No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Substance use among young indigenous Sami - A summary of findings from the North Norwegian Youth Study
International Journal of Circumpolar Health
Abstract
To summarise knowledge about substance use among young indigenous Sami living in Norway.
Data from the North Norwegian Youth Study (NNYS)--a longitudinal questionnaire study conducted in 1994-1995 and 1997-1998 that represents the main source of information in the 1990s.
The 1994-1995 sample included 3,000 ethnically diverse high school students (response rate [RR]: 85%), while the 1997-1998 follow-up sample included 1500 respondents (RR: 55%).
Young Sami did not show higher rates than their non-Sami peers for any of the investigated substances. In contrast, young Sami reported lower drinking rates at both assessments when compared with regional and national non-indigenous peers. Nonetheless, Sami with weaker cultural ties reported the highest intraethnic smoking and drinking rates.
Young Sami are not at higher risk for substance use than their regional and national non-indigenous peers. These findings contrast some findings among other indigenous groups indicating "high" indigenous and "low" majority substance use rates.
... The Kvens are people of Finnish speaking ancestry, whose current status is that of a national ethnic minority. They comprise about 10% of the NNYS samples (Spein 2008a;Spein et al. 2002Spein et al. , 2007. Socio-demographics included gender, age, and parental socioeconomic status. ...
... Both Laestadians and Sami experience greater involvement with the extended family, thus providing important social support. In addition, both experience less alcohol exposure through higher parental abstainer rates (Javo et al. 2004;Leganger-Krogstad 1995;Spein 2008a). Moreover, this may contribute to both more adult monitoring and abstinence role modeling, thus influencing youth drinking habits in a positive manner. ...
It has been hypothesized that Laestadianism has contributed to the less drinking observed among indigenous Sami. This paper further investigates the bivariate protective influence of Sami ethnicity on youth drinking behavior using logistic regressions. We simultaneously controlled for the influence of religious revival movements (Laestadianism or evangelic) and religious importance (being personally Christian), in addition to socio-demographics and parental factors. Cross-sectional data from the 1994/95 North Norwegian Youth Study including 2,950 (675 Sami) 15-19 year-old high school students (RR: 85%) was used. Sami ethnicity was statistically significant for two out of six alcohol outcome measures, after adjustment for religiosity and other covariates, indicating less current drinking and party drinking. Religiousness was associated with higher youth and parental abstinence across ethnicities. Generally, stronger protective influences on drinking behavior were found for religious importance (being personally Christian) than religious affiliation (Laestadianism). The non-significance between Sami and non-Sami drinking may partly be explained by ethnic differences in religiosity, but also socio-demographics (e.g., residing in the Sami Highland) and parental factors (e.g., abstinence) contributed to such a result. Laestadianism`s profound impact on Sami culture, and its strong anti-alcohol norms may have contributed to a religious-socio-cultural context of abstinence.
... Lastly, the survey did not include indicators related to ethnicity. Given the distinct socio-cultural and multiethnic contexts of Finnmark County, particularly the presence of the Sámi and Kven people, as well as individuals from Northern Finland, Northern Sweden, and Russia, and the inter-marriage of these groups, the diversity within these populations may have influenced factors affecting adolescents, such as family, social networks, health, and risk behaviours [20]; [53]; [16]. Different cultures and different group of people shape individuals' behavioural decisions in various ways. ...
This study examines trends in health, well-being, and risk behaviours among high school students in Finnmark, Norway, and compares them with the national average. Data were drawn from the Ungdata survey, covering three waves between 2014 and 2023. The sample included 6,084 high school students in Finnmark and 254,048 students nationwide. MANOVA with polynomial contrasts assessed linear trends among students in Finnmark, and MANOVA with difference contrast tested pairwise differences between Finnmark and national samples. Trend analysis revealed that 26 out of 63 variables, including digital use, school-related variables, antisocial behaviours, and depressive thoughts, increased over time, while 25 variables, such as physical activities, local environment, and bullying remained unchanged. Relationships with parents and substance use improved. Pairwise comparisons showed worse outcomes for Finnmark students in 43 and 41 out of 63 variables across waves, except for substance use and antisocial behaviours. This study indicates limited improvement in health and risk behaviours among high school students in Finnmark. Public health policies tailored to adolescents in Finnmark should focus on mental health services, promoting physical activity, and reducing antisocial behaviours and bullying. Further research should explore Finnmark’s multiethnic context, including the Sámi and Kven populations.
... 7,13 Similarly, among youth in Norway, comparable rates of smoking but lower drinking rates were found between Sámi and non-Sámi peers. 37 These findings are distinct to patterns found in other Indigenous groups from high-income countries where polarizing trends of either abstinence or heavy episodic drinking have been found. 38,39 Methodological considerations Several issues should be considered when interpreting the results of this study. ...
Background:
The Sámi are an ethnic minority and the only Indigenous people in the European Union. Population-based health studies among Sámi in Sweden are scarce and outdated. The aim of this study was to analyse the ethnic, Sámi vs. non-Sámi, health differences among men and women living in Sweden.
Methods:
This study combined two data sources: the national Health on Equal Terms (HET) survey and a similar study conducted among the Sámi population, the SámiHET study, both carried out during spring 2021. Twelve outcomes were used to capture different aspects of the population's health organized along four dimensions: general health, physical health, mental health and lifestyle behaviours. Prevalence ratios, adjusted for age, civil status, education and income, were used as the measure of effect with 95% confidence intervals to provide inference. Analyses were disaggregated by sex.
Results:
The prevalence of poor self-rated dental health (and chronically ill health among men), asthma and overweight were higher among the Sámi; however, the mental health outcomes were similar or lower among the Sámi participants. The Sámi ate less vegetables and fruits, but they were smoking and drinking alcohol less than the national Swedish population. These patterns were similar among both men and women.
Conclusion:
Poor self-rated dental health, asthma, overweight and a low consumption of vegetables and fruits were a concern among the Sámi population in both men and women. These areas therefore require specific targeted interventions to decrease the observed ethnic health inequalities in Sweden. The design of this study opens the possibility for continuous monitoring of the health of the Sámi but also offers the best possible comparison with Swedish population health data.
... For some physical conditions such as obesity, diabetes and ischaemic stroke the Sami people seem to have a higher risk. A higher risk has also been shown for mental health problems in adults, including suicide risk (430) physical, emotional and sexual violence in childhood and adulthood (431) and discrimination (432) but less for substance abuse (433). ...
This report of a rapid review of inequalities in health and wellbeing in Norway since 2014
was commissioned by the Norwegian Directorate of Health to inform the development
of a National Strategy to Reduce Social Inequalities in Health. It is a joint collaboration
between UCL Institute of Health Equity (IHE) and WellFare: Nordic Research Centre for
Wellbeing and Social Sustainability, Department of Education and Lifelong Learning at
the Norwegian University of Science and Technology (NTNU).
... Although stereotypical images of the Sámi as heavy drinkers have been part of mainstream culture throughout Nordic parts of Sápmi, research on Sámi drinking habits has failed to confirm this supposition (Kaiser, Nordström, Jacobsson, & Salander Renberg, 2011;Omma & Sandlund, 2015;Orjasniemi, 2012;Spein, 2008;Spein, Sexton, & Kvernmo, 2007;Spein, Sexton, & Kvernmo, 2006). It seems Sámi do not generally drink more than non-Sámi peers. ...
Background: In suicidological research, it is well known that suicide rates differ, sometimes to a great extent, between countries, sexes, religious and ethnic populations. It has been suggested that in-depth exploration of social, cultural, contextual and historical perspectives on suicide is needed to explain this, and increase efficacy of prevention efforts. Sámi are the Indigenous people who traditionally live in northern parts of Norway, Sweden, Finland and north-western Russia (the Kola Peninsula). Generally, Sámi seem to enjoy good health along with the majority populations, at least in jurisdictions where some data is available (no Russian data is available). However, suicide is considered a major public health issue among Sámi, as it is globally. Sámi men have died more often by suicide than the majority populations in Nordic countries, ranging from 17% excess in Sweden (1961–2000), to 150% excess in Finland (1997–2005). An increased focus on the importance of reducing suicide among Sámi has led to creation of a ‘Plan for suicide prevention among Sámi in Norway, Sweden and Finland’ in 2017. However, research on this issue is still very limited and mainly includes cohort studies on suicide mortality and cross-sectional studies on suicidal behaviour. There are no studies that have evaluated suicide prevention programs among Sámi.
