Native American Studies: Health

More than 2 million Americans below age 24 self-identify as being of American Indian or Alaska Native descent. Many of the serious behavioral, emotional, and physical health concerns facing young people today are especially prevalent with Native youth (e.g., depression, violence, and substance abuse). Adolescent Native Americans have death rates two to five times the rate of whites in the same age group because of higher levels of suicide and a variety of risky behaviors (e.g., drug and alcohol use, inconsistent school attendance). Violence, including intentional injuries, homicide, and suicide, accounts for three-quarters of deaths for Native American youth ages 12 to 20. Suicide is the second leading cause of death--and 2.5 times the national rate--for Native youth ages 15 to 24. Arrayed against these health problems are vital cultural strengths on which Native Americans can draw. At a workshop held in 2012, by the National Academies of Sciences, Engineering, and Medicine, presenters described many of these strengths, including community traditions and beliefs, social support networks, close-knit families, and individual resilience. In May 2014, the Academies held a follow-up workshop titled Advancing Health Equity for Native American Youth. Participants discussed issues related to (1) the visibility of racial and ethnic disparities in health and health care as a national problem, (2) the development of programs and strategies by and for Native and Indigenous communities to reduce disparities and build resilience, and (3) the emergence of supporting Native expertise and leadership. This report summarizes the presentations and discussions from the workshop.

In "Reproductive Justice," sociologist Barbara Gurr provides the first analysis of Native American women's reproductive healthcare and offers a sustained consideration of the movement for reproductive justice in the United States. The book examines the reproductive healthcare experiences on Pine Ridge Reservation, home of the Oglala Lakota Nation in South Dakota--where Gurr herself lived for more than a year. Gurr paints an insightful portrait of the Indian Health Service (IHS)--the federal agency tasked with providing culturally appropriate, adequate healthcare to Native Americans--shedding much-needed light on Native American women's efforts to obtain prenatal care, access to contraception, abortion services, and access to care after sexual assault. Reproductive Justice goes beyond this local story to look more broadly at how race, gender, sex, sexuality, class, and nation inform the ways in which the government understands reproductive healthcare and organizes the delivery of this care. It reveals why the basic experience of reproductive healthcare for most Americans is so different--and better--than for Native American women in general, and women in reservation communities particularly. Finally, Gurr outlines the strengths that these communities can bring to the creation of their own reproductive justice, and considers the role of IHS in fostering these strengths as it moves forward in partnership with Native nations.

This volume examines concepts of disability and wellness in Native American communities, prominently featuring the life's work of Dr. Carol Locust. Authors Locust and Lovern confront the difficulties of translating not only words but also entire concepts between Western and Indigenous cultures, and by increasing the cultural competency of those unfamiliar with Native American ways of being are able to bring readers from both cultures into a more equal dialogue. The three sections contained herein focus on intercultural translation; dialogues with Native American community members; and finally a discussion of being in the world gently as caregivers.

In recent years, efforts to recognize and accommodate cultural diversity have gained some traction in the politics of US health care. But to date, anthropological perspectives have figured unevenly in efforts to define and address mental health problems. Particularly challenging are examinations of Native peoples’ experiences with alcohol. Erica Prussing provides the first in-depth assessment of the politics of Native sobriety by focusing on the Northern Cheyenne community in southeastern Montana, where for many decades the federally funded health care system has relied on the Twelve Step program of Alcoholics Anonymous. White Man’s Water provides a thoughtful and careful analysis of Cheyenne views of sobriety and the politics that surround the selective appeal of Twelve Step approaches despite wide-ranging local critiques. Narratives from participants in these programs debunk long-standing stereotypes about ”Indian drinking” and offer insight into the diversity of experiences with alcohol that actually occur among Native North Americans.This critical ethnography employs vivid accounts of the Northern Cheyenne people to depict how problems with alcohol are culturally constructed, showing how differences in age, gender, and other social features can affect involvement with both drinking and sobriety. These testimonies reveal the key role that gender plays in how Twelve Step program participants engage in a selective and creative process of appropriation at Northern Cheyenne, adapting the program to accommodate local cultural priorities and spiritual resources. The testimonies also illuminate community reactions to these adaptations, inspiring deeper inquiry into how federally funded health services are provided on the reservation. This book will appeal to readers with an interest in Native studies, ethnography, women’s studies, and medical anthropology. With its critical consideration of how cultural context shapes drinking and sobriety, White Man’s Water offers a multivocal perspective on alcohol’s impact on health and the cultural complexities of sobriety.

This book provides the reader with a basic understanding of the historical impact of colonization, the ensuing results of urban migration and boarding schools, and the effects that these events have had on the Native community.

In "Fighting Firewater Fictions", Richard W. Thatcher describes and explains the emergence and perpetuation of the 'firewater complex' ? the cultural construct of an informally sanctioned, destructive, binge-drinking norm in First Nations reserve communities. The complex has reified alcoholism as an inevitability in the First Nations ? an approach that has resulted in essential aspects of collective and personal responsibility being vacated in favour of therapeutic interventions assisted by social personnel of questionable expertise. This substitution has had the effect of relieving government policy-makers and reserve leadership from accountability for problematic community development strategies that have long since outgrown their support capacities. Thatcher argues that the conditions that give rise to extraordinary alcohol abuse rates in First Nations are largely traceable to the hopelessness associated with multi-generational unemployment. "Fighting Firewater Fictions" calls for community re-organization around a band development policy that looks beyond the reserve, and outlines a strategy that shifts the current, exclusive emphasis on the needs of alcoholics towards the neglected counselling and non-residential service needs of potential or actual binge-drinkers. This is essential reading for anybody working in, or seeking to understand, aboriginal communities that are experiencing problems with alcoholism.

Examines historical perspectives on Native American addictions, the nature of their substance abuse, prevention, intervention, cultural treatment, and addiction to gaming and gambling.

This book provides a comprehensive review of the health of Native Americans in Canada and the United States. Historical trends in population and health status from pre-European contact to the present are examined in three groups of diseases: infectious diseases, chronic diseases, and injuries. The author discusses the etiology and pathogenesis of different diseases in each group, and weighs genetic and environmental risk factors. He also compares the incidence of disease among Native Americans and non-Native Americans, examines variations among Native Americans belonging to different geographical, cultural, and linguistic groups, and reviews control and prevention strategies. On a broader level, the author's purpose is to integrate the approaches of anthropology and epidemiology in order to show the interaction of biology and culture on disease causation, distribution, and control. Attention to both perspectives offers a promising approach to understanding and improving the health status of Native Americans.