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At least 55 records · Page 3Linked to original sources
PubMed2006

Prostate cancer in Alaska Native men, 1969-2003.

OBJECTIVES: The incidence of prostate cancer differs significantly between US race groups. In prior reviews of cancer in Alaska Natives, the incidence of prostate cancer has been observed to occur at a low rate compared to US Whites and Blacks. However, a detailed report of prostate cancer in this population has not been previously published. STUDY DESIGN: Incidence of prostate cancer in Alaska Native men was determined for the time period 1969-2003 using data from the Alaska Native Tumor Registry. The registry is a population-based registry which participates in the National Cancer Institute Surveillance, Epidemiology and End Results Program, and has collected cancer information on Alaska Natives since 1969. METHODS: Incidence rates were calculated for all Alaska Natives and for each of the three major ethnic groups (Aleut, Eskimo, Indian). Comparisons of incidence rates between Alaska Natives and US Whites were performed using odds ratios. Temporal changes were identified by a Chi square analysis for trend. RESULTS: During the 35-year period of review, 332 Alaska Native men were diagnosed with prostate cancer. The age-adjusted incidence rate of 69.5 per 100 000 in Alaska Native men during 1994-2003 was significantly higher than the rate of 45.5 per 100 000 for the earlier period 1969-1983. The US White rate for 1994-2002 of 169.5 per 100 000 was significantly higher than the rate for Alaska Native men for 1994-2003. Results of comparisons between Alaska Native ethnic groups for 1969-2003 showed that prostate cancer was highest in Indians and Aleuts and lowest among Eskimos. CONCLUSIONS: Compared to the US White population, the incidence of prostate cancer in Alaska Native men is significantly lower. Prostate cancer rates among Alaska Native ethnic groups differ. The reason for these differences remains undetermined.

Adult↗
PubMedDate not supplied

Pilot test of a cervical cancer prevention video developed for Alaska Native women.

Cancer of the cervix is twice as likely to occur among Alaska Native women than among Caucasian women in the United State. To understand some of the factors associated with this high incidence, a random sample of 528 Alaska Native women were surveyed about their knowledge, attitudes, and behavior regarding cervical cancer and its risk factors. From the results of the Alaska Native Women's Health Project study, the need for more public education related to cervical cancer prevention was identified. A review of existing educational resources revealed that no culturally appropriate materials related to cervical cancer had been developed for Alaska Native women. To increase Native women's knowledge about cervical cancer and to motivate them to obtain annual Papanicolaou tests, a 12-minute videotape presentation was developed specifically for this population. The videotape portrayed Alaska Native women as role models from the community discussing cervical cancer and Papanicolaou tests and engaging in healthy lifestyles. The videotape was pilot tested with several groups of Alaska Native women. The women were surveyed before and after watching the video and were asked to rate the tape and make comments about it. The results of the posttest demonstrated a significant increase in the knowledge level of the participants. The videotape was well received because of its cultural sensitivity and appropriateness. On the basis of this study, the development of additional culturally appropriate educational materials related to cancer prevention of Alaska Native women is recommended.

Adolescent↗
PubMed1990

Federal nutrition services for American Indian and Alaska native elders.

American Indian and Alaska native elders have a poverty rate of 61% and a life expectancy between 3 and 4 years less than that of the general older U.S. population. In 1978, Congress enacted a separate title under the Older Americans Act to address some of the special needs of American Indian elders. Since enactment of specific provisions for American Indians, Congress has continued to amend the Older Americans Act to ensure that the nutritional needs of American Indian elders are addressed. Currently, federal nutrition services are provided to American Indian and Alaska native elders through both Title III, Grants for State and Community Programs on Aging, Part C, Nutrition Services, and Title VI, Grants for Native Americans, of the Older Americans Act. In fiscal year 1987, more than 52,000 American Indian and Alaska elders received meals from congregate nutrition sites and/or home-delivered meals.

Aged↗
PubMedDate not supplied

Occurrence of esophageal and gastric cancer in Alaska Natives, 1969-2003.

BACKGROUND: Early reports of esophageal and gastric cancer in American Indians/Alaska Natives documented high rates. METHODS: Esophageal and gastric cancers in Alaska Natives were reviewed for 1969-2003 using the Alaska Native Tumor Registry database. Alaska Native incidence rates were age-adjusted and compared to rates of several US populations. RESULTS: The incidence of esophageal and gastric cancer has remained relatively stable during the 35-year period. Gastric cancer is higher than that seen in US Whites, Blacks and American Indians of New Mexico and similar US Asian/Pacific Islanders. Esophageal cancer incidence is higher than US Whites, Asian/Pacific Islanders and American Indians of New Mexico but similar to US Blacks. CONCLUSION: The rates of esophageal and gastric cancer in the Alaska Native population have remained high over 35 years. While the rate of gastric cancer has declined among US Whites, a similar decline has not been seen in Alaska Natives.