Objective: The overarching aim of this thesis was to explore and elucidate how suicide is understood among Sámi and what specific actions have been taken to prevent suicide among Sámi in Nordic parts of Sápmi.
Methods: This thesis is composed of three studies. Studies I and II utilized qualitative focus group discussions (FGDs) to explore and describe cultural meanings of suicide among Sámi, in Sweden and Norway, respectively. Study III identified, described and analysed suicide prevention initiatives targeting Sámi in Nordic countries (Norway, Sweden and Finland), during 2005 – 2019.
Results: Studies I and II found that specific cultural meanings were attached to suicide among Sámi, focussing on how suicide is understood to occur when Sámi are unable to maintain their Sámi identity. Contextual issues that enable such interpretations to make sense included perceptions of shortcomings in mental health services for Sámi, strong Sámi networks that increase the impacts of suicide among Sámi, and internal as well as external threats that lead to Sámi struggling. Study III identified seventeen initiatives in Sweden (9), Norway (5), Finland (1), and internationally (2). Analysis of initiatives yielded 40 problematizations regarding how initiatives aimed to prevent suicide among Sámi, addressing shortcomings on individual, relational, community/cultural, societal and health systems levels. Initiatives generally lacked evaluation components.
Conclusions: The findings in studies I and II show that there are ways of investigating culture-specific understandings of suicide among Sámi, and that suicide among Sámi is currently understood to be linked to the difficulties of maintaining Sámi identities. As regards prevention, it is suggested that the dominant rationales for suicide prevention were addressing shortcomings on individual and relational levels, and raising awareness in the general public. This threatens to obscure more critical approaches such as broadening perspectives in prevention planning, improving health systems for Sámi, and promoting cultural empowerment among Sámi. To improve evaluation and identify most promising practices, increased support regarding development of plans and implementation for evaluation components is needed.
... Change or loss in traditional diet also indicates change in cultural values, livelihoods, and lifestyle. Recent studies found no differences in the substance use between the Saami and the majority population in Norway [53,54] and Sweden [55,56]. However, 50% of non-natural deaths among Saami reindeer herders in Sweden occurred under the influence of alcohol [57•]. ...
Purpose of Review
(1) To develop a framework for understanding the holistic effects of climate change on the Saami people; (2) to summarize the scientific evidence about the primary, secondary, and tertiary effects of climate change on Saami culture and Sápmi region; and (3) to identify gaps in the knowledge of the effects of climate change on health and well-being of the Saami.
Recent Findings
The Saami health is on average similar, or slightly better compared to the health of other populations in the same area. Warming climate has already influenced Saami reindeer culture. Mental health and suicide risk partly linked to changing physical and social environments are major concerns.
Summary
The lifestyle, diet, and morbidity of the Saami are changing to resemble the majority populations posing threats for the health of the Saami and making them more vulnerable to the adverse effects of climate change. Climate change is a threat for the cultural way of life of Saami. Possibilities for Saami to adapt to climate change are limited.
... Ethnic pride is often considered to be a predictor of well-being and health [45]. Quantitative measures of ethnic identity and acculturation among young Sami in Norway have revealed both negative and positive health impacts [39,46,47]. Sami adolescents with a stronger sense of ethnic identity were less likely to binge drink than peers with a poorer sense of Sami ethnic identity [22]. ...
Background: This study was part of the international research project “Circumpolar Indigenous Pathways to Adulthood” (CIPA).
Objectives: To explore ethnic identity negotiation, an unexplored theme, among indigenous North Sami youth living in a majority Sami community context in Arctic Norway.
Methods: A qualitative design was followed using open-ended, in-depth interviews conducted in 2010 with 22 Sami adolescents aged 13–19 years, all reporting Sami self-identification. Grounded theory, narrative analysis, theories of ethnic identity and ecological perspectives on resilience were applied in order to identify the themes.
Findings: All 22 youth reported being open about either their Sami background (86%) and/or ethnic pride (55%). Ethnic pride was reported more often among females (68%) than males (27%). However, a minority of youth (14%) with multi-ethnic parentage, poor Sami language skills, not having been born or raised in the community and with a lack of reindeer husbandry affiliation experienced exclusion by community members as not being affirmed as Sami, and therefore reported stressors like anger, resignation, rejection of their Sami origins and poor well-being. Sami language was most often considered as important for communication (73%), but was also associated with the perception of what it meant to be a Sami (32%) and “traditions” (23%).
Conclusion: Ethnic pride seemed to be strong among youth in this majority Sami context. Denial of recognition by one’s own ethnic group did not negatively influence ethnic pride or openness about ones’ ethnic background, but was related to youth experience of intra-ethnic discrimination and poorer well-being. As Sami language was found to be a strong ethnic identity marker, effective language programmes for Norwegian-speaking Sami and newcomers should be provided. Language skills and competence would serve as an inclusive factor and improve students’ well-being and health. Raising awareness about the diversity of Sami identity negotiations among adolescents in teacher training and schools in general should be addressed.
... The non-completion rates vary from 23 to 29 %, increasing with a higher latitude and more remoteness [31]. The indigenous Sami are strongly affiliated to the Laestadian religious movement traditionally considered a Sami version of Lutheran Christianity, and is still strongly maintaining abstinence norms, conservative moral ethics and an ideal of strong family cohesion [32][33][34][35]. The sociocultural and geographical context of Arctic Norway constitutes a unique structural frame, compared to more centralized locations, with its indigenous Sami, the Lutheran Christian Laestadians and the geographical periphery. ...
Background
Education is closely associated with health. Non-completion of upper secondary school influences academic achievement, employment, income and personal well-being.The purpose of the study is to explore predictors of non-completion of upper secondary school among female and male young adults in relation to mental health and educational factors in a socio-cultural, Arctic context. Methods
The Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003–2005. Eighty-three percent of the population of 5,877 10th graders participated; 49.1%females, 450 reported indigenous Sami ethnicity, and 304 reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database (NUDB) Norway for 3,987 adolescents who gave their consent for follow-up studies. ResultsNon-completion of upper secondary school was 36.9 % among females and 36.6 % among males. Among females, predictors for non-completion were related to mental health symptoms, and among males, to residency in the northernmost and remote areas and self-reported functional difficulties at school, home and in leisure activities due to mental health problems.There was marginal significance between ethnicity and non-completion of upper secondary school, measured at 41.3 % for Sami and 36.8 % for non-Sami, respectively. Conclusions
The gender differences found in this study emphasize the need for gender-specific interventions in preventing non-completion of upper secondary school. There is a need to recognize and treat extensive pro-social behaviour and social problems in young females. Young males from remote areas and those who in early adolescence struggle with functional impairment due to mental health problems need early interventions in lower secondary school. Enhancing parents’ and teachers’ ability to detect symptoms and problems as well as low-threshold health services starting in primary school can be effective means. Education, mental health and social inclusion are prominent factors for future employment, income and independent living for young people. Future research should focus more on gender-specific patterns of risk and protective factors for completion of upper secondary school.
... They stated that in "Swedish" schools, pupils learn very little about the Sami, with a great deal of prejudice as a result. For example, it is often claimed that Sami drink a lot of alcohol, despite the fact that nobody has undertaken a study of this question in Sweden (in Norway there are studies looking into this issue [Spein 2008]). A Sami in traditional dress is easy to identify, and if you then get drunk it is easy to extrapolate from one individual to the entire group. ...
Objective: The aim of the present study was to illuminate the contemporary cultural reality of being a young Sami in Sweden, with special reference to issues such as identity/self-perception, autonomy, and experiences of being ill treated and discrimination. Design: The study comprises a qualitative and a quantitative part. The qualitative part includes meetings, discussions and dialogues with young Sami and others. The quantitative part includes a questionnaire on socioeconomic conditions, Sami ethnicity, experiences of being ill-treated because of a Sami background, specific questions on identity and self-perception, questions about self-determination, and thoughts and expectations of the future. The sample consists of 876 young Sami aged 18–28, of whom 516 (59 per cent) responded to the questionnaire. Results: A majority are proud to be Sami and wish to preserve their culture. 71 per cent have a close connection to a Sami community. Most of the young Sami have had to explain and defend their culture and way of life. Nearly half had perceived discrimination or ill-treatment because of their ethnicity, with reindeer herders reporting a higher degree of ill-treatment (70 per cent). Reindeer herders exist in a severe environment with an insecure legacy. Most of the young Sami in this study have a positive self-perception and think that their lives are meaningful. Very few dropped out of school and very few are unemployed. Conclusion: We believe that there are protective factors that potentially explain the well-being of this group; a strong feeling of belonging among the Sami, strong connections to family, relatives and friends and good sociocultural adaptation (to have a job, completed school).
