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Non-ceremonial tobacco use among southwestern rural American Indians: the New Mexico American Indian Behavioural Risk Factor Survey.

OBJECTIVES: To ascertain non-ceremonial tobacco use among rural American Indians in New Mexico (United States). DESIGN: A geographically targeted telephone survey. SETTING: Rural New Mexico. PARTICIPANTS: American Indian residents aged 18 years and older. MAIN OUTCOME MEASURES: Prevalence of ever-smokers and current smokers of cigarettes and ever-users and current users of smokeless tobacco, number of cigarettes smoked, and prevalence of cigarette smoking quitting behaviour. RESULTS: Of the 1266 respondents, 38.5% (95% confidence interval (CI) = 34.5% to 42.1%) reported ever smoking, and 16.3% (95% CI = 13.5% to 19.0%) reported being current smokers. Current smokers averaged 7.6 (95% CI = 6.0 to 9.3) cigarettes per day. Current smoking prevalence was highest among men and lowest among college graduates. Prevalence of smokeless tobacco use was 24.1% for ever-use and 7.2% for current use and showed a strong male predominance of use. CONCLUSIONS: The prevalence of current smokers among rural American Indians in New Mexico was lower than among American Indians of other regions in the United States, all New Mexicans, and the national population as a whole. Although smoking prevalence was lower among American Indians in New Mexico, variation by sex and education followed the same patterns as reported among American Indians of other regions.

Adolescent↗

Comparison of drug use rates for reservation Indian, non-reservation Indian and Anglo youth.

Rates of drug use and involvement were compared for three groups: Indian youth living on reservations, Indian youth living off reservations and Anglo youth. A consistent pattern emerged, showing the lowest rates of use among Anglo youth, higher rates among non-reservation Indian youth, and the highest rates among Indian youth on reservations. Rates of tobacco use, both smoked and smokeless, and marijuana use are especially high for Indian youth. Indian youth also show a pattern of earlier initiation to drug use. Gender differences reveal slightly higher rates of use for males, although the differences are not great enough to suggest that prevention efforts for males should have a higher priority.

Adolescent↗

Infant mortality among status Indians on Vancouver Island, British Columbia: evidence of variability within the Status Indian population.

Following reports of high infant mortality in Central Vancouver Island, total and cause-specific infant death rates (IDR) for Status Indians and for Other Residents of Vancouver Island (VI) were compared to those for their counterparts in the rest of the province (RoP). Data for 1991-97, in which Status Indians had been identified through record linkage, were obtained from BC Vital Statistics. The IDR was higher on VI than in RoP for Status Indians (IR = 1.84: 95% CI; 1.43, 3.37), but not for Other Residents (IR = 0.91: 95% CI; 0.79, 1.05). SIDS and perinatal conditions were responsible for most of the increase, with SIDS accounting for about half. This study demonstrates that, in addition to the well-recognized difference in infant mortality between Status Indians and Other Residents, important regional differences exist within the Status Indian population itself. As these differences are relevant to effective health planning and evaluation, health information systems should enable calculation of separate rates for Status Indians.

British Columbia↗

The Indian Health Service approach to alcoholism among American Indians and Alaska Natives.

