Relationship between socioeconomic status, health status, and lifestyle practices of American Indians: evidence from a Plains reservation population (original) (raw)
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Annals of Epidemiology, 1998
There is a growing need for disease risk factor data for various chronic diseases among American Indian (AI) populations. The purpose of this study was to determine the prevalence of disease risk and protective behaviors among AI women living on the Hopi reservation. METHODS: 559 randomly selected AI women 18-89 years of age completed an interviewer-administered questionnaire which included questions on smoking, alcohol consumption, weight, height, and self-identified practices to keep healthy. RESULTS: The proportions of smoking and alcohol consumption were low with only 5.4% women reported currently smoking and 23.1% reported consuming any alcohol. Both these risk factors significantly decreased with age and significantly increased with higher education. The proportions who were overweight (body mass index (BMI) 27.3-32.2) and obese (BMI Ն 32.3) were 36.2% and 27.0%, respectively, and were highest in the ages 25-64 years. Over 80% of women reported practicing behaviors to keep healthy. Significantly higher proportions of older women reported practicing behaviors to keep healthy compared with younger women. CONCLUSIONS: To develop and evaluate programs aimed at decreasing rates of chronic diseases among AI populations a disease risk factor surveillance system needs to be implemented by region and tribe.
Food Insecurity and Chronic Diseases Among American Indians in Rural Oklahoma: The THRIVE Study
American journal of public health, 2017
To examine food insecurity and cardiovascular disease-related health outcomes among American Indians (AIs) in rural Oklahoma. We surveyed a cross-sectional sample of 513 AI adults to assess food insecurity domains (i.e., food quality and quantity) and obesity, diabetes, and hypertension. Among AIs surveyed, 56% reported inadequate food quantity and 62% reported inadequate food quality. The unadjusted prevalence of diabetes (28.4% vs 18.4%), obesity (60.0% vs 48.3%), and hypertension (54.1% vs 41.6%) was higher among participants with inadequate food quantity than among those with adequate food quantity. These associations did not reach statistical significance after adjustment for age, gender, study site, education, and income. The unadjusted prevalence of obesity (60.7% vs 45.8%), diabetes (27.3% vs 18.8%), and hypertension (52.5% vs 42.5%) was higher among those with inadequate food quality than among those with adequate food quality, even after adjustment for age, gender, study s...
Social Determinants of American Indian Nutritional Health
Current Developments in Nutrition, 2019
The American Indian (AI) population suffers from significant health disparities, including nutrition-related chronic diseases (diabetes, cancer, and heart disease). Several risk factors for disease and social determinants of health have unique histories in the AI population, including historical trauma, boarding schools, adverse childhood experiences, poverty, federal food programs, and food deserts. To effectively address these disparities, a multipronged approach in collaboration with stakeholders is needed to address the upstream social determinants of health and to increase access to healthier foods. Promising practices and strategies can be considered in several focus areas, including 1) improving existing food programs, 2) promoting breastfeeding and early childhood nutrition, 3) promoting food sovereignty and access to traditional foods, 4) expanding locally cultivated foods, and 5) taxing unhealthy foods and subsidizing healthier options. As these strategies are implemented, it is vital that they are studied, evaluated, and reported to expand tribally specific evidence-based practices.
Health Behaviors among American Indian/Alaska Native Women, 1998–2000 BRFSS
Journal of Womens Health, 2006
Background and objective: Minority populations, including American Indians and Alaska Natives (AI/AN), in the United States generally experience a disproportionate share of adverse health outcomes compared with whites. The prevalence of risk behaviors associated with these adverse health outcomes among AI/AN women is not well documented, especially for those who live outside areas serviced by Indian Health Service. We sought to describe the prevalence of selected health risk behaviors among AI/AN women, document the disparities between AI/AN women and all U.S. women, and demonstrate the efforts needed for AI/AN women to reach Healthy People 2010 goals. Methods: Age-adjusted prevalence estimates for selected sociodemographic characteristics, current smoking, obesity, lack of leisure time physical activity, and binge drinking were calculated using Behavioral Risk Factor Surveillance System (BRFSS) data from 1998 to 2000, combined. Comparisons were made between prevalence estimates for AI/AN women and all women who participated in the BRFSS and Health People 2010 goals. Results: The prevalences of current smoking (27.8%) and obesity (26.8%) were significantly higher among AI/AN women than among all U.S. women. AI/AN women did not meet Healthy People 2010 goals for current smoking, obesity, leisure time physical activity, or binge drinking. Conclusions: These data highlight both disparities in health risk behaviors between AI/AN women and all U.S. women and improvements needed for AI/AN women to meet Healthy People 2010 goals. This project demonstrates the overwhelming need for culturally appropriate and accessible prevention programs to address health risk behaviors associated with the leading causes of death among urbanized AI/AN women.