... The present study focuses on the situation of young male reindeer herders as motivated by their core position in Sami society and the special attention that has been devoted to health risk exposure among young indigenous persons (16–18) and young indigenous men in particular as they generally are less prone to use health care services, are less educated and have higher proportions of alcohol abuse and mental problems (19). This study thereby covers the need to deepen our understanding of what it is to be a young male reindeer herder, as presented through their own experiences. ...
To explore experiences of what it is to be a young male Sami reindeer herder in Sweden, a group with previously known stigma and specific health issues, and to understand experiences in perspective of mental health.
A qualitative content analysis was employed. Data were collected by in-depth interviews with 15 strategically selected reindeer herders aged 18-35 years old.
The analysis resulted in 5 sub-themes: (a) being "inside" or "outside" is a question of identity; (b) a paradox between being free/bound; (c) an experience of various threats and a feeling of powerlessness; (d) specific norms for how a "real" reindeer herder should be; and (e) the different impacts and meanings of relations. The overarching theme is summarized thus: being a young reindeer herder means so many (impossible) dreams and conditions. Overall, the experience of the informants was that being a reindeer herder is a privileged position that also implies many impossibilities and unjust adversities they have no control over, and that there is nothing they can do but "bite the bullet or be a failure."
Knowledge about this group's experiences can be used to understand difficulties faced by young reindeer herders and its consequences regarding mental health problems. This also implies a need for a broader perspective when discussing future interventions aimed at preventing mental health problems in this group.
... Research on health issues among the Sami has been primarily quantitative, and results for the Sami are often compared with those for the majority population. The focus has been on health behaviour (e.g., Spein, 2008;Spein, Sexton, & Kvernmo, 2004), risk for disease (e.g., Hassler, 2005;, and causes of death (Hassler, Johansson, Sjölander, Grönberg, & Damber, 2005). Research suggests that the Sami do not face the same health-related challenges as Indigenous people in Canada, the United States, Russia, or Greenland (Symon & Wilson, 2009). ...
The Sami people have historically been exposed to severe assimilation processes. The objective of this study was to explore elderly Samis' experiences of health. A total of 19 elderly Sami individuals in Norway were interviewed.This article is a dialogical narrative analysis of the life stories of 3 Sami women. The life stories are perceived as narratives of health and resistance. Postcolonial theory provides a framework for understanding the impact of historical and socioeconomic factors in people's lives and health. Narratives of resistance demonstrate that people are not passive victims of the legacy of colonialism. Resistance is not a passive state but an active process, as is health. Resistance is a resource that should be appreciated by health services, both at a systemic level--for example, through partnership with Indigenous elderly in the planning and shaping of services--and in individual encounters between patients and healthcare providers.
... Young Sami in northern Norway consume less alcohol than young non-Sami Norwegians (for review, see (43)). Interestingly, the lowest consumption was found among Sami with a strong Sami identity. ...
The Sami are the indigenous ethnic population of northern Scandinavia. Their health condition is poorly known, although the knowledge has improved over the last decade.
The aim was to review the current information on mortality, diseases, and risk factor exposure in the Swedish Sami population.
Health-related research on Sami cohorts published in scientific journals and anthologies was used to compare the health condition among the Sami and the majority non-Sami population. When relevant, data from the Sami populations in Swedish were compared with corresponding data from Norwegian and Finnish Sami populations.
Life expectancy and mortality patterns of the Sami are similar to those of the majority population. Small differences in incidences of cancer and cardiovascular diseases have been reported. The traditional Sami lifestyle seems to contain elements that reduce the risk to develop cancer and cardiovascular diseases, e.g. physical activity, diet rich in antioxidants and unsaturated fatty acids, and a strong cultural identity. Reindeer herding is an important cultural activity among the Sami and is associated with high risks for accidents. Pain in the lower back, neck, shoulders, elbows, and hands are frequent among both men and women in reindeer-herding families. For men, these symptoms are related to high exposure to terrain vehicles, particularly snowmobile, whereas for women psychosocial risk factors seem to more important, e.g. poor social support, high effort, low reward, and high economical responsibilities.
Although the health condition of the Sami population appears to be rather similar to that of the general Swedish population, a number of specific health problems have been identified, especially among the reindeer-herding Sami. Most of these problems have their origin in marginalization and poor knowledge of the reindeer husbandry and the Sami culture in the majority population. It is suggested that the most sustainable measure to improve the health among the reindeer-herding Sami would be to improve the conditions of the reindeer husbandry and the Sami culture.
Taking a new and innovative angle on social work, this book seeks to remedy the exclusion of holistic perspectives and rejection of the diversity of human socio-cultural understandings and experiences of healing currently seen in western social work practice.
This book examines six areas of healing through an integrative holistic approach that is grounded in a decolonizing perspective. Situating integrative healing within social work education and theory, the book takes an interdisciplinary approach, drawing from social memory and historical trauma, contemplative traditions, storytelling, healing literatures, integrative health, and the traditional environmental knowledge of Indigenous peoples.
Exploring issues of movement, play, creativity, animals and the natural world in relation to social work it will appeal to all scholars, practitioners, and community members interested in decolonisation and Indigenous studies.
Iktedimmie 1. kapihtelisnie aktem åenehks bijjieguvviem vedtebe åarjelsaemiej histovrijes, gïeleldh jïh politihkeles posisjovnen bijjelen goh akte unnebelåhkoe dan saemien unnebelåhkoen sisnjelen Fennoskandijesne. Akte dejstie dotkemegyhtjelassijste gærjesne lea guktie åvtetje aejkie lea meatan vaaltasovveme dan daajbaaletje åarjelsaemien jïjtjegoerkesen sïjse, jïh guktie åvtetje aejkie eadtjohkelaakan åtnasåvva juktie daajbaaletje tïjjem hammoedidh. Abpe daennie gærjesne eajhnadovvebe dotkemem åehpiedehtedh mij gellievoetem jïh evtiedimmiem dejstie åarjelsaemien siebriedahkijste vuesehte. Bielie II tjoevkesem beaja dejtie sosio-gïeleldh bielide åarjelsaemien daajbaaletje gïelesne. Bielie III vihkeles histovrijes jïh arkeologeles gyhtjelassh analyserede jïh digkede mah leah dej åvtehistovrijes jïh histovrijes gyhtjelassi bïjre åarjelsaemien suerkien sisnjelen. Bielie IV jarngesne åtna man vijries jïh guktie almetjh jïh åarjelsaemien aamhtesh leah åehpiedahteme, jïh man vijries jïh guktie doh åarjelsaemien gïelh leah meatan dennie byögkeles sïejhme digkiedimmesne. Bielie V såemies daejbaaletje politihkeles strategijh Nöörjesne digkede. Gyhtjelassh guktie ovvaantoeh dajvi bïjre jïh åarjelsaemien åtnoe histovrijistie, kultuvreste jïh aerpievuekijste aktem råållam utnieh identiteeteprosessine, jïh gæmhpoe dan åarjelsaemien dajven åvteste lea akte biehkie maam lea goerehtamme daennie kapihtelisnie, lissine dejtie rååresjimmide aalkoealmetjedåehkiej jïh jienebelåhkoesiebriedahki gaskem.
The Sámi in Finland have statutory rights that recognize their cultural needs in customer service situations within social and health care. The aim of this study is to describe and understand Sámi's perception of their welfare and its influencing factors. The study is part of an ethnographic research project aiming to examine Sámi health as a cultural phenomenon. The study was carried out using ethnographic fieldwork method in the Sámi area of Finland. The data was gathered by interviews, observation and informal discussion. According to the findings the Sámi who took part in this study have a holistic health view prevalent among indigenous peoples. Nature and environment formed the basis of well-being for the Sámi and their well-being is also inseparable from traditional Sámi livelihoods, values and philosophy.
This qualitative study explores community resilience factors within an indigenous Sámi community in Northern Norway. Semistructured interviews were conducted with 22 informants, 12 females and 10 males, ranging in age from 13 to 19 years old, 12 of whom had reindeer husbandry affiliation. Data analysis used a modified grounded theory approach and narrative analysis. Interpretation of the data was based on ecological perspectives theory and the identification of possible community resilience factors including Sámi language competence, use of recreational and natural resources, and traditional ecological knowledge, such as reindeer husbandry related activities. These cultural factors appear to strengthen adolescents' ethnic identity and pride, which in turn act as potential resilience mechanisms. Land was a significant arena for traditional practices and recreation. The majority of the youth reported support from relationships with extended godparents (fáddarat) and extended family (sohka) networks. The fáttar network was particularly strong among adolescents with reindeer husbandry affiliations. Native language competence and reindeer husbandry were key components in adolescent social networks. Interconnectedness among the community members and with the environment seemed to promote resilience and well-being. Two factors that excluded adolescents from full community membership and participation were being a nonnative Sámi language speaker and the absence of extended Sámi family networks.
