Authors: Sugarman JR., Brenneman G., LaRoque W., Warren CW, Goldberg HI
Publication Year: 1994
Last Updated: 2010-01-21 08:14:08
Journal: Public Health Reports
Keywords: Adult; Female; Health Surveys; Infant; infant Welfare/Statistics & Numerical Data; Maternal Health Services/Statistics & Numerical Data; Maternal Welfare/Statistics & Numerical Data; Pregnancy; Socioeconomic Factors; Urban Health/Statistics & Numerical Data 

Short Abstract: The Indian Health Service sponsored a special effort to survey mothers of AI infants as part of the 1988 National Maternal and Infant Health Survey (NMIHS), a comprehensive national study conducted by the National Center for Health Statistics, Centers for Disease Control. The authors analyzed questionnaires completed by mothers residing in selected locations served by urban Indian health programs and compared the data with those for women of other races residing in metropolitan areas.

Abstract: Although more than two-thirds of American Indians and Alaska Natives (AI) live outside reservations and Tribal lands, few data sets describe social and maternal-child health risk factors among urban AI. The Indian Health Service sponsored a special effort to survey mothers of AI infants as part of the 1988 National Maternal and Infant Health Survey (NMIHS), a comprehensive national study conducted by the National Center for Health Statistics, Centers for Disease Control. The authors analyzed questionnaires completed by mothers residing in selected locations served by urban Indian health programs and compared the data with those for women of other races residing in metropolitan areas. After adjusting the sample for nonparticipating States, the response rate in the Urban Indian Oversample was 60.8 percent (763 of 1,254). More than 45 percent of AI and black respondents, compared with 15 percent of white respondents, reported an annual household income of less than $10,000. About half of AI and black women, compared with nearly three-quarters of white women, reported having insurance or health maintenance organization coverage during pregnancy. Despite having a similarly low rate of health insurance coverage and low household income, AI respondents were far less likely than black respondents to have Medicaid coverage. A higher proportion of AI women than of black or white women reported difficulties in obtaining prenatal care, and AI women were less likely to obtain prenatal care. AI women were also less likely than white women to obtain prenatal care in the first trimester.(

Source: Link to Original Article.
Funding:
Code: 3092
Source:

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Authors: Indian Health Service

Publication Year: 1998

Last Updated: 2010-01-21 08:14:08

Journal: Indian Health Service, Staff Office of Planning, Evaluation, and Research

Keywords: Community Health Services; Delivery of Health Care; Health Policy; Health Services Administration; Health Services; Rural Health Services

Short Abstract: Purpose: The focus of the Roundtable Conference was the reauthorization of the Indian Health Care Improvement Act (IHCIA), Public Law 94-437.  The purpose of this Roundtable Conference was to stimulate discussion and recommendations regarding the Indian Health Care Improvement Act (IHCIA) that would result in a base of information from which the Indian Health Service (IHS) will begin to plan a tribal consultation process.  

Abstract: Purpose: The focus of the Roundtable Conference was the reauthorization of the Indian Health Care Improvement Act (IHCIA), Public Law 94-437. The purpose of this Roundtable Conference was to stimulate discussion and recommendations regarding the Indian Health Care Improvement Act (IHCIA) that would result in a base of information from which the Indian Health Service (IHS) will begin to plan a tribal consultation process. The expiration of the IHCIA in fiscal year 2000 is of great concern to the participants of this roundtable discussion. Methods: This Roundtable brought together approximately 25 participants from the field of Indian health care delivery and program services. Each participant brought extensive background and expertise in the Indian health care field as tribal leaders, health care providers, public health administrators, urban program directors, and Congressional technical advisors. The participants were asked to: 1) think globally and futuristically about the national health care environment as it is currently evolving; 2) identify environmental influences and changes in the health care industry and the impact on IHS, tribal and urban (ITU) systems; 3) identify opportunities for change in the reauthorization process; 4) envision how " Indian Country" will work with U.S. congressional committees; 5) identify key issues and goals of the new legislation; 6) provide guidance on the IHS/tribal consultation process; 7) discuss emerging trends such as managed care; and 8) be solution oriented. Results The results of this discussion will assist the IHS and local tribal and urban health officials define the many issues involved in the pending reauthorization; changes in health care environment affecting Indian health today; and an analysis of the opportunities presented through the passage of comprehensive health care legislation. The roundtable participants identified health care issues in two major areas. Each of these major areas was reviewed in detail by subgroups of the roundtable participants. The two groups are: 1) Patient Bill of Rights for Indian People and 2) Changing Health Care Environment. Conclusion Recommendations focus on: 1) the National political process and environment and its effect on Indian health; 2) refocus IHCIA on prevention and a meeting the needs of the patient base; 3) public health infrastructure; 4) community ownership of health care delivery systems; 5) urban programs; 6) managed care; 7) health care partnerships - federal, state, tribal governments and the ITUs; 8) psychosocial and behavioral health; 9) tribal self-determination and self-governance; 10 ) cost factors; 11) facilities; 12) health care manpower; 13) billing, reimbursement and financing; 14) health care accessibility; 15) data and technology; 16) long-tem health care

Source: Link to Original Article.