The transfer to the Indian Health Service (IHS) of 158 alcohol treatment programs that had been administered by the National Institute on Alcohol Abuse and Alcoholism began in 1978. Today, approximately 300 alcohol and substance abuse treatment programs offer services to American Indians, among them primary residential treatment, halfway houses, outreach, and aftercare. This system provides a national network upon which additional activities may be established. Along with increasing its attention to health promotion and disease prevention, the IHS has moved toward the prevention of alcoholism. A variety of preventive programs are in place that emphasize improved self-image, value and attitude clarification, decision-making, and physical and emotional effects of alcohol and substance abuse. Many begin as Head Start programs and continue through adulthood. In 1986, after consulting with both academic and tribal experts, the IHS devised a strategic plan for alcoholism control that stresses comprehensive care and prevention activities; it serves as a guide for further program development. The Secretary of Health and Human Services created a Task Force on Indian Alcoholism in 1986 to serve as a coordinating body for activities carried out by the IHS and other agencies and units of the Department. Passage of the Anti-Drug Abuse Act in 1986 added resources for the development of adolescent treatment centers and, more importantly, for community-based pre- and post-residential care for youths and their families. Concomitant with these initiatives have been several instances of increased attention by various tribes to the problem of alcoholism. The IHS strategic plan, together with the Secretary's initiative, the Anti-Drug Act, and tribal actions, has added substantial momentum to efforts directed at controlling alcoholism among American Indians. Although the mortality rate from alcoholism is about four times greater for the American Indian population than for the entire U.S. population, it decreased from 54.5 per 100,000 population to 26.1 between 1978 and 1985-a reduction of 52 percent.The philosophy of the IHS in emphasizing prevention of disease and promotion of wellness provides an opportunity for continuing the considerable progress already made. The critical and decisive role played by the Indian communities themselves will determine whether ultimate success can be achieved.

Adolescent↗

Initiation of formal death investigation procedures among the Northern Plains Indians: a necessary adjunct in the study of American Indian sudden infant deaths.

The high rate of infant mortality among native peoples in the Aberdeen Service Area of the Indian Health Service (primarily North and South Dakota) prompted a multi-institutional study of this problem. The study investigators assumed that local coroners or medical examiners would be able to perform suitable death scene investigations. However, during the design portion of the study it became apparent that, with one exception, none of the participating Indian Nations had a death investigator or even a legal mandate to provide death investigation. To allow the study to go forward, and ultimately to better the community health within its service area, the Aberdeen Area Indian Health Service submitted a draft enabling coroner legislation/resolutions to the area tribes. By November of 1996, 6 of the 19 Indian Nations enacted enabling coroner legislation. To facilitate both the study and general death investigation within the area, the Aberdeen Area Indian Health Service since 1993 has held five 2-day death investigation training programs covering a variety of death investigation topics which were attended by 68 participants. Without further recognition of the need for tribal death investigation and additional funding, these gains in tribal death investigation will probably be transitory.

Cause of Death↗

Activity of glucose-6-phosphate dehydrogenase among Indians living in a malarial region of Mato Grosso and its implication to the Indian-mixed populations in Brazil.

Erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) activity and electrophoresis were investigated among 154 Indians living in a region hyperendemic for malaria at Alto Xingu, Mato Grosso, Brazil. No enzyme-deficient individual was found, and all subjects belonged to enzyme type B. No statistical difference in G-6-PD levels was found between tribes and sexes. The average of G-6-PD activity of the Indians was significantly higher than the normal mean values found by the same technique in Caucasians, Negroes and Japanese of Säo Paulo, Brazil. The high rates of G-6-PD activity of the Indians are not correlated to an increased reticulocytosis by hypochromic anaemia and appear to be typical of Indian or Indian-mixed populations. Resistance to malaria in those populations should not involve erythrocyte G-6-PD deficiency. It is suggested that the apparent association between G-6-PD deficiency and resistance to malaria found in other populations could be a statistical accident determined by the racial correlation between the incidence of G-6-PD deficiency and sickle-cell or thalassaemic haemoglobins among Negro and Mediterranean populations.

ABO Blood-Group System↗

Public health issues concerning American Indian and non-Indian uranium millworkers.

An exploratory study of 170 former American Indian (83) and non-Indian (87) uranium millworkers who worked in six mills was conducted in the southwestern United States. It was found that over 80 percent of the former millworkers felt they were not informed about the hazards of radiation during their employment and a majority reported respiratory diseases or symptoms. Study findings include a comparison of Indian and non-Indian perceptions of mill working conditions and self-reported health histories. The Indians have not been studied previously as a distinct group and, given their low smoking incidence, an epidemiologic study is warranted. Issues related to adequate diagnoses of workers' health problems are presented.

