lived closer to their tribal lands were less likely to report alcohol dependence, the study found.

Researchers said their findings showed the need to develop social programs to lessen the exposure to adult drinking and to establish intensive preventive education on childhood sexual abuse.

The study authors were Mary P. Koss, Nicole P. Yuan, Douglas Dightman, Ronald J. Prince, Mona Polacca and Byron Sanderson from the University of Arizona College of Public Health. Author David Goldman was from the National Institute on Alcohol Abuse and Alcoholism, which funded the study through a contract.

Relevant Links:
American Journal of Preventive Medicine - http://www.elsevier.com/locate/amepre
National Institute on Alcohol Abuse and Alcoholism - http://www.niaaa.nih.gov

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Report: Native youth highest drug users (10/5)
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