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Health Status of American Indian and Alaska Native Women

American Indians and Alaska Natives are five times more likely to die of alcohol-related deaths causes than Whites and face high rates of chronic liver disease and cirrhosis.

In addition, American Indians and Alaska Natives have a high rate of drinking and driving and alcohol-related fatal crashes compared to the general population.

Binge drinking is generally defined as having 5 or more drinks on one occasion, meaning in a row or within a short period of time.  However, among women, binge drinking is often defined as having 4 or more drinks on one occasion—this is because women are generally of smaller stature than men, and absorb and metabolize alcohol differently than men.

In the United States in 2003, 13.1 percent of women reported binge drinking in the past month.

Cardiovascular Disease
In the United States in 2002, all cardiovascular diseases combined claimed the lives of 493,623 females while all forms of cancer combined to kill ed 268,503 females. Breast cancer claimed the lives of 41,514 females; lung cancer claimed 67,542.

Cardiovascular disease (CVD), including stroke, is the leading cause of death for American Indian/Alaska Native women.

Among American Indians/Alaska Natives age 18 and older, 61.4 percent of women have one or more CVD risk factors—hypertension, current cigarette smoking, high blood cholesterol, obesity or diabetes.

Among American Indian or Alaska Natives only ages 18 and older, 55.5 percent of women report no physical activity.

The Center for Disease Control and Prevention estimates that 20.8 million Americans—7 percent of the U.S. population—have diabetes, up from 18.2 million in 2003. Nearly a third of these Americans are undiagnosed.

Diabetes is most common among some groups of American Indians and Alaska Natives. Findings from the latest report show these percentages of people aged 20 and older with diabetes:

  • American Indians in southern Arizona: 27.6 percent
  • American Indians in the southern U.S.: 26.7 percent
  • American Indians and Native Alaskans (overall): 12.8 percent

Diabetes contributes to several of the leading causes of death in American Indians/Alaska Natives (AI/AN), including heart disease, stroke, pneumonia and influenza.

Specific tribes have much higher rates. For example, 50 percent of Pima Indians in Arizona who are between the ages of 30 and 64 have type 2 diabetes.

Pregnant AI/AN women with type 2 diabetes are at an increased risk of having babies born with birth defects. Diabetes that shows up in pregnancy is called gestational diabetes. This form of diabetes is high among certain AI/AN. Gestational diabetes increases the baby's risk for problems such as macrosomia (large body size) and neonatal hypoglycemia (low blood sugar). Although the blood glucose levels of women with gestational diabetes usually return to normal after childbirth, these women have an increased risk of developing gestational diabetes in future pregnancies. In addition, studies show that many women with gestational diabetes will develop type 2 diabetes later in life.

Serious complications of diabetes are increasing. The most concerning are kidney (or renal) failure, heart disease, amputations, and blindness. Infections, including tuberculosis (TB), are of particular concern to both American Indians and Alaska Natives who have diabetes. Tuberculosis is a disease caused by bacteria. If TB is in the lungs, it can cause a bad cough, chest pain, fatigue, weight loss, chills, and fever. A study of Sioux Indians showed that their rate of developing tuberculosis is higher if they had diabetes than if they did not.

In 2001, American Indian/Alaska Native women were 30 percent less likely to have breast cancer as non-Hispanic white women.  American Indian Women were 1.9 times as likely to die from cervical cancer compared to white women.

American Indian/Alaska Native women have 2.4 times the AIDS rate of non-Hispanic white women. In 2003, there were an estimated 46 cases per 100,000 of AIDS among American Indians/Alaska Natives females.

In 2002, American Indian/Alaska Native adults aged 18 to 64 years were slightly more likely than their non-Hispanic white counterparts to have received the influenza (flu) shot in the past 12 months. In 2002, 62 percent of American Indian/Alaska children aged 19 to 35 months were fully immunized.

Gallstones are pieces of solid matter that form in the gallbladder, a part of the digestive system that stores bile, which helps your body digest food. Gallstones form when parts of the bile form hard crystals. There are 2 types of gallstones: pigment (bilirubin) and cholesterol. Most people have cholesterol gallstones—80 percent have this type.

While it is believed that the mere presence of gallstones may cause more gallstones to develop, other factors that contribute to gallstones have been identified, especially for cholesterol stones, include: obesity, estrogen, ethnicity, gender and diabetes.

Because of high levels of cholesterol in their bile, more American Indians have gallstones than other women in the United States.

Among the Pima Indians of Arizona, 70 percent of women have gallstones by age 30.