Arizona↗

Differences between American Indian and non-Indian children referred for psychological services.

The physical and social characteristics of 60 American Indian children referred for psychological services were compared to those of 60 matched, non-Indian controls. Data were obtained from detailed records available in a multidisciplinary, medical school-related child study clinic. Indian children exhibited more health and social risk factors, but were superior to non-Indians on a variety of motor variables. Interpretations are offered concerning better psychological services for American Indian children based on better understanding of their possible exposure to physical health and social risks which may be related to psychological development.

Adolescent↗

mtDNA provides the first known marker distinguishing proto-Indians from the other Caucasoids; it probably predates the diversification between Indians and Orientals.

The concomitant presence of the two sites Ddel at 10,394 and Alul at 10,397 has been considered an East-Asian marker of ancient origin (it was also observed in Australians, Melanesians and Native Americans). Unexpectedly, it was found in more than 50% of Indians (133 Hindus and 30 Tribals) who had shown Caucasoid characteristics not only at nuclear DNA but also at mtDNA level. It can therefore no longer be considered an exclusively East-Asian mtDNA feature. The analysis of more than 200 Caucasoids, mainly from the Mediterranean basin, showed that it is only sporadically present in these people. Thus it represents the first known marker which distinguishes Indians from the other Caucasoids. The lack of this marker in Indian mtDNA molecules carrying Caucasoid characteristics suggests that it predates the invasion of India by speakers of an Indo-European language and, if it is valid to extrapolate from Near Eastern data, the arrival in India of the farmers who spread the Dravidian language. If this polymorphism had a common origin in both Orientals and Indians, it should also predate the diversification between ancient Indians and Mongoloids.

Africa South of the Sahara↗

High nucleotide and amino acid sequence similarities in tumour necrosis factor-alpha amongst Indian buffalo (Bubalus bubalis), Indian cattle (Bos indicus) and other ruminants.

Tumour necrosis factor-alpha (TNF-alpha) mRNA from Indian water buffalo (Bubalus bubalis) and Indian cattle (Bos indicus) was reverse transcribed and amplified using reverse transcriptase-polymerase chain reaction (RT-PCR). The nucleotide sequences of cDNAs were determined after cloning into pGEM-T-Easy vector (Promega, Madison, WI) and compared with reported nucleotide sequences of TNF-alpha cDNA from other species. The nucleotide sequences of TNF-alpha from Indian cattle revealed significantly high similarities at nucleotide (99.2%) and amino acid (100%) levels with those of cattle (Bos taurus; Zebu). The sequences from buffalo had 98.4% nucleotide and 99.1% amino acid similarities with Indian cattle, indicating functional cross-reactivity. One amino acid deletion at position 63 and one substitution (A-->P) at position 64 were observed in buffalo compared with Indian cattle. The amino acid deletion at position 63 was predicted due to differences in pre-mRNA splicing.

Amino Acid Sequence↗

High-resolution mtDNA studies of the Indian population: implications for palaeolithic settlement of the Indian subcontinent.

The population of the Indian subcontinent represents a very complex social and cultural structure. Occupying a geographically central position for the early modern human migrations, indications are that the founder group that migrated out of East Africa also reached India. In the present study we used the twin strategy of mapping the whole mitochondrial DNA (mtDNA) using the standard 14 restriction enzymes, and sequencing the non-transcribed HVSI region, to derive maximum maternal lineages from a sample of non-tribal Indians. The essential features of the reduced median network of the two datasets were the same. Both showed two demographic expansions of two major haplogroups, 'M' and 'N'. The reduced median network was drawn with inputs from other studies on the Indian population, and correlated with data from other ethnic populations. The coalescence time of expansions and genetic diversity were estimated. A reduced median network was also drawn combining data from studies on Africans, Southeast Asians and West-Eurasians, tracing the migration of 'M' from East Africa to India. A time estimate of the migration of major mtDNA haplogroups from Africa was attempted. The comparison of a set of Indian maternal lineages belonging to different geographical regions of the country, with other populations revealed the in-situ differentiation and antiquity of the Indian population. Our analysis places the 'southern route' migration as the source of haplogroup 'M'. Multiple migrations might have brought the other major haplogroups, 'N' and 'R', found in our sample to India. Archaeological evidence of modern humans in the subcontinent supports this mtDNA study.