Alaska↗
PubMed1994

Use of mental and health services by American Indian and Alaska Native elders.

American Indian and Alaska Native elders are an important at-risk population in need of mental health services, yet little is known about the factors that influence Indian/Native elders to actually seek mental health services. This study uses the Anderson and Newman conceptual framework to identify need as well as enabling and predisposing factors for mental health service use in a national sample of reservation and urban American Indian and Alaska Native elders. Results indicate that self-perceived need is the strongest predictor of mental health service use for elders living on reservations. However, for Indian/Native elders in urban areas, degree of mental impairment is most likely to predict use of mental health services. For both groups of elders, enabling variables, such as total income, level of education and access to medical insurance, were the least important in influencing whether or not an elder elected to use mental health services.

Aged↗
PubMed2003

Establishing a culturally sensitive palliative care program in rural Alaska Native American communities.

End-of-life programs that provide an option for patients to die at home are available in most U.S. communities. However, Alaska Natives living in remote Alaska villages often die alone in hospitals and nursing homes hundreds of miles away from home. The Bristol Bay Area Health Corporation (BBAHC), a tribal organization, is the sole provider of comprehensive primary care services to 34 Alaska Native villages located within a 46,000 square mile area in southwest Alaska. The closest tertiary care hospital is 329 air miles away in Anchorage. Because of the high cost of, and difficulties encountered in trying to deliver end-of-life care services to remote communities, a village-focused, culturally sensitive, volunteer and primary care program combined with a regionally based physician and home health nurse to deliver multi-disciplinary palliative care was developed. The Helping Hands Program blends cultural practices with contemporary palliative care medicine to allow Alaska Natives and others living in remote communities to be cared for at home through the end of life. Since the program was implemented in 1999, the percentage of home deaths for selected causes has changed from 33% in 1997 to 77% in 2001. The Anchorage-based Alaska Native Tribal Health Consortium (ANTHC) and the Alaska Native Medical Center (ANMC) have recognized the importance and success of the BBAHC program and are investigating expanding the program to other parts of Alaska. Centralizing the program in Anchorage will allow staff trained in palliative care to travel to regional Alaska Native hospitals to help train health care professionals.

Alaska↗
PubMed2003

Asthma prevalence among Alaska Native and nonnative residents younger than 20 years enrolled in Medicaid.

BACKGROUND: No study of childhood asthma prevalence in Alaska or among Alaska Natives has been conducted. OBJECTIVE: To determine asthma prevalence among Alaska Medicaid enrollees younger than 20 years, with an emphasis on Alaska Natives, the state's largest minority and predominant rural citizens. METHODS: A master database was obtained that included all children enrolled in Medicaid during July 1998 through June 1999. Physician, pharmacy, and hospital claims files for International Classification of Diseases codes 493.0x to 493.9x were linked to this master database. Asthma was defined as any asthma-related care or medication claim. RESULTS: Asthma prevalence among the study population was 6.9%. Alaska Natives had a lower asthma prevalence than nonnatives (risk ratio [RR], 0.70; 95% confidence interval [CI], 0.66-0.75), but among the subgroup of children residing in the state's major urban center, Alaska Natives had a higher prevalence. Overall, 0.22% of the study population experienced an asthma-related hospitalization, with Alaska Natives having a higher risk of hospitalization than nonnatives (RR, 1.6; 95% CI, 1.2-2.3). Among hospitalized children, Alaska Natives were less likely to have received a long-term control medication (RR, 0.54; 95% CI, 0.33-0.88). CONCLUSIONS: Compared with nonnatives, Alaska Natives have a lower risk of asthma but only among nonurban residents. The increased risk of hospitalization among Alaska Natives may be related to underuse of long-term control medications.

Administration, Inhalation↗
PubMedDate not supplied

Tobacco erases 30 years of progress: preliminary analysis of the effect of tobacco smoking on Alaska Native birth weight.