During their lifetimes, the current cohort of elderly Sami in Norway witnessed tremendous social changes regarding the situation of the Sami people. These individuals experienced a historical period characterized by public assimilation policies and stigmatization and one characterized by ethnic revitalization and changing minority policies. Furthermore, they currently live in a historical period where contrasting public narratives on the Sami co-exist and are articulated to various extents.
The overall aim of the study was to explore how elderly Sami’s experiences of health and identity in old age are worked and expressed in the stories they tell about their lives.
The thesis is based on a discourse analysis of Norwegian policy documents regarding healthcare services for elderly Sami and a narrative analysis of the life stories of nineteen elderly Sami as related in the context of qualitative research interviews. Through the discourse analysis, I sought insights on the discursive landscape in which the elderly Sami told their life stories. Policy documents were considered both as products of and contributors to contemporary discourses. Through the narrative analysis of the elderly Sami’s life stories, I explored their perceptions of health and how they were working their identities.
The documents reflected a close association between Sami culture and personal identity. The image of Sami culture constructed in the documents was dominated by symbols associated with certain aspects of Sami culture. The Sami were presented as either Sami-speaking or bilingual, and never as monolingual Norwegian speakers. Furthermore, the elderly individuals were referred to as either Norwegian or Sami, and more fluid and ambiguous identities were excluded. There was a strong focus on healthcare providers’ cultural and linguistic competence in the documents. Competence in Sami language and culture was considered a precondition for understanding the Sami patient. The discourse analysis demonstrated a high degree of discursive continuity throughout the documents.
The narrative analysis of three women’s life stories demonstrated that rather than being a passive condition, being healthy is an active process in which resistance plays a central role. The women’s life stories were perceived as narratives of resistance. The women could not change the historical and social settings of their life stories, and they could not change the fact that they experienced health problems such as asthma, congenital handicaps, walking difficulties, and blindness. Nonetheless, they did control the role that these settings and health problems played in their stories. In their stories, the women challenged established “truths” about what is considered healthy and the perception of the Sami people as victims of Norwegianization.
In the thesis, I also explored the relationship between elderly Sami’s individual life stories and two contrasting public narratives on the Sami. The narrative analysis of four life stories demonstrated that rather than having an established Sami identity, the elderly Sami were actively identifying through the stories they told about their lives. All four life stories reflected contrasting public narratives on the Sami, but the individual stories varied with respect to which of the public narratives dominated. They also varied with respect to the extent to which they actively challenged these public narratives. The study demonstrated that identifying is an ongoing process that continues throughout life.
The insights from this study provide reasons to nuance existing assumptions regarding the strong relationship between elderly Sami and the image of “the Sami culture” constructed in the policy documents. The current cohort of elderly Sami represents one of the generations most strongly affected by assimilation policies. However, they also experienced the Sami awakening. Rather than expressing a particular Sami perspective, the elderly Sami were negotiating the impact of their Sami heritage on their life stories.
This study demonstrated that elderly Sami’s life stories are sources of insights regarding their experiences of identity and health in old age, both as subjective conditions and influenced by historical and social contexts. Each individual’s story is framed by a unique combination of broader narratives and political discourses. The theoretical framework of this study made it possible to contextualize this subjectivity.
To investigate the experience of suicidal expressions (death wishes, life weariness, ideation, plans and attempts) in young Swedish Sami, their attitudes toward suicide (ATTS), and experience of suicidal expressions and completed suicide in significant others and to compare with Swedes in general.
A cross-sectional study comprising 516 Swedish Sami, 18-28 years of age together with an age and geographically matched reference group (n=218). Parts of the ATTS questionnaire have been used to cover different aspects of the suicidal complex. Data were analysed with regard to gender, occupation, counties and experience of negative societal treatment due to Sami background.
Both young Sami and young Swedes reported suicidal ideation, life weariness, and death wishes in a high degree (30-50%), but it was more common among the Sami. Having had plans to commit suicide showed a significant gender difference only in the Sami. The prevalence of suicide attempts did not differ significantly between Sami and Swedes. Subgroups of the Sami reported a higher degree of suicidal behaviour, Sami women and reindeer herders reported a 3, 5-fold higher odds of suicide attempts and a 2-fold higher odds having had plans committing suicide. Sami living in Vasterbotten/Jamtland/Vasternorrland and Sami with experience of ethnicity related bad treatment 2-fold higher odds of suicidal plans compared to those living in other counties.
An increased occurrence of suicidal ideation/death wishes/life weariness in young Sami compared to young majority Swedes was found, but not an increased prevalence of suicide attempts and positive attitudes together with an increased awareness to handle suicide problems could be a contributing factor. Severe circumstances and experience of ethnicity-related bad treatment seems to contribute to increased levels of suicidal plans and attempts in subgroups of Sami.
Unnatural deaths among Indigenous populations, including the Swedish Sami, occur more often than among the general population. To find prevention strategies, we explored the circumstances of the unnatural deaths of members of reindeer-herding Sami families.
The number of deaths from among a cohort of 7,482 members of reindeer-herding Sami families were retrieved from the National Board of Health and Welfare for the years 1961- 2001.
An evaluation of the information from autopsy records at the National Board of Forensic Medicine, police reports, and available medical records identified 158 unnatural deaths. These were then analysed in detail.
Transport-related deaths and suicides were the most common unnatural deaths among Swedish reindeer-herding Sami family members. Suicides contributed to 23% of all deaths, road traffic accidents to 16%, and snowmobile fatalities to 11%. The accidents generally reflected an "outdoor lifestyle" and the working conditions were characterized by the use of off-road vehicles such as snowmobiles. Half of the number of victims tested positive for alcohol and alcohol abuse was documented in 15% of all victims.
The results indicate that alcohol is an important factor in preventing unnatural deaths among reindeer-herding Sami, together with increased safety of both on-road and off-road transportation.
The authors suggest that the most promising route to effective strategies for the prevention of adolescent alcohol and other drug problems is through a risk-focused approach. This approach requires the identification of risk factors for drug abuse, identification of methods by which risk factors have been effectively addressed, and application of these methods to appropriate high-risk and general population samples in controlled studies. The authors review risk and protective factors for drug abuse, assess a number of approaches for drug abuse prevention potential with high-risk groups, and make recommendations for research and practice.
To extend the analysis of psychosocial risk factors for smoking presented in the United States surgeon general's 1994 report on smoking and health, and to propose a theoretical frame of reference for understanding the development of smoking.
General Science Index, Medline, PsycLIT, Sociofile, Sociological Abstracts, and Smoking and Health. Holdings of the Addiction Research Foundation of Ontario Library as well as the authors' personal files.
Reviewed literature focused on studies that examined the association of sociodemographic, environmental, behavioural, and personal variables with smoking.
Adolescent smoking was associated with age, ethnicity, family structure, parental socioeconomic status, personal income, parental smoking, parental attitudes, sibling smoking, peer smoking, peer attitudes and norms, family environment, attachment to family and friends, school factors, risk behaviours, lifestyle, stress, depression/distress, self-esteem, attitudes, and health concerns. It is unclear whether adolescent smoking is related to other psychosocial variables.
Attempts should be made to use common definitions of outcome and predictor variables. Analyses should include multivariate and bivariate models, with some attempt in the multivariate models to test specific hypotheses. Future research should be theory driven and consider the range of possible factors, such as social, personal, economic, environmental, biological, and physiological influences, that may influence smoking behaviour. The apparent inconsistencies in relationships between parental socioeconomic status and adolescent disposable income need to be resolved as does the underlying constructs for which socioeconomic status is a proxy.
This study examined trends in the prevalence of smoking and snuff use among Norwegian adolescents in lower secondary school (ages 13-15 years) from a national survey conducted every 5 years between 1975 and 1995.
Pupils completed a brief written questionnaire on tobacco use and related information. Local school administrators coordinated data collection and forwarded a sample of completed questionnaires to the National Council on Tobacco and Health for compilation and analysis. Effects for age, gender and survey year were examined using logistic regression analysis. Overall, 24,127 pupils in five different cohorts were included.