Cluster Analysis↗

Suicide and self-burning among Indians and West Indians in England and Wales.

Suicide levels in England and Wales during 1979-83 were low among males from the Indian subcontinent (SMR 73) and significantly high in young Indian women (age-specific ratios 273 and 160 at ages 15-24 and 25-34 respectively). Suicide levels were low in Caribbeans (SMRs 81 and 62 in men and women respectively) and high in East Africans (SMRs 128 and 148 in men and women respectively). The excess in East Africans (most of whom are of Indian origin) was largely confined to younger ages. Immigrant groups had significantly higher rates of suicide by burning, with a ninefold excess among women of Indian origin. The pressures leading to higher suicide levels among young women of Indian origin highlight the need for making appropriate forms of support and counselling available to this community.

Adolescent↗

Knowledge and practice: the risk of cardiovascular disease among Asian Indians. Results from focus groups conducted in Asian Indian communities in Northern California.

OBJECTIVE: The focus groups were utilized to gather information on the perceptions of cardiovascular risk within the Asian Indian community, and to identify opportunities to design health promotion and intervention programs for Asian Indian communities. DESIGN: Qualitative methods were utilized to obtain perceptions of cardiovascular risk within 3 Asian Indian communities. Eight focus groups were conducted in either English or Punjabi. SETTING: These focus groups were conducted as part of a 3-year community-based participatory research project examining cardiovascular risk factors among the Asian Indian population in Northern California. PARTICIPANTS: Focus group participants were selected through referrals from community-based organizations, postings in local community centers, and businesses. Fifty-seven men and women were recruited using snowball sampling. RESULTS: Six themes emerged from the focus groups: knowledge of cardiovascular disease, health and cultural concerns regarding diet, physical activity levels, stress as a factor for cardiovascular disease, acculturation concerns, and cardiovascular prevention ideas. CONCLUSIONS: The use of focus groups was an effective method for gathering information on perceptions of cardiovascular risk, and collecting information on risk behaviors within these Asian Indian communities. In this study, we found that psychosocial and cultural factors, especially cultural issues concerning stress and acculturation, surfaced as key elements across all 8 focus groups.

Acculturation↗

Maxillary first premolar angular differences between North American Indians and non-North American Indians.

A quantitative technique for obtaining angular data on human maxillary first premolar teeth is presented. Measurement indicates that North American Indian buccal cusps are either buccolingually compressed mesially, or expanded distally, or both, when compared with non-Indian teeth. Surprisingly, data on Chinese and Eskimo samples are similar to non-Indian teeth rather than Indian teeth. Similar techniques may be applied to the more complex multicusped molar teeth in order to extract quantitative data from them.

Asian People↗

Environmental justice in Indian country: dumpsite remediation on the Swinomish Indian reservation.

The U.S. Environmental Protection Agency (EPA) defines environmental justice as the "fair treatment for people of all races, cultures, and incomes, regarding the development of environmental laws, regulations, and policies." The last decade has focused considerable national attention on the environmental pollution inequity that persists among the nation's poorest communities. Despite these environmental justice efforts, poor communities continue to face adverse environmental conditions. For the more than 550 Native American communities, the struggle to attain environmental justice is more than a matter of enforcing national laws equitably; it is also a matter of a federal trust duty for the protection of Indian lands and natural resources, honoring a promise that Native American homelands would forever be sustainable. Equally important is the federal promise to assist tribes in managing their reservation environments under their reserved powers of self-government, an attribute that most distinguishes tribes from other communities. The PM Northwest, Inc. (PMNW) dumpsite is located within the boundaries of the Swinomish Indian Reservation in Washington State. Between approximately 1958 and 1970, PMNW contracted with local oil refineries to dispose of hazardous wastes from their operations at the reservation dumpsite. Almost two decades would pass before the Swinomish tribe was able to persuade EPA that a cleanup action under Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) was warranted. This article reviews the enduring struggle to achieve Indian environmental justice in the Swinomish homeland, a process that was dependent upon the development of the tribe's political and environmental management capacity as well as EPA's eventual acknowledgement that Indian environmental justice is integrally linked to its federal trust responsibility.

