A Nationwide Population-Based Study Identifying Health Disparities Between American Indians/Alaska Natives and the General Populations Living in Select Urban Counties

Urban Indian Health Institute, Seattle Indian Health Board, Seattle, WA 98114, USA.
American Journal of Public Health (Impact Factor: 4.55). 09/2006; 96(8):1478-84. DOI: 10.2105/AJPH.2004.053942
Source: PubMed


Despite their increasing numbers, little is known about the health of American Indians/Alaska Natives living in urban areas. We examined the health status of American Indian/Alaska Native populations served by 34 federally funded urban Indian health organizations.
We analyzed US census data and vital statistics data for the period 1990 to 2000.
Disparities were revealed in socioeconomic, maternal and child health, and mortality indicators between American Indians/Alaska Natives and the general populations in urban Indian health organization service areas and nationwide. American Indians/Alaska Natives were approximately twice as likely as these general populations to be poor, to be unemployed, and to not have a college degree. Similar differences were observed in births among mothers who received late or no prenatal care or consumed alcohol and in mortality attributed to sudden infant death syndrome, chronic liver disease, and alcohol consumption.
We found health disparities between American Indians/Alaska Natives and the general populations living in selected urban areas and nationwide. Such disparities can be addressed through improvements in health care access, high-quality data collection, and policy initiatives designed to provide sufficient resources and a more unified vision of the health of urban American Indians/Alaska Natives.

1 Follower
25 Reads
  • Source
    • "Further, there are marked health disparities between Alaska Natives/American Indians and the U.S. general population. Alaska Natives and American Indians have comparatively poor access to, and utilization of, health care resources, and tend to be of lower socioeconomic status and have higher rates of alcohol use disorders and nicotine dependence (Castor et al., 2006; Falk et al., 2006). These factors may influence susceptibility to OC exposures. "
    [Show abstract] [Hide abstract]
    ABSTRACT: St. Lawrence Island, Alaska, is the largest island in the Bering Sea, located 60 km from Siberia. The island is home to approximately 1600 St. Lawrence Island Yupik residents who live a subsistence way of life. Two formerly used defense sites (FUDS) exist on the island, one of which, Northeast Cape, has been the subject of a $123 million cleanup effort. Environmental monitoring demonstrates localized soil and watershed contamination with polychlorinated biphenyls (PCB), organochlorine (OC) pesticides, mercury, and arsenic. This study examined whether the Northeast Cape FUDS is a source of exposure to OC pesticides. In total, 71 serum samples were collected during site remediation from volunteers who represented three geographic regions of the island. In addition, ninespine stickleback (Pungitius pungitius) and Alaska blackfish (Dallia pectoralis) were collected from Northeast Cape after remediation to assess continuing presence of OC pesticides. Chlordane compounds, DDT compounds, mirex, and hexachlorobenzene (HCB) were the most prevalent and present at the highest concentrations in both fish tissues and human serum samples. After controlling for age and gender, activities near the Northeast Cape FUDS were associated with an increase in serum HCB as compared to residents of the farthest village from the site. Positive but nonsignificant relationships for sum-chlordane and sum-DDT were also found. Organochlorine concentrations in fish samples did not show clear geographic trends, but appear elevated compared to other sites in Alaska. Taken together, data suggest that contamination of the local environment at the Northeast Cape FUDS may increase exposure to select persistent OC pesticides.
    Journal of Toxicology and Environmental Health Part A 09/2015; 78(15):976–992. · 2.35 Impact Factor
  • Source
    • "Keywords: FITNESSGRAM w , fitness levels, Native American, school health Previous studies have highlighted the health disparity of American Indian (AI) youth. For example, AI youth have the highest rates of obesity and type 2 diabetes of youth in the United States (e.g., Castor et al., 2006; Fagot- Campagna, Burrows, & Williamson, 1999) and are at great risk (when compared with other youth) for other hypokinetic diseases (Kriska et al., 2003). When matched to an age and sex reference population at 5 and 10 years of age, AI youth were heavier and had a higher percentage of body fat (Salbe et al., 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: A physically fit lifestyle is important for American Indian (AI) youth who are at risk for hypokinetic diseases, particularly type 2 diabetes. Some evidence exists on the physical activity patterns of AI youth, but there is little information on their health-related fitness. Purpose: The purpose of this study was to describe the health-related fitness levels of youth living in an AI community. Method: Participants included youth from 5th to 9th grade (N=85) in a Southwestern U.S. AI community. Youth were of AI descent and were 12.36 +/- 1.68 years of age. Participants completed 5 parts of the FITNESSGRAM((R)) fitness test during physical education. The tests included the Progressive Aerobic Cardiorespiratory Endurance Run fitness test (cardiovascular fitness), curl-up (muscular endurance), pushup (muscular strength), sit-and-reach (flexibility), and body mass index (estimated body composition). Results: Results were similar to other youth studies with some of the students reaching the healthy fitness zone for muscular strength (28%), body composition (30%), flexibility (60%), aerobic fitness (63%), and muscular endurance (74%). Conclusions: Findings highlight the capacity for improvement for students across all of the components of health-related fitness.
    Research quarterly for exercise and sport 06/2014; 85(2):257-61. DOI:10.1080/02701367.2014.893050 · 1.57 Impact Factor
  • Source
    • "However, there are several reasons to worry that UIHOs may be limited or fragile forms of therapeutic landscapes . First, UIHOs are very limited in financial resources, collectively receiving only 1% of the IHS's already impoverished total budget (Castor et al., 2006). Thus, there may be significant limitations in providing adequate services and facilitating social support for a largely low-income community. "
    [Show abstract] [Hide abstract]
    ABSTRACT: We engage and extend the concept of therapeutic landscapes through a case study at an urban American Indian health organization in the Midwestern United States. This case affords insights at the unique confluence of indigeneity and urbanization, prompting us to coin the construct "urban-indigenous therapeutic landscapes" to characterize such sites. These landscapes warrant urgent attention in light of increasing urbanization and health disparities among indigenous peoples internationally. On the basis of thematic content analysis, three themes were identified from 17 open-ended interviews with American Indian community members. Specifically, respondents viewed the health organization as (a) a vital place to be among other American Indians and connected to Native culture, (b) a place where one feels at home and welcome, and (c) a place in which health services are delivered in an especially intimate and hospitable manner. Significant challenges and tensions were also communicated, in terms of unique intersections of health care and indigeneity. Results are interpreted in terms of urban Indian health organizations as urban-indigenous therapeutic landscapes.
    Health & Place 06/2012; 18(5):1025-33. DOI:10.1016/j.healthplace.2012.06.004 · 2.81 Impact Factor
Show more