OBJECTIVE: Investigate the relationship between tobacco and/or alcohol use and Alaska Native birth weight. METHODS: Data on weight, tobacco smoking and alcohol use among Alaska Natives were abstracted from 1989-91 Indian Health Service natality records based on birth certificates. RESULTS: Birth certificate data were available for 9,175 live births. Single live births were analyzed for 8,994 Alaska Natives. In women with no tobacco smoking the mean birth weight of their infants was 3,571 g; 1-5 cigarettes/day 3,429 g; 6-10 cigarettes/day 3,332 g (p < .05); and > 10 cigarettes/day 3,260 g (p < .05). Infants of Alaska Natives who reported no alcohol and no tobacco use had a mean birth weight of 3,579 g; alcohol use but no tobacco use 3,452 g; no alcohol but tobacco use 3,388 g; and both alcohol and tobacco use 3,281 g. (p < .001). CONCLUSIONS: The mean birth weight of infants born to Alaska Native women with the highest use of tobacco were reduced by over 300 g compared to non-smoking Alaska Native women. Mean infant birth weight of tobacco smoking Yup'ik women in 1989-91 were reduced by over 400 g, comparable to weights reported in the 1960s.

Alaska↗
PubMed1998

Alaska native suicide: lessons for elder suicide.

Suicide rates in Alaska Native elders are studied to further explore cultural factors in elderly suicide. Data for the 1960s and 1970s are reviewed, and new data on Alaska Native suicide rates are presented for the 10-year period of 1985 through 1994. In many areas throughout the world, suicide rates are the highest for the elderly. During the Alaska "oil boom," suicide rates more than tripled for the general population but decreased to zero for Alaska Native elders. Cultural teachings from the society's elders were more important during this time of culture upheaval. During the study period, the cultural changes dissipated, and suicide rates for Alaska Native elders, although lower than those of White Alaskans, increased. This provides further evidence that suicide rates for elders can be influenced by social factors--both to raise to lower rates.

Adolescent↗
PubMed2003

Cardiovascular disease among Alaska Natives: a review of the literature.

BACKGROUND: We reviewed the literature of population-based studies regarding heart disease and stroke occurrence among Alaska Natives. The existing literature suggests that differences in cardiovascular mortality rates and risk factors exist in Alaska Natives by ethnicity and residence. However, data sources are largely limited to mortality data and small community-based studies. OBJECTIVES: Because cardiovascular disease occurrence has not been well studied among Alaska Natives, it is important to avoid sweeping generalizations about the increasing or decreasing prevalences of cardiovascular disease and risk factors. RESULTS: Recent mortality rates from heart disease (of all types) among Alaska Natives are similar to rates for U.S. whites, and mortality rates from stroke among Alaska Natives are higher than rates for U.S. whites. Mortality rates from ischemic heart disease have been relatively constant among Alaska Natives over the past 20 years, while over the same time period, rates declined dramatically among U.S. Whites. The ischemic heart disease mortality rates among Alaska Native males are now comparable to rates among U.S. White males. CONCLUSIONS: Although available data indicate no increase in mortality from ischemic heart disease in Alaska Natives, the relatively constant death rates over the recent 20 years, compared with declining rates elsewhere in the U.S, and the high prevalence of risk factors for ischemic heart disease calls for increased descriptive epidemiologic studies of the incidence and prevalence of cardiovascular disease outcomes. In addition, analytic epidemiologic studies are needed to examine the relationship between lifestyle, especially subsistence and traditional lifestyles, and cardiovascular disease outcomes.

Alaska↗
PubMed2000

Alcohol control and injury death in Alaska native communities: wet, damp and dry under Alaska's local option law.

OBJECTIVE: This article tests whether different forms of community-level alcohol control significantly affect injury deaths in a population with extremely high injury mortality. METHOD: The 1981 Alaska local option law provides a natural experiment for studying how implementation of community level controls may be associated with changes in injury deaths, most of which are alcohol-related, among Alaska Natives living in small communities. The study compares population and community-specific death rates under different levels of alcohol control for the 97 communities that passed restrictions between 1980 and 1993 with the death rates in the same communities during periods when no restrictions were in place. RESULTS: Injury death rates were generally lower during periods when alcohol sales, importation or possession were restricted than when no restrictions were in place (wet). More restrictive controls (dry) significantly reduced homicides; less restrictive control options (damp) reduced suicides. Accident and homicide death rates fell, on average, by 74 and 66 per 100,000, respectively, for the 89 communities that banned sale and importation or possession. A control group of 61 small communities that did not change control status under the law showed no significant changes over time in accident or homicide death rates. CONCLUSIONS: The changes in accidental and homicide death rates are statistically significant, although these reduced rates remain 2.5 to 7 times national death rates. The isolated nature of Alaskan villages may explain why alcohol control has more effect in Alaska than has been found in studies of Native Americans living in other states.