American Indian health disparities: psychosocial influences
Social and Personality Psychology Compass, 2015
The American Indian (AI) population suffers from significant health disparities. Death rates from diabetes, cancer, infant mortality, and other causes are higher among AIs. Numerous psychosocial inf luences, including a history of genocide and boarding school experiences, have led to unresolved historical trauma and its associated poor health outcomes. Adverse childhood experiences are also a strong predictor of risk for numerous chronic and behavioral health conditions. Food programs for impoverished populations historically have led to high rates of formula feeding of infants and intake of high-calorie, low nutritional value foods. Adverse adulthood experiences, including poverty, racism, and substance abuse, lead to depression, anxiety, and poor health outcomes. These social circumstances can have an impact on the quality of parenting skills for the next generation, leading to continued intergenerational health disparities. Additional research into the psychosocial inf luences and social determinants of health is needed to ensure improved policy and program development.
Sociocultural and behavioral influences on health status among the Mississippi Choctaw
Medical Anthropology, 1996
Native American populations in North America are at increased risk of a variety of health problems, including (but not limited to) diabetes. This risk is presumed to be a result of the interaction of environmental influences with a population genetic susceptibility. Anthropologists have subsumed those environmental influences under the term "acculturation." Here, we break that broad concept into physical, behavioral, and sociocultural components in an examination of the correlates of arterial blood pressure and plasma glucose among the Mississippi Choctaw. In a sample of 93 adults, higher plasma glucose was associated with lower physical activity, higher body mass index, and higher lifestyle incongruity, after controlling for age, sex, and recency of food consumption. Higher arterial blood pressure was associated with higher body mass index and being single. These results suggest that the risk of disordered glucose metabolism within this Native American population is associated with acculturation broadly construed, but that refined models of health and disease must take into account the multiple dimensions of this concept. Physical, behavioral, and sociocultural factors combine to describe more precisely the concept of acculturation, and hence the factors contributing to the risk of disease in Native American communities.
Objective—This report compares national estimates for selected health status indicators, health behaviors, health care utilization, and health conditions of American Indians and Alaska Natives (AIAN) with those of white, black, and Asian non-AIAN adults 18 years of age and over. Methods—The estimates in this report were derived from the Family Core and the Sample Adult Core components of the 1999-2003 National Health Interview Surveys, conducted by the National Center for Health Statistics. Estimates were generated and compared using the SUDAAN statistical package to account for the complex sample design. Results—AIAN adults were more likely to be current smokers than other adults. They were as likely as white adults to be moderate or heavier drinkers and as likely as black adults to be obese or never engage in leisure-time physical activity. They were at least twice as likely to have unmet medical needs due to cost and were much less likely to have seen a dentist within the last 5 ...
An Overview of the State of Native American Health: Challenges and Opportunities
International Relief and Development, 2008
American Indian/Alaska Native (AIAN) populations are facing a number of serious challenges, including poverty and health-related issues. Many of these problems have, at their root cause, lack of sufficient and consistent access to nutritious foods. Integrally related to poverty, significant portions of reservation residents and urban AIAN populations are reliant of subsidized food programs, community food distribution centers, and soup kitchens for the bulk of their diet. Studies have demonstrated the negative impacts this has on physiological pathologies such as obesity and diabetes mellitus. While these situations are critical, it is important to note that consumption patterns and food choices are modifiable. This provides significant opportunities for positive, sustainable interventions to improve the quality of life for AIAN populations.