Smoking was highest in 1975 when 45.5% of youth reported smoking either daily or occasionally (figures adjusted for age and gender). Smoking declined each year thereafter through to 1990 (23.6%) but increased in 1995 (26.0%), primarily due to an increase in occasional smoking. Like smoking, snuff use declined between 1985 and 1990 but increased in 1995. All changes across survey years were statistically significant. Smoking was higher among girls than boys, while snuff use was much higher among boys.
Several hypotheses that might account for the recent increase were examined with the most likely factor being Norway's low allocation of resources for educational interventions and public information campaigns during the years studied. However, in the past 2 years Norway has undertaken a number of new tobacco control initiatives that may result in reversal of the most recent trends.
Objective.
—To assess risk behaviors, health problems, worries and concerns, and resiliency-promoting factors among American Indian—Alaska Native adolescents.Design.
—Survey.Setting.
—Nonurban schools from eight Indian Health Service areas.Participants.
—A total of 13454 seventh- through 12th-grade American Indian— Alaska Native youths.Main Outcome Measures.
—A revised version of the Adolescent Health Survey, a comprehensive, anonymous, self-report questionnaire with 162 items addressing 10 dimensions of health.Results.
—Poor physical health was reported by 2% of the study sample and was significantly correlated with social risk factors of physical and/or sexual abuse, suicide attempts, substance abuse, poor school performance, and nutritional inadequacies. Injury risk behaviors included never wearing seatbelts (44%), drinking and driving (37.9% of driving 10th through 12th graders), and riding with a driver who had been drinking (21.8%). Physical and sexual abuse prevalence was 10% and 13%, respectively, with 23.9% of females reporting physical abuse and 21.6% of females reporting sexual abuse by the 12th grade. Almost 6% of the entire sample endorsed signs of severe emotional distress. Eleven percent of the teens surveyed knew someone who had killed himself or herself, and 17% had attempted suicide themselves. Sixty-five percent of males and 56.8% of females reported having had intercourse by the 12th grade. Weekly or more frequent alcohol use rose from 8.2% of seventh graders to 14.1% by the 12th grade; for males, the survey noted an increase in regular alcohol use of 3% to 5% a year to 27.3% by the 12th grade. For each variable measured, rates are much higher for American Indian adolescents than those for rural white Minnesota youth, except for age at first intercourse and alcohol use.Conclusions.
—American Indian—Alaska Native adolescents reported high rates of health-compromising behaviors and risk factors related to unintentional injury, substance use, poor self-assessed health status, emotional distress, and suicide. Interventions must be culturally sensitive, acknowledge the heterogeneity of Indian populations, be grounded in cultural traditions that promote health, and be developed with full participation of the involved communities.(JAMA. 1992;267:1637-1644)
Objective:
To determine whether students older than most other students at their grade level ("old for grade") are more likely to report engaging in alcohol, tobacco, and drug-related behaviors.Design:
Cross-sectional analyses of the Centers for Disease Control and Prevention Youth Risk Behavior Survey.Setting:
Monroe County, New York.Participants:
A total of 1396 high school students from selected classrooms; 68 classrooms randomly selected within schools with the number of students per school proportionally selected from the 28 schools in the county.Main Outcome Measure:
Rates of drug-related behaviors by age-for-grade status.Results:
Thirty-six percent of adolescents surveyed were old for grade. Adjusting for multiple potential confounders, old-for-grade high school students were more likely to report being regular smokers, chewing tobacco, drinking alcoholic beverages, driving in a car with someone who had been drinking, using alcohol or other drugs before last sexual intercourse, using cocaine in the past month, ever using crack, and using injected or other illicit drugs.Conclusions:
Old-for-grade status is a potentially important marker for drug-related behaviors in adolescents. The antecedents of adolescent risk-taking behavior may begin before the teen years, and prevention of school failure or interventions targeted toward old-for-grade children could affect their propensity to experiment with or use drugs during adolescence.Arch Pediatr Adolesc Med. 1996;150:470-476)
The present article explores differences in self-reported alcohol consumption in Saami and non-Saami areas in the Finnmark region. A representative group of 659 respondents from Finnmark, where most Saamis in Norway live, participated in the study. Respondents indicated how much they drank on their latest drinking occasion and how often they used alcohol. The respondents’ scores on these items were used to estimate the average annual alcohol consumption. Results indicate that respondents from Saami municipalities on the average consume less alcohol than respondents from other municipalities in the area.Copyright © 1996 S. Karger AG, Basel
Ethnic differences in alcohol intake among male reindeer herders were studied, since historical evidence suggests that Lapps drink more than Finns and since the considerable freedom of the herding occupation may imply a high risk for alcohol problems. In 1988, 2001 men answered a mail questionnaire including questions on alcohol intake over the past 12 months. The mean alcohol intake was 22.3 g/day among the Lapps and 13.2 g/day among the Finns (P < 0.001). The percentage of heavy drinkers (20 g or more daily) was 33.9 among the Lapps and 19.1 among the Finns. The mean frequency of getting drunk was 35 occasions/year among both Lapps and Finns. An analysis of variance showed that alcohol intake was significantly related to age, marital status, region and being of Lappish origin, but not to being a full-time reindeer herder. A significant interaction between region and marital status was also detected. The Lappish reindeer herders drink more than their Finnish counterparts. The ethnic difference is not, however, very large when compared with the stereotypic view of the drunken Lapp.
To assess risk behaviors, health problems, worries and concerns, and resiliency-promoting factors among American Indian-Alaska Native adolescents.
Survey.
Nonurban schools from eight Indian Health Service areas.
A total of 13,454 seventh- through 12th-grade American Indian-Alaska Native youths.
revised version of the Adolescent Health Survey, a comprehensive, anonymous, self-report questionnaire with 162 items addressing 10 dimensions of health.
Poor physical health was reported by 2% of the study sample and was significantly correlated with social risk factors of physical and/or sexual abuse, suicide attempts, substance abuse, poor school performance, and nutritional inadequacies. Injury risk behaviors included never wearing seatbelts (44%), drinking and driving (37.9% of driving 10th through 12th graders), and riding with a driver who had been drinking (21.8%). Physical and sexual abuse prevalence was 10% and 13%, respectively, with 23.9% of females reporting physical abuse and 21.6% of females reporting sexual abuse by the 12th grade. Almost 6% of the entire sample endorsed signs of severe emotional distress. Eleven percent of the teens surveyed knew someone who had killed himself or herself, and 17% had attempted suicide themselves. Sixty-five percent of males and 56.8% of females reported having had intercourse by the 12th grade. Weekly or more frequent alcohol use rose from 8.2% of seventh graders to 14.1% by the 12th grade; for males, the survey noted an increase in regular alcohol use of 3% to 5% a year to 27.3% by the 12th grade. For each variable measured, rates are much higher for American Indian adolescents than those for rural white Minnesota youth, except for age at first intercourse and alcohol use.
American Indian-Alaska Native adolescents reported high rates of health-compromising behaviors and risk factors related to unintentional injury, substance use, poor self-assessed health status, emotional distress, and suicide. Interventions must be culturally sensitive, acknowledge the heterogeneity of Indian populations, be grounded in cultural traditions that promote health, and be developed with full participation of the involved communities.
1934 school children 12 to 19 years of age answered anonymously a questionnaire, which was sent to all towns and the larger settlements in Greenland. The questionnaire was administered by teachers in the classroom to all pupils in grades seven to eleven. The survey was conducted in November 1990. 1557 students were Greenlandic and 377 were Danish. There were 774 Greenlandic boys and 783 girls. There were 208 Danish boys and 169 girls. The questionnaire had questions about age, sex, social background and use of substance. The substances surveyed for were tobacco, alcohol, hashish/marihuana and different substances for sniffing. 26% of the Danish boys and 45% of the Greenlandic boys were smokers compared to 39% of the Danish girls and 61% of the Greenlandic girls. In the 15-19 age group about 75% were smokers. 71% of the smokers smoked more than three cigarettes a day. 87% of the Danish pupils and 63% of the Greenlandic had used alcohol. Greenlandic students had more often used beer than any other beverage, Danish students had wine more often than the Greenlanders. Out of the total 13% of the boys and 4% of the girls regularly took more than ten times 2cc of pure alcohol on each occasion. 6% of the Danish students and 25% of the Greenlandic students had tried sniffing. They mostly used lighter-gas or glue. Boys used sniffing more often than girls. 25% of the Greenlandic students had tried smoking hashish, in the age group 16-17 about 50%. Cigarette smokers more often than non-smokers used other substances.(ABSTRACT TRUNCATED AT 250 WORDS)
An overview is presented of the processes of acculturation and adaptation. Research with a variety of acculturating groups (including Refugees, Immigrants, Sojourners, Native Peoples and Ethnic Groups) shows that satisfactory adaptations are possible given appropriate conditions in the host or settlement countries. These conditions are largely under the potential control of policy makers and programm developers, and hence healthy outcomes are within reach. When these findings and conclusions are applied to Native Peoples in Circumpolar regions, some particular experiences stand out, resulting in the potential for difficult social and psychological adaptations. However, the literature shows that like all other acculturating groups, successful adaptations are possible for Circumpolar peoples, especially when they are in a position to understand and control the process.