Accidents↗
PubMedDate not supplied

The financial burden of injury-related hospitalizations to an Alaska Native health system.

The injury death rate in Alaska for American Indians and Alaska Natives is more than triple the injury death rate for the United States. We examined the direct medical expenditures for injury-related hospitalizations to one Alaska Native health care system, the Tanana Chiefs Conference in Interior Alaska, to identify priorities for injury prevention and to promote efforts at prevention. The total expenditure for the 511 injuries resulting in hospitalizations from 1994-1998 was $4,145,440. Suicide attempts, falls, and acts of violence were the most frequent causes of injury hospitalization. Injuries caused by acts of violence, suicide attempts, and falls had the highest overall expenditures. On a per-victim basis, unintentional injuries involving the use of firearms and snowmobile/all-terrain vehicle injuries were the most expensive. We hope this report will raise the visibility of injuries as a prevention priority for Alaska Native communities, Native health systems, and community action programs.

Accidental Falls↗
PubMedDate not supplied

Alaska native mortality, 1979-1998.

OBJECTIVES: This study compares mortality patterns for the Alaska Native population and the U.S. white population for 1989-1998 and examines trends for the 20-year period 1979-1998. METHODS: The authors used death certificate data and Indian Health Service population estimates to calculate mortality rates for the Alaska Native population, age-adjusted to the U.S. 1940 standard million. Data on population and mortality for U.S. whites, aggregated by 10-year age groups and by gender, were obtained from the National Center for Health Statistics, and U.S. white mortality rates were age-adjusted to the U.S. 1940 standard million. RESULTS: Overall, 1989-1998 Alaska Native mortality rates were 60% higher than those for the U.S. white population for the same period. There were significant disparities for eight of 10 leading causes of death, particularly unintentional injury, suicide, and homicide/legal intervention. Although declines in injury rates can be documented for the period 1979-1998, large disparities still exist. Alaska Native death rates for cancer, cerebrovascular disease, chronic obstructive pulmonary disease, and diabetes increased from 1979 to 1998. Given decreases in some cause-specific mortality rates in the U.S. white population, increased rates among Alaska Natives have resulted in new disparities. CONCLUSIONS: These data indicate that improvements in injury mortality rates are offset by marked increases in chronic disease deaths.

Adolescent↗
PubMed2005

Improving the oral health of Alaska Natives.

There is a high prevalence of oral disease in the Alaska Native population, much of which goes untreated, creating a large discrepancy between the level of their oral health and that of the general population. The causes of this discrepancy are multiple--a major cause being the lack of access to care, especially in remote Alaska Native villages. Improving the oral health status of Alaska Natives will require treatment of current disease and initiation of an effective program to prevent oral disease. Cooperation between the Alaska Native organizations, dental health aides, the dental profession, and the government will be important. A strategy that combines addressing the disease currently present and preventing the occurrence of disease in the long run is the only strategy that offers a sustainable solution.

Adolescent↗
PubMed1993

Alcohol and suicide in Alaska Natives.

A retrospective review of hospital records from the Alaska Native Medical Center, controlled for age, sex, and race, is presented for 33 Alaska Native suicide completers who died between 1980 and 1984. Suicide rates for Alaska Natives were twice the national average during the study period. The only significant differences between the suicide and control groups was the history of a prior suicide attempt (p 0.003). Alcohol abuse was diagnosed more often than any other psychiatric disorder in the suicide group and appears to be the most important antecedent of suicide in this study.

Alaska↗
PubMed1992

Severity and frequency of sequelae of bacterial meningitis in Alaska Native infants. Correlation with a scoring system for severity of sequelae.