Funding:

Code: 3060

Source:

Type of Resource: Best Practices Newsletter

Authors: Baldwin LM., Grossman DC., Casey S., Hollow W., Sugarman JR., Freeman WL, Hart LG

Publication Year: 2002

Last Updated: 2010-01-21 08:14:08

Journal: American Journal of Public Health

Keywords: Adolescence; Adult; Alaska/epidemiology; Cause of Death; Cross-Sectional Studies; Eskimos/statistical & numerical data; Female; Infant; Infant Mortality; Infant welfare/ethnology; Low Birth Weight; National Center for Health Statistics; Pregnancy; Prenatal Care/standards; Public Health Risk Factors; Rural Health; Urban Health

Short Abstract: Objectives. We sought to provide a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health.

Abstract: Objectives. We sought to provide a national profile of rural and American Indian/Alaska Native (AI/AN) maternal and infant health. Methods. In this cross-sectional study of all 1989-1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (<2500), infant mortality, and cause of death for US rural and urban AI/AN and non AI/AN populations. Results. Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs. 14.4%, P?.001), rates for both groups were over twice that for Whites (6.8%). AI/AN postneonatal death rates (rural=6.7 per 1000; urban=5.4 per 1000) were more than twice of Whites (2.6 per 1000). Conclusions. Preventable disparities between AI/AN and Whites in maternal and infant health status persist. (Am J Public Health. 2002;92:1491-1497)

Source: Link to Original Article.

Funding:

Code: 3028

Source:

Type of Resource: Best Practices Newsletter

Authors:
Publication Year: 2001
Last Updated: 2010-01-21 08:14:08
Journal: Harvard Project on American Indian Economic Development
Keywords: Native America; cultural diversity; American Indian/Alaska Native; tribes; government; leadership; socio-economic status; youth; education; crime; Indian Country; gang violence; teen drug use; family; community

Short Abstract:

It is impossible to weave a concise and meaningful summary of the state of Native America at the new millennium without losing a sense of the cultural richness and diversity that characterizes Indian Country.  The experiences, concerns, problems, and succeses of tribes and individuals are as varied as the American Indian and Alaska Native people themselves.  Indeed, looking across the more than 550 tribes that comprise Indian Country, one sees a picture of diversity-of societies and cultures, of governments and leadership, of organizations and activities, of socio-economic status, and of trends and concerns.  Nonetheless, there are identifiable common threads that tie America's 2.4 million Native Americans together.  The task of this introduction is to highlight th patterns.

Abstract: It is impossible to weave a concise and meaningful summary of the state of Native America at the new millennium without losing a sense of the cultural richness and diversity that characterizes Indian Country.  The experiences, concerns, problems, and successes of tribes and individuals are as varied as the American Indian and Alaska Native people themselves.  They are as different as the subsistence fisherman from the Native Village of Quinhagak, Alaska, is from the Wall Street-savy Mohegan Tribal Council member, as the parliamentary Flathead democracy is from the traditional Cochiti theocracy, and as the Navajo "code talking" veteran of World War II is from the hip-hopping Pima teenager skateboarding on the Gila River reservation.  Indeed, looking across the more than 550 tribes that comprise Indian Country, one sees a picture of diversity - of societies and cultures, of governments and leadership, of organizations and activities, of socio-economic status, and of trends and concerns.  Nonetheless, there are identifiable common threads that tie America's 2.4 million Native Americans together.  The task of this introduction is to highlight the patterns.  At the turn of the millennium, Amerian Indians face old challenges armed with newfound strengths, and new obstacles braced by deep traditions.  A single, yet incisive example of this convergence of past and present concerns youth on the reservation, especially with the respect to two major issues: education and crime.  The need for adequate education continues to challenge tribes, but a recent economic resugence in Indian Country has given many tribes the wherewithal to begin to make up for chronic federal shortfalls in curriculum development and school contstruction funds.  Likewise, while the burgeoning youth population strains standard non-Indian approaches to gang violence, teen drug use, and youth crime, tribes are tapping deep cultural connections to find solutions.  Whether it is the union of Ho-Chunk elders and youth in mentoring programs, the restorative systems of justice for Navajo juveniles, or the training of Ojibwe teens to make music videos in their Native tongue, tribes are finding that traditional intergenerational bonds form a strong foundation for addressing today's issues.  Those bonds of family, community, shared history and shared challenges stretch back through centuries.  They undergird what it is to be "Indian" in America at the new millennium.  They are the foundation on which Indian peoples now strive to define their own futures for themselves.  

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