It was hypothesized that drinking patterns, treatment goals and psycho-social consequences of drinking (as measured by the MAST) would be different in Saami ('Lapp') and Norwegian in-patient problem drinkers, due to differences in cultural background. Drinking patterns and treatment goals differed significantly, implying that Saami clients demonstrated a more periodic drinking pattern and, to a smaller extent, tended to prefer total abstinence or a large reduction in alcohol consumption as their treatment goal compared to Norwegian clients. Furthermore, the Saami clients obtained significantly lower scores on the MAST than the Norwegian clients. No differences in degree of physical dependence and self-reported alcohol consumption were observed. These findings indicate that the drinking culture in the two groups is different. Furthermore, the results imply that the MAST yields different problem scores in Saami and Norwegian clients, probably due to differences in ways of living in the two ethnic groups.
The consumption of alcohol has often been described as a socially mediated activity (MacAndrew & Edgerton, 1969). Social-learning approaches of alcohol use endorse this view and conceptualize drinking habits as being on a continuum from abstinence to problem drinking. On such a continuum the “social drinker” represents a moderate level of alcohol use. Moderate drinking habits are said to develop via the laws of learning, including the influence of social processes such as modeling. Since we learn adaptive styles and levels of alcohol use via such social influence processes it seems likely that the use of techniques such as modeling should be a highly effective strategy for preventing and treating the development of maladaptive drinking habits.
A follow-up study on schoolchildren in Greenland was conducted in order to evaluate the effect of intervention programmes from 1990 on substance abuse. Questionnaires were completed anonymously by 75% of a total of 2692 pupils aged 12 to 19 years. The substances in question were tobacco, cannabis, alcohol and solvents or other substances for sniffing. Thirty-one percent of the Danish boys and 46% of the Greenlandic boys were tobacco smokers compared to 49% of the Danish girls and 53% of the Greenlandic girls. Eighty-nine percent of the Danish and 63% of the Greenlandic pupils had experienced drinking alcohol. Nine percent of the Danish pupils and 19% of the Greenlandic pupils had tried sniffing. Twenty-five percent of the Greenlandic pupils and 30% of the Danish pupils had tried cannabis. Seventeen percent of all pupils were current users of cannabis. The patterns of substance abuse in Greenlandic girls changed from 1990 through 1992, in that the prevalence of smoking tobacco, smoking cannabis and sniffing decreased. However, the smoking of cigarettes and cannabis must still be considered a major health problem. Continuing surveys of substance abuse among schoolchildren is recommended.
The present paper addressed the problem of the origin of alcohol-related social norms in the Saami minority in northern Norway. Based on data from studies of comparable ethnic minorities in Greenland, North America and Australia it could be expected that alcohol use- and abuse would be more prevalent in the Saami than in the Norwegian populations of northern Norway. No data to support this hypothesis exist. On the contrary, available data suggest that drinking problems in this group are similar to those of the majority in the area. The present paper developed the hypothesis that Saami alcohol-related social norms originated in the Laestadian religious revival. The paper investigated the impact of the Laestadian culture in the formation of alcohol-related social norms. It was concluded that the Laestadian sobriety norm, and the norm of abstinence from the use of adiafora, have influenced alcohol-related behaviour in the Saami group in such a way that this group does not conform to the drinking behaviour found in comparable minorities.
Few epidemiological studies have investigated the relative importance of major coronary risk factors in the two sexes within the same study population. In particular, it is not clear whether smoking carries a similar risk of coronary heart disease in men and women.
The associations between smoking, serum lipids, blood pressure, and myocardial infarction were examined in a population-based prospective study of 11,843 men and women aged 35 to 52 years at entry. During 12 years, 495 cases of first myocardial infarction among men and 103 cases among women were identified. Myocardial infarction incidence was 4.6 times higher among men. The incidence was increased sixfold in women and threefold in men who smoked at least 20 cigarettes per day compared with never-smokers, and the rate in female heavy smokers exceeded that of never-smoking men. Multivariate analysis identified current smoking as a stronger risk factor in women (relative risk, 3.3; 95% confidence interval [CI], 2.1 to 5.1) than in men (relative risk, 1.9; 95% CI, 1.6 to 2.3). Among those under 45 years old at entry, the smoking-related sex difference was more pronounced (in women: relative risk, 7.1; 95% CI, 2.6 to 19.1) (in men: relative risk, 2.3; 95% CI, 1.6 to 3.2). Serum total cholesterol, HDL cholesterol, and systolic blood pressure were also highly significant predictors in both sexes.
Smoking was a stronger risk factor for myocardial infarction in middle-aged women than in men. Relative risks associated with serum lipids and blood pressure were similar despite large sex differences in myocardial infarction incidence rates.
To determine whether students older than most other students at their grade level ("old for grade") are more likely to report engaging in alcohol, tobacco, and drug-related behaviors.
Cross-sectional analyses of the Centers for Disease Control and Prevention Youth Risk Behavior Survey.
Monroe County, New York.
A total of 1396 high school students from selected classrooms; 68 classrooms randomly selected within schools with the number of students per school proportionally selected from the 28 schools in the county.
Rates of drug-related behaviors by age-for-grade status.
Thirty-six percent of adolescents surveyed were old for grade. Adjusting for multiple potential confounders, old-for-grade high school students were more likely to report being regular smokers, chewing tobacco, drinking alcoholic beverages, driving in a car with someone who had been drinking, using alcohol or other drugs before last sexual intercourse, using cocaine in the past month, ever using crack, and using injected or other illicit drugs.
Old-for-grade status is a potentially important marker for drug-related behaviors in adolescents. The antecedents of adolescent risk-taking behavior may begin before the teen years, and prevention of school failure or interventions targeted toward old-for-grade children could affect their propensity to experiment with or use drugs during adolescence.
In order to develop effective smoking cessation programmes, it is important to understand why people stop smoking. This study is based on data from two population-based health surveys carried out in the northernmost county of Norway in 1977-78 and 1987-88. 6,254 men and 6,404 women smokers participated in the survey. For both surveys questionnaires were used to collect information on smoking habits, sociodemographic variables, various diseases, symptoms, health related behaviours, and social network. Ten years later 19.3% of the men and 16.0% of the women had stopped smoking. The primary factors for giving up were: a short history of smoking, older age, having non-smoking family and friends, and acquiring a smoking related disease during the period. Health promoting behaviours, such as low consumption of coffee, alcohol, butter and margarine, also increased the chances of giving up smoking. Developing smoking related symptoms, such as a morning cough, or coughing up mucus in the mornings, predicted continuous smoking. Future health promotion programmes should be targeted at young smokers and persons with smoking related diseases; and efforts should probably be directed towards lifestyle with the aim of modifying general attitudes to health.
The mortality from coronary and cerebrovascular diseases is higher in Finnmark County than in other Norwegian counties. In a population-based cohort study, we compared the incidence of myocardial infarction, stroke, and diabetes mellitus in different ethnic groups in Finnmark. A total of 10,622 subjects of Norse, Sami, and Finnish origin were followed for 14 years. During approximately 150,000 person-years, we identified 509 and 84 cases of myocardial infarction, 107 and 75 cases of stroke, and 96 and 73 cases of clinical diabetes mellitus among men and women, respectively. A total of 533 men and 199 women died. Norse subjects born outside of Finnmark had the most favorable risk factor levels and, in general, the lowest incidence of disease. Men of Finnish origin had a higher incidence rate of all endpoints than other men, and Finnish women had a higher incidence rate of myocardial infarction than other women. Sami women were more obese but did not have a higher diabetes mellitus incidence than other women. After adjustment for major cardiovascular risk factors and height, most ethnic differences were attenuated.