OBJECTIVES: To (1) determine the frequency and severity of sequelae of Haemophilus influenzae type b and Streptococcus pneumoniae meningitis in Alaska Native children, (2) compare morbidity and mortality of H influenzae b and S pneumoniae meningitis, and (3) evaluate the applicability of the Herson-Todd prognostic score (HTPS) to both H influenzae b and S pneumoniae meningitis in this population. DESIGN: A retrospective study of all cases of H influenzae b and S pneumoniae meningitis in Alaska Native children younger than age 5 years. Data on meningitis sequelae, obtained from medical charts and records of the Infant Learning Program, were collected, and incidence of sequelae tabulated. Data obtained on admission to the hospital were used to calculate HTPS. SETTING: Indian Health Service facility for the Yukon-Kuskokwin Delta region of southwest Alaska. STUDY SUBJECTS: 51 of 63 Alaska Native children with H influenzae b meningitis and 13 of the same 63 Alaska Native children with S pneumoniae meningitis occurring between 1980 and 1988. One child was infected with both organisms, producing a total of 64 cases for study. SELECTION PROCEDURES: Cases were identified by surveillance for these diseases between January 1, 1980, and December 31, 1988, maintained by the Arctic Investigations Program, Centers for Disease Control. MEASUREMENTS AND RESULTS: Sequelae of bacterial meningitis caused by H influenzae b were equal to or exceeded rates of sequelae described in other children in the United States. After H influenzae b meningitis, motor abnormalities (29%) and hydrocephalus (7%) occurred two to four times more often in Alaska Native children than in children in other parts of the United States. Differences in severity of H influenzae b sequelae could not be accounted for by microbiologic markers of the H influenzae b strain, including ampicillin sensitivity, biotype, outer membrane protein type, or electropherotype. Numbers of cases of S pneumoniae meningitis were too small for statistically valid comparison, but sequelae of S pneumoniae meningitis occurred in roughly equal proportion as sequelae of H influenzae b meningitis. The HTPS was applied to Alaska Native children with H influenzae b meningitis and was found to be very accurate in predicting children with major sequelae. Analysis of the prognostic factors used in deriving the HTPS revealed a unique set of predictors for sequelae in Alaska Native children: seizures at admission, glucose levels in cerebrospinal fluid of less than 1.1 mmol/L; and male gender, with a significant predictive interaction between male gender and age less than 6 months at admission. CONCLUSIONS: Alaska Native children suffer greater neurologic morbidity as a result of H influenzae b meningitis than do their non-Native counterparts. The HTPS was a good predictor of major sequelae in Alaska Native children with H influenzae b or S pneumoniae meningitis and could be useful in determining which patients need referral to a tertiary care center.

Alaska↗
PubMed2000

Alcohol dependence among Alaska Natives entering alcoholism treatment: a gender comparison.

OBJECTIVE: An ongoing study of phenotypes of alcohol dependence among Alaska Natives provides an opportunity to investigate the nature and patterns of alcohol problems among Alaska Native men and women admitted to treatment in three residential programs in Anchorage, Alaska. METHOD: A comprehensive, standardized clinical assessment (including the SSAGA-I diagnostic interview, family history information, personality traits and cognitive functioning) of consecutive admissions to each of the three programs is being undertaken by trained interviewers. To date, 200 (103 male) subjects have been assessed. The mean (+/- SD) age of the sample is 32+/-8.5 years old. The development of alcohol problems, the psychological and physical consequences of chronic drinking, the flushing response, withdrawal symptoms and comorbid lifetime psychiatric conditions were examined. RESULTS: The sample was characterized by an early onset of drinking and an acute exacerbation and clustering of drinking problems during late adolescence, followed by the development of severe alcohol dependence. A high lifetime prevalence of DSM-III-R major depressive disorder was found, typically complicated by chronic drinking. The rates of other substance dependencies were relatively low, except for cannabis and cocaine dependence among female subjects. CONCLUSIONS: This sample of treatment-seeking Alaska Natives was found to have an early onset and severe form of DSM-III-R alcohol dependence, with few gender differences noted. While the prevalence of alcohol abuse and alcohol dependence among Native American populations has been reported to be quite high, the onset and patterning of symptoms among this sample of treated Alaska Natives has revealed more similarities with treated alcoholics from the majority population than important differences specific to Alaska Natives.

Adult↗
PubMed1991

Health implications of obesity in American Indians and Alaska Natives.

American Indians and Alaska Natives (AI/ANs) are experiencing an epidemic of diabetes, increasing rates of coronary artery disease and hypertension, and poor survival rates for breast cancer that are likely partially attributable to the increasing prevalence of obesity over the past generation. Obesity may also contribute to the high rates of gallstones and to adverse outcomes of pregnancy in AI/ANs. Although overall mortality was not associated with obesity in Pima Indians (except in the most obese men), the relationship of obesity to longevity in other AI/AN groups is not known. Further study of the specific health effects of obesity in various groups of AI/ANs are needed. In the meantime, community-based programs to prevent obesity and its sequelae should be implemented in all AI/AN communities.

Alaska↗