Environment↗

HLA class I variation controlled for genetic admixture in the Gila River Indian Community of Arizona: a model for the Paleo-Indians.

The genetic distribution of the HLA class I loci is presented for 619 "full blooded" Pima and Tohono O'odham Native Americans (Pimans) in the Gila River Indian Community. Variation in the Pimans is highly restricted. There are only three polymorphic alleles at the HLA-A locus, *A2, *A24, and *A31, and only 10 alleles with a frequency greater than 0.01 at HLA-B where *Bw48 (0.187), *B35 (0.173), and the new epitope *BN21 (0.143) have the highest frequencies. Two and three locus disequilibria values and haplotype frequencies are presented. Ten three-locus haplotypes account for more than 50% of the class I variation, with *A24 *BN21 *Cw3 (0.085) having the highest frequency. Gm allotypes demonstrate that little admixture from non-Indian populations has entered the Community since the 17th century when Europeans first came to this area. As a consequence many alleles commonly found in Europeans and European Americans are efficient markers for Caucasian admixture, while the "private" Indian alleles, *BN21 and *Bw48, can be used to measure Native American admixture in Caucasian populations. It is suggested that this distribution in "full blooded" Pimans approximates that of the Paleo-Indian migrants who first entered the Americas between 20,000 and 40,000 years ago.

Alleles↗

Dogrib Indians of the Northwest Territories, Canada: genetic diversity and genetic relationship among subarctic Indians.

Phenotypes and gene frequencies of genes at the ABO, Rhesus, MNSs, Diego, Duffy, Kell, Kp, Kidd and P blood group systems are presented for three villages of Dogrib Indians. This population resides between Great Slave and Great Bear Lakes in the Northwest Territories of Canada. Until recently they pursued an exclusively hunting-gathering-fishing lifestyle in the subarctic forest. Maximum European admixture in the Dogrib is 8.7%. Nei's coefficient of gene diversity, GST is 0.0121. Blood group data from other Athapaskan-speaking Indians were also examined. GST for Kutchin villages is approximately 1.1%. GST obtained over five tribes of Northern Athapaskans is 0.0264, a figure slightly lower than that found in comparable groups of Mexican Indians. Overall genetic differentiation (HT) in Northern Athapaskans was greater than in the Mexicans, presumably because of high, though nonquantifiable European admixture in some of the tribes. The bulk of the genetic variability in Athapaskans exists within tribes, and then within villages of the same tribe. Genetic distance analysis with Nei's standard distance D shows that Dogrib and Kutchin Indians are very close. Geographic proximity has no significant influence on inter-tribal gene flow, but is significantly associated with intra-tribal gene flow.

Adult↗

Diabetes education materials: recommendations of tribal leaders, Indian health professionals, and American Indian community members.

PURPOSE: The Association of American Indian Physicians, the only national organization of its kind, conducted a series of focus groups to gather input from tribal leaders, Indian health professionals, and American Indian community members to guide the development of culturally appropriate diabetes education materials for the National Diabetes Education Program. METHODS: During the focus groups, participants shared their experiences with and recommendations for a variety of diabetes education materials. RESULTS: Overall, 95% of participants expressed a strong preference for diabetes education materials relevant to their specific tribe or culture. CONCLUSIONS: Recommendations from these focus groups were used to develop a national diabetes education campaign for American Indian communities.

Adolescent↗