Fighting Suicide (health/community)

Tribes fight suicide, a leading killer of native youth

Native youth die from suicide at a higher rate than any other population in Washington, and tribes in the state are fighting back.

By Lynda V. Mapes  Seattle Times staff reporter

Students in a suicide prevention session at the Lummi Youth Academy near Bellingham engage in an exercise that brings them closer together builds trust and is simply fun to do They gather in a circle tighten the circle and drop down

Enlarge this photo


Students in a suicide prevention session at the Lummi Youth Academy near Bellingham engage in an exercise that brings them closer together, builds trust and is simply fun to do. They gather in a circle, tighten the circle and drop down.

Suicide stalks Indian Country, claiming more lives of native youth than those in any other population, not only in Washington, but nationally.

State Department of Health statistics released this month show that in Washington, the rate of suicide among native youth from 10 to 24 years old was more than double the rate of any other ethnic population.

Tribes are fighting back. At the Lummi Nation, tribal leaders last year enhanced a long-standing social-services program with a youth suicide-prevention component. The Colville, Spokane and Yakama tribes also are utilizing prevention grants and training through the Native Aspirations Program. The Spokane-based program for the past five years has helped 65 tribes across the country combat suicide, the second-biggest killer of native youth, after accidents.

That might even be an undercount, experts say.

“The car accident, the gun death, the overdose, there are a lot of suicides that are not reported as such,” said Victoria Wagner, executive director of the Youth Suicide Prevention Program, a nonprofit based in Seattle with outreach workers across the state working with schools and parent groups to teach the warning signs of suicide and prevention strategies.

In Indian Country, poverty, isolation, lack of adequate resources to treat mental-health issues, substance abuse and family problems compound the risks of youth suicide, Wagner said.

“There is this feeling of being trapped, and having nowhere to go.”

At a recent prevention training session at the Lummi Youth Academy outside Bellingham, the emphasis was on the positive.

“How do we make life less to do with pain, and more to do with beauty?” asked executive director Shasta Cano-Martin, as two youth coaches led the kids in writing lists of things that built their self-esteem — and root causes that could lead to risky behavior.

“No support,” offered one teenager. “Feeling like you don’t belong,” said another. “Abuse,” said another. “Failure,” came a tiny voice from a child who seemed too young to know the feeling, but clearly did.

But the kids were quick, too, with long lists of things that lead to feelings of self-worth and confidence: Succeeding on tests. Nailing a basket on the court. Hugs. Doing something nice for someone else. Sobriety. Having the urge to try, and succeeding beyond expectations.

Kyla Frajman, 21, said suicide was no stranger to her. “I thought about it a lot, but always fought my way through it,” said Frajman, a member of the Cowichan First Nation in British Columbia. “I don’t do it myself,” she said of suicide, “because I don’t want the younger kids to think it’s allowed.”

But she has a friend she knows is going through a rough patch. “When I don’t hear from him, I worry about it.”

Experts who track the problem of native youth suicide fear it will get worse, as sequestration reduces funding already scarce for mental-health services for Indian people.

Indian Health Services, the major federal program that provides funding for health-care services for tribes, today covers only about 52 percent of the needed care, and mental-health needs account for more than a third of the underfunding, said Erin Bailey, director of the Center for Native American Youth, a nonprofit based at the Aspen Institute, a think tank in Washington, D.C.

As in Washington, the suicide rate among native youth nationally is 2½ times that of any other youth population, Bailey said. “It is definitely a national problem, a national emergency,” Bailey said. “This is weighing especially hard on our hearts at this time, with native communities facing cuts for native health care.”

Patricia Whitefoot, director of Indian Education for the Toppenish School District, said suicide prevention is a top priority identified by parents of students at Toppenish High School in Yakima County. Native students embarked on a wellness walk Friday to emphasize the positive role that culture can play in wellness, she said.

It’s just one step in what will have to be a longer journey, she said. “Teachers are so busy paying attention to test scores, how much time is there for addressing these major health issues in our community? And, as teachers, that has not been their training.”

At the Yakama Nation, Vanessa Smartlowit, administrative assistant in the tribe’s behavioral-health department, said the tribe is seeking to bolster its youth with everything from motivational speakers to dealing with bullying in schools. Even simple things — talking circles, bead-working classes and cultural activities — “just something for them to learn and keep busy,” can help, she said.

Taboo no longer, suicide is a danger that has to be talked about, Wagner said.

“You are not planting the idea,” Wagner said. “It is already there.”

Lynda V. Mapes: 206-464-2736 or

Herbalists keep alive ancient knowledge of plants (health)

0 0 1 1125 6414 NCIDC 53 15 7524 14.0 Normal 0 false false false EN-US JA X-NONE

A medicine garden

A few herbalists keep alive ancient knowledge of plants

Sunday, October 29, 2006

Robin Chenoweth



The town drunk likely earned his nickname by panhandling small change to buy his next bottle of hooch. Everyone knew Fifty-Cent Freddie was dancing a two-step with death. But something compelled him to go to the herbal healer who lived in the mountains overlooking Bluefield, W.Va.


Seeing her grandmother treat Freddie with valerian root and skullcap jostled something in young Sarah Brown’s consciousness.


"I remember that so clearly," said Brown, who lives in the Hilltop area. "She helped him come off alcohol because it was killing him. Anybody who came, my grandmother helped."


Even as a child who ran barefoot and worry-free through the hills, Brown was marked to pass down a tradition of healing that predates recorded civilization.


The roots of that tradition, grafted from ancient African and American Indian cultures, grow deep in Brown’s garden.


"You are born and die an herbalist," Brown said. "It’s a continuous study. . . . It takes years to master."


Plants such as Saint-John’s-wort, plantain, comfrey and lemon balm nestle in Brown’s tightly planted beds. She picks the herbs and brews them or makes them into salves, just as her grandmother did.


Others taught her grandmother the herbal way, and before them were others.


Some consider the tradition lost, except that it isn’t: More than 80 percent of the world uses medicinal plants to heal and maintain health, said James Duke, an ethnobotanist who has studied plants throughout the world.


"Man has been experimenting with herbs as long as man has been here," Duke said. "There have been people in India and China for 1 million years and (people) in Africa for 8 million years.


"The longer they’ve had to evolve with these (plants), the better their genes recognize them. . . . We’ve had less than 200 years with synthetic medicine."


Many modern drugs, in fact, are derived from medicinal plants or are modeled biochemically after them.


The indigenous plant black cohosh, for example, is used to treat menopause in the prescription drug Remifemin; compounds from rosy periwinkle help cure 90 percent of childhood leukemia.


But much of nature’s medicine chest remains untapped.


Most drug trials on herbs are conducted in Europe. In the United States, herbalists are barred from diagnosing illness or prescribing herbs. And many doctors are skeptical of their claims.


"The cautionary push-back for most physicians is that our market for herbs and dietary supplements is horribly under-, said Dr. Brent - Bauer, director of the Mayo Clinic’s Complementary and Integrated Medicine Program.


The Dietary Supplement Health and Education Act of 1994 made manufacturers responsible for ensuring the safety of their products. Since then, variations in the quality of herbs have been huge from brand to brand, he said.


"I can basically go out in my backyard, squeeze up some grass clippings, call it Dr. Bauer’s