In this second in a series of articles on religion and medicine, I focus on the relationship between religion and mental health. This discussion is based on a comprehensive and systematic review of a century of research examining religion's relationship to mental health, social support, substance abuse, and other behaviors affecting mental or social functioning. This review includes over 630 separate data-based reports that focus on religion and well-being, hope and optimism, meaning and purpose, depression, suicide, anxiety, psychosis, social support and marital stability, alcohol and drug abuse, cigarette smoking, extra-marital sexual behaviors, and delinquency. Reasons for the associations found are discussed and conclusions drawn in light of the findings.
To examine ethnic and gender differences in the prevalence of cigarette smoking among indigenous Sami, ethnocultural Kven and majority Norwegian adolescents, and ethnic-specific gender differences in smoking.
'The North Norwegian Youth Study' was a longitudinal epidemiological study. It collected data at two time points at a three-year interval (1994/95 and 1997/98). It was based on student self-reports (10-12th grade) from 21 state schools in North Norway. The initial analysis included 2997 students aged 15-19 years (response rate (RR): 85%) and 1533 responders at follow-up (RR: 55%). The sample consisted of 12% Kvens, 23% Sami and 65% Norwegians.
Baseline (follow-up) smoking rates were; 38% (35%) never smokers, 29% (29%) current regular smokers, 11% (12%) current irregular smokers and 23% (24%) former smokers. Ethnic differences in cigarette smoking were minor and found at baseline only. Sami students reported a lower proportion of current irregular smokers (8%) and a higher rate of former smokers (26%). Gender differences were most pronounced at baseline with females more involved in cigarette smoking than their male peers. However, males were more likely to be heavy smokers at both time points.
Cigarette smoking among adolescents and young people in North Norway was generally independent of the ethnicity of the respondents. There were no ethnic differences in smoking rates at follow-up. Sami youth were not at higher risk of cigarette smoking than their non-indigenous peers. This finding contrasts with findings among other Arctic indigenous youth.
To examine the trends in drug use among American Indian adolescents attending schools on, or near, Indian reservations in the United States, to provide comparisons with non-Indian youth, and to discuss implications for prevention.
Reliable and valid school administered drug use surveys have been given every year for 25 years (1975-2000) to representative samples of Indian youth living on reservations, yielding a continuous record of trends in drug use. Comparisons are made with non-Indian youth with data from the Monitoring the Future project. Data were analyzed to obtain measures of lifetime prevalence ("ever tried a drug"), use in the last 30 days, and proportions at high risk and at moderate risk from their drug use. Comparisons utilized difference in proportion tests.
From 1975 to 2000, reservation Indian youth show elevated levels of drug use for most illicit drugs compared with non-Indian youth. Despite higher levels of use, the trends showing increases and decreases in use over time mirror those shown by non-Indian youth. Indian youth who use drugs can be divided into moderate and high levels of use. The number of youth in the moderate category varies over time whereas the number in the high category remains relatively constant.
There is a clear need for intensive efforts to reduce the levels of drug use among Indian youth. Although interventions must be tailored to the social and cultural milieu of Indian reservations, the rates of use vary over time in the same pattern as seen for non-Indian youth. Further, interventions must address the differing characteristics of high and moderate risk users of drugs.
A study was undertaken to examine predictors of smoking behaviour among indigenous Sami adolescents and non-indigenous peers in North Norway, and to examine for ethnic-specific predictors.
This is a cross-sectional and longitudinal school-based and postal questionnaire study initially including 2,718 10th to 12th grade students (response rate (RR): 85%) in 1994-95 (T1). At the three-year follow-up (T2), in 1997-98, 1,405 were included (RR: 57%). Indigenous Sami contributed 23% (599/324) of the total samples. Logistic regression was used to examine the influence of sociodemographic and psychosocial predictors on smoking behaviour.
The proportions of regular smokers were 33% (729) and 35% (401) at T1 and T2, respectively, while 19% (153) had initiated current smoking during the study period. Substance use, externalizing problems, sexual activity and vocational training (p </= 0.01) predicted regular smoking both cross-sectionally and prospectively. Among non-smokers at T1, age and frequent alcohol intoxication predicted current smoking prospectively (p </= 0.01). Frequent intoxication predicted all stages of smoking (p </= 0.001). Ethnicity did not predict smoking in this study. Laestadian Christian affiliation increased the prevalence of experimental smoking at T1 but only for Sami students.
Youth smoking behaviour was strongly associated with risk-taking behaviours, indicating that a broader focus on health-compromising behaviours in anti-smoking campaigns is needed. The findings indicate little need for culturally sensitive anti-smoking campaigns specially designed for indigenous Sami youth, as the main predictors (risk-taking behaviours) were similar across ethnic groups.
Drinking patterns among indigenous Sami and non-Sami adolescents in northern Norway were explored. Longitudinal data were collected in 1994/95 among 2,950 high school students (RR: 85%) and in 1997/98 among 1,510 follow-ups (RR: 57%). Longitudinally, Sami had significantly lower drinking rates for all measures. An increase in 30-day drinkers occurred during the follow-up period: 23% in Sami and 19% in non-Sami. Sami reported higher paternal abstinence. Sami drank more often in public places. Sami reported more worries from friends and family about their drinking. The lower drinking rates in Sami relative to majority adolescents contrast with findings among indigenous peers elsewhere, but corresponds with the lower parental drinking rates.
The cross-sectional and prospective influences of ethnocultural factors on substance use were explored among indigenous Sami in northern Norway. Longitudinal data was collected in 1994/95 (school-based survey; N = 675; RR: 85%; late adolescence: 15-19; 54% females) and 1997/98 (combined school-based and postal questionnaire study; N = 360; RR: 57%; young adulthood; 18-22; 62% females). When controlled for sociodemographics, logistic regression analyses indicated that favoring assimilation, residing in assimilated contexts, and having a weaker ethnic identity were associated with more drinking in late adolescence. Prospectively, favoring assimilation in late adolescence predicted the respondents' perception of excessive drinking in young adulthood. In late adolescence, the effect of assimilation on current smoking was moderated by living in an assimilated context and associated with stronger ethnic group identification. Prospectively, favoring assimilation in late adolescence predicted current smoking in young adulthood. Generally, less Sami oriented individuals were more likely to use substances. The implications and limitations of the findings along with recommendations for future research were discussed.
Hvem stumper royken? (What kind of people give up smoking? Results from the Finnmark studies carried out in 1977-78 and 1987-88.) Tidsskr Nor Lwgefor
- A K Abildsnes
- A J Sogaard
- A Hafstad
Abildsnes AK, Søgaard AJ, Hafstad A. Hvem stumper
røyken? (What kind of people give up smoking? Results from the Finnmark studies carried out in 197778 and 1987-88.) Tidsskr Nor Laegefor (J Norwegian Med Association) 1998;14(18):2170-2175.
Smoking, serum lipids, blood pressure, and sex differences in myocardial infarction. A 12-year follow-up of the Finnmark Study Substance use among Sami 1 8. Njølstad I, Arnesen E, Lund-Larsen PG. Cardiovascular diseases and diabetes mellitus in different ethnic groups: The Finnmark Study
- I Njølstad
- E Arnesen
- Lund
- Larsen
Njølstad I, Arnesen E, Lund-Larsen PG. Smoking, serum lipids, blood pressure, and sex differences in myocardial infarction. A 12-year follow-up of the Finnmark Study. Circulation 1996;93(3):450–456. Substance use among Sami 1 International Journal of Circumpolar Health 67:1 2008 8. Njølstad I, Arnesen E, Lund-Larsen PG. Cardiovascular diseases and diabetes mellitus in different ethnic groups: The Finnmark Study. Epidemiology 1998;9(5):550–556.
Koronar hjertesykdom hos samiskattende og norskattede i Finnmark (Coronary heart disease among Sàmis and Norwegian in the County of Finnmark). Tidsskr Nor lægefor
- E Utsi
- K H Bønna
Utsi E, Bønna KH. Koronar hjertesykdom hos
samiskaettende og norskaettede i Finnmark (Coronary heart disease among Sàmis and Norwegian in
the County of Finnmark). Tidsskr Nor laegefor (J
Norwegian Med Association) 1998;118(9):13581362.
Jokkmokks socken 1860-1910 (Alcohol and the nomadic Saami - Jokkmokk parish 1860-1910). Alkoholpolitikk. Tidsskrift for Nordisk Alkoholfors-kning
- P Sköld
- R Kvist
Kvist R. Samerna och alkoholen-Jokkmokks socken
1860-1910 (The Saami and alcohol-Jokkmokk parish
1860-1910). Alkoholpolitikk. Tidsskrift for Nordisk
Alkoholforskning (Nordic Studies on Alcohol and
Drugs) 1986;3:122-128.