Infant Deaths
Understanding infant death is difficult and can bring anger, pain, sadness, and confusion. Causes of infant deaths vary, but could include SIDS, birth defects, pre-term/low birthweight, problems from pregnancy, accidents, or respiratory distress syndrome.

In the United States, prematurity/low birthweight is the second leading cause of all infant deaths (during the first year of life).

During 2000-2002 (average) in the United States, preterm birth rates were highest for black infants (17.6 percent), followed by Native Americans American Indians (12.9 percent), Hispanics (11.4 percent), whites (10.7 percent) and Asians (10.2 percent).

American Indian and Alaska Natives have the second highest number of infant deaths in the U.S.—8.9 deaths per 1,000 live births in 2002.

In 2002 about 4 percent of women began care in the third trimester of pregnancy or received no care at all, compared with 6 percent in 1990.

The proportion of women receiving late or no prenatal care was highest among American Indian or Alaska Native women, non-Hispanic black women, and women of Mexican origin (6–8 percent).

69.8 percent of American Indian women received prenatal care began during the 1st trimester in 2002, compared to 83.7 percent of all women of all races.

Obesity and Overweight
Obesity is measured with a Body Mass Index—BMI—which shows the relationship of weight to height. Women with a BMI of 25 to 29.9 are considered overweight, while women with a BMI of 30 or more are considered obese.

Among Americans ages 20 and older, 134.8 million are overweight or obese—68.6 million are men and 66.2 million are women. Of these, 63.1 million are obese—27.5 million are men and 35.6 million are women.

Being overweight or obese increases your risk of heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), osteoarthritis and some cancers.

In one specific population in Arizona, a study found that 80 percent of American Indians were overweight.

Higher BMI predicts the risk for type 2 diabetes in Pima Indians. Type 2 diabetes affects about half of the Pima people.

Among 15 American Indian tribes studied in Oklahoma, 77 percent of adults screened for diabetes are reported to be obese.

Sedentary life style, which can contribute to the development of obesity, has been reported by 44 to 60 percent of Native American men and 40 to 65 percent of women.

Smoking and Tobacco Use
The percentage of American Indian/Alaska Natives ages 12-17 reporting cigarette use during the preceding month, was 29.5 percent for males and 26.3 percent for females. Among those age 18 and older the percentages were 40.9 for men and 40.0 for females.

Smoking increases the risk for a lot of diseases, including cancer, heart attacks, oral diseases and lung problems.

Lung cancer is the largest single cause of cancer deaths in the U.S. For years, men were at higher risk for lung cancer because of their higher smoking rates. However, with the rising number of women who smoke, lung cancer surpassed breast cancer in 1987 as the leading cause of cancer deaths among women.

It is the leading cause of cancer death among American Indians and Alaska Natives.

American Indians and Alaska Natives have the highest smoking rates and use of smokeless tobacco (chewing tobacco or snuff) of any group in the United States.

More people smoke in Alaska and North Plains than in the Southwest, where smoking rates are the lowest.

Sudden Infant Death Syndrome (SIDS)
SIDS remains the leading cause of death in the United States among infants between 1 month and 1 year of age and the third leading cause of death overall among infants less than 1 year of age, according to the National Center for Health Statistics.

The National Center for Health Statistics reported that in 2002 in the United States , 2,295 infants under 1 year of age died from SIDS in the United States.

African American and American Indian infants are two to three times more likely to die from SIDS as other infants.

A study of Northern Plains Indians found that infants were less likely to die of Sudden Infant Death Syndrome (SIDS) if their mothers received visits from public health nurses before and after giving birth.

The Aberdeen Area Infant Mortality Study also found that binge drinking (five or more drinks at a time) during the mother's first trimester of pregnancy made it eight times more likely that her infant would die of SIDS.

The rate of SIDS in the Aberdeen Area of the Indian Health Service, which serves reservations in North and South Dakota, Nebraska and Iowa, is the highest of all of the 12 IHS regions.

In some segments of the American Indian and Alaska Native populations, there have been high rates of suicide. Between 1979 and 1992, the U.S. Surgeon General reported that overall, these groups have a higher rate of suicide, compared to the rest of the American population.

Also, the age of suicide for American Indians is quite unlike that for the general population, because of the high rates among young adults and lower rates among the elderly.

Among American Indian/Alaska Native women ages 15-24, suicide was the 2 nd leading cause of death in 2002.

Content Last Modified: 11/23/2005 1:36:00 PM
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