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General Health Condition of American Indians By Ann Dapice, Ph.D. 2004 Accidents, homicide and suicide kill Indian children and youth in far larger numbers than any other racial group. Later in life, heart disease, chronic liver disease/cirrhosis, and diabetes kill Indian adults greatly out of proportion to other groups. Lung cancer is increasing among Indians but even though Indians smoke more than any other group (Indians—40%, all races—25%), they have usually suffered and died of other maladies before developing lung cancer. Smoking, of course, complicates the other causes of death. American Indians also have the highest incidence of alcoholism of any racial group. The experience of reading statistics on death and disease among Indians is similar to that of reading about a fourth world country in the news. Yet, because these numbers are not “statistically significant” to the US as a whole, they are seldom seen. Indians have become accustomed to hearing statistics regarding other racial groups and noting that while their own disease and death numbers are far greater, Indian numbers are most often ignored. There is little recognition that the history of near extermination, cultural genocide, land loss, oppression, ongoing racism, and poverty are related to not only emotional, spiritual and mental disease, but physical disease as well. These are the result of complex interactions between previously adaptive survival mechanisms, pre-Columbian culture and diet, and include past and present US policy (Dapice, et al, 2001, 2002). In summary, American Indians have higher rates than any other US group of— --Depression and post-traumatic stress disorder --Accidents, suicide, homicide by non-Indians against Indians --Violent crime --Domestic violence --Alcohol and nicotine abuse --Type Two Diabetes with related cardiovascular disease --Unemployment, poverty and school dropout Specific statistics on violence The Bureau of Justice Statistics reports that between 1993 and 1998, American Indians sustained violent victimization at a higher per capita rate than any other group. The highest rates of victimization occurred at the highest poverty rates of less than $10,000 per year. According to 1999 Department of Justice Statistics, comparative violent victimization for ages 12 and older by race was: 1)    124 per 1,000 Native Americans 2)    61 per 1,000 Blacks 3)    49 per 1,000 Whites 4)    29 per 1,000 Asians Interracial victimization. About 7 in 10 victimizations of American Indians involve an offender described by the victim as someone of a different race—a substantially higher rate of interracial violence than experienced by white or black victims. About half of the violent victimization experienced by American Indians involved an offender with whom the victim had a previous relationship. Domestic Violence. Studies also indicate that American Indian and Alaska Native women suffer a disproportionate level of intimate partner violence. The 1999 study by the US Department of Justice’s Bureau of Justice Statistics shows the frequency of battering in Indian Country to be much higher than the national norm. The College of Emergency Physicians Report in 1995 noted that American Indian women are at high risk of homicide, including domestic violence. Homicide is the 3rd leading cause of death for Native women. Of Native American women murdered, more than 75% were killed by a family member, an acquaintance, or someone they knew (Homicide and Suicide Among Native American 1979-1992). Stalking. Jo Hally, Director, Native American Circle, Ltd., notes that while more than one million women in the United States are stalked each year, American Indian/Alaska Native women are stalked at a rate at least twice that of any other race. Statistics established by the 1998 National Violence Against Women Survey reflect that 17 percent of American Indian and Alaska Native women are stalked in their lifetime, compared to 8.2 percent of white women, 6.5 percent of African-American women, and 4.5 percent of Asian/Pacific Islander women. Rape and sexual assault. According to the "American Indians and Crime" report (US Department of Justice, Bureau of Justice Statistics, February 1999) for the period 1992-1996: American Indians were the victims of rape or sexual assault at 3.5 times the rate of United States residents of other races. About 90% of the American Indian victims of rape or sexual assault reported an offender of a different race. Nearly a third of all American Indian victims of violence were between the ages of 18 and 24. American Indian women suffered 7 rapes or sexual assaults per 1,000 compared to 3 per 1.000 among black, 2 per 1,000 among white, and 1 per 1,000 Asians (American Indian and Crime, 1999). Many Native Americans, service providers and national researchers are convinced that, even though statistics reflect an alarming rate of sexual violence in Indian Country, the rate of sexual assault in particular is underrepresented, most likely due to being underreported. The history of cultural and personal oppression of Native American women, fear of familial reprisal and shame, overlapping and confusing federal, state and tribal legal jurisdictions hindering investigations and prosecutions, discourage Native American women victims from obtaining support and justice. As Sheree Hukill, Supervising Attorney for Spirits of Hope Legal Assistance Program (for violence against American Indian women) noted in a personal communication, “Our jurisdiction system is designed so that non-Natives are not accountable to anyone for abuse perpetrated against Native women.” Research and issues remaining.  Brain imaging to assess the unknowns related to domestic violence and stalking is critical, as is research to assess better why American Indians are victimized so much more than any other group by other races.  Legal issues continue related to court systems and laws that allow such crimes to continue to affect Indian women, men and children to such an extent.   There are related complex social issues of high unemployment, lack of education and poverty.   However, adequate treatment that is scientifically based and culturally competent will go a long way to address these ills.  Sadly, we are one of the three facilities in the country that utilize such treatments and the only Indian facility to do so.   Conference opportunities to educate tribal administrators, health facilities, health professionals, and legal systems will address these gaps in care. References. Statistics have been taken from a variety of sources where noted, as well as from the author’s own writings. In order to obtain the most recent statistics, with as little overlap and confusion between years as possible, most statistics can be found in the Indian Health Service October 2002 Family Violence and American Indians/Alaskan Natives: A Compendium by Laura A. Williams, et al.       Thank you to Active iNet Services for hosting this website.    visitors since March 9, 2006