Alkoholen och de nomadiserande samerna Jokkmokks socken 1860-1910 (Alcohol and the nomadic Saami – Jokkmokk parish 1860–1910). Alkoholpolitikk. Tidsskrift for Nordisk Alkoholforskning
- P Sköld
- Kvist
Sköld P, Kvist R. Alkoholen och de nomadiserande samerna. Jokkmokks socken 1860-1910 (Alcohol and the nomadic Saami – Jokkmokk parish 1860–1910). Alkoholpolitikk. Tidsskrift for Nordisk Alkoholforskning (Nordic Studies on Alcohol and Drugs) 1988; 5(4):249–253.
De rettferdiges stridThe battle of the righteous Nesbru: Norsk Folkemuseum and Vett and Viten
- N Zorgdrager
Zorgdrager N. De rettferdiges strid. Kautokeino 1952 (The battle of the righteous, Kautokeino 1952). Nesbru: Norsk Folkemuseum and Vett and Viten; 1997. 558 pp.
Ungdom og rusmidler (Youth and intoxicants) Oslo: Rusmiddeldirektoratet/Statens Institutt for Alkohol-og Narkotikaforskning (National Institute for
- A Skretting
Skretting A. Ungdom og rusmidler (Youth and intoxicants). Oslo: Rusmiddeldirektoratet/Statens Institutt
for Alkohol-og Narkotikaforskning (National Institute for Alcohol and Drug Research); 1996. 72 pp.
En landsdekkende opfolgingsundersogelse af skoleelevers rusmiddelvaner (Substance abuse among schoolchildren in Greenland). Ugeskr for Lager
- J M Pedersen
Pedersen JM. Skoleelevers brug af rusmidler i Grønland 1992. En landsdekkende opfølgingsundersøgelse af skoleelevers rusmiddelvaner (Substance abuse among schoolchildren in Greenland). Ugeskr for Laeger (J Danish Med Association) 1994;156(27):4036– 4038.
Statistic Greenland). ESPAD99. Rusmiddelundersogelse blant unge, irgang 1983 og 1984, i Gronland (Drug use survey among young people
- Grønlands Statistikk
Grønlands Statistikk (Statistic Greenland). ESPAD99.
Rusmiddelundersøgelse blant unge, årgang 1983 og
1984, i Grønland (Drug use survey among young people, born 1983 and 1984, in Greenland). Specialpublikation, 2000:2. Nuuk: Grønlands Statistik (Statistic
Greenland); 2000.
Tall om tobakk 1973–2003 (Tobacco statistics 1973–2003) SIRUS skrifter nr. 2. Oslo: Statens Institutt for Rusmiddelforskning
- M Lund
- Lindbak
Lund M, Lindbak R. Tall om tobakk 1973–2003 (Tobacco statistics 1973–2003). SIRUS skrifter nr. 2. Oslo: Statens Institutt for Rusmiddelforskning (National Institute for Alcohol and Drug Research); 2004. 39 pp.
Religion and medicine II: religion, mental health, and related behaviors Larsen S. The origin of alcohol related social norms in the Saami minority
- Hg Koenig
Koenig HG. Religion and medicine II: religion, mental health, and related behaviors. Int J Psychiat Med 2001;31(1):97–108. 40. Larsen S. The origin of alcohol related social norms in the Saami minority. Addiction 1993;88(4):501–
Cigarettes, nicotine, and health: a biobehavioral approach
- L T Kozlowski
- J E Henningfield
- J Brigham
Kozlowski LT, Henningfield JE, Brigham J. Cigarettes,
nicotine, and health: a biobehavioral approach.
Thousand Oaks, CA: SAGE; 2001. 192 pp.
Rusmidler i Norge (Alcohol and drugs in Norway) Oslo: Statens Institutt for Alkohol-og Narkotika Forskning
- Ek Bye
- Editor
Bye EK, editor. Rusmidler i Norge (Alcohol and drugs in Norway). Oslo: Statens Institutt for Alkohol-og Narkotika Forskning (Norwegian Institute for Alcohol and Drug Research); 2003. 178 pp.
Samernas historie (The history of the Sami) Jokkmokk: Sameskolstyrelsen & Sàmi Girjjit
- Pg Kvaenangen
Kvaenangen PG. Samernas historie (The history of
the Sami). Jokkmokk: Sameskolstyrelsen & Sàmi Girjjit; 1996. 157 pp.
Risikogrupper blant samisk ungdom (Groups at risk among the Sami) In: Samisk helse-og sosialplan. Plan for helse-og sosialtjenester til den samiske befolkningen i Norge. (The health and social plan. The plan for health and social services to the Norwegian Sami population)
- Nou Norges Offentlige
- Utredninger
NOU. Norges Offentlige Utredninger (Norwegian
Official Reports). Risikogrupper blant samisk ungdom (Groups at risk among the Sami). In: Samisk
helse-og sosialplan. Plan for helse-og sosialtjenester
til den samiske befolkningen i Norge. (The health
and social plan. The plan for health and social services to the Norwegian Sami population), 1995. 152–
177. Oslo: The Norwegian Ministry of Health and
Care Services.
Alcoholism in the Sàmi (Lappis) areas of Indre-Finnmark (Alkoholproblemer i de samiske områder i Finnmark). Paper presented at the International Council of
- Om Hetta
- P Somby
- Ø Vandbakk
- A Nordsletta
- R Solbakk
- Ai Keskitalo
Hetta OM, Somby P, Vandbakk Ø, Nordsletta A, Solbakk R, Keskitalo AI. Alcoholism in the Sàmi (Lappis) areas of Indre-Finnmark (Alkoholproblemer i
de samiske områder i Finnmark). Paper presented at
the International Council of Alcohol and Addictions
(ICAA) Conference in Fairbanks, Alaska; 15-20
Helse, livsstil og levekår i Finnmark Resultater fra hjerte-kar undersøkelse i 1987–88. Finnmark III (Health, life-style and living conditions in Finnmark: results from a cardiovascular survey
- K Westlund
- Aj Søgaard
Westlund K, Søgaard AJ. Helse, livsstil og levekår i
Finnmark. Resultater fra hjerte-kar undersøkelse i
1987–88. Finnmark III (Health, life-style and living
conditions in Finnmark: results from a cardiovascular survey conducted in 1987–88. Finnmark III).
Rusmidler i Norge (Alcohol and drugs in Norway) Oslo: Statens Institutt for Alkohol-og Narkotika Forskning (Norwegian Institute for
- Ek Bye
Bye EK, editor. Rusmidler i Norge (Alcohol and
drugs in Norway). Oslo: Statens Institutt for Alkohol-og Narkotika Forskning (Norwegian Institute
for Alcohol and Drug Research); 2003. 178 pp.
Religion og helbredelse (Sami shamans. Religion and faith healing). Oslo: Gyldendal Norsk Forlag A/S; 1993
- B Pollan
- Samiske
Pollan B. Samiske sjamaner. Religion og helbredelse
(Sami shamans. Religion and faith healing). Oslo:
Gyldendal Norsk Forlag A/S; 1993. 207 pp.
The Norwegian Ministry of Health and Care Services
- Oslo
Oslo: The Norwegian Ministry of Health and Care
Services; 1999.
- Alkoholpolitikk
Alkoholpolitikk. Tidsskrift for Nordisk Alkoholforskning (Nordic Studies on Alcohol and Drugs) 1988;
5(4):249-253.
The development of drug abuse in Norway in the 1990s
- E Ødegård
- A L Brettville-Jensen
- A Skretting
Ødegård E, Brettville-Jensen AL, Skretting A. The
development of drug abuse in Norway in the 1990s.
Nordisk Alkohol-& Narkotika Tidsskrift (Nordic
Studies on Alcohol and Drugs) 2002;29(2):113-122.
Centre for Sami Health Research Institute of Community Medicine Faculty of Medicine University of Tromsø Brevika N-9037 Tromsø NORWAY Corresponding address: Centre for Sami Health
- Anna Rita Spein
- M D D Ph
Anna Rita Spein, M.D., Ph.D.
Centre for Sami Health Research
Institute of Community Medicine
Faculty of Medicine
University of Tromsø
Brevika
N-9037 Tromsø
NORWAY
Corresponding address:
Centre for Sami Health Research
Box 71
N-9735 Karasjok
NORWAY
Email: annas@ism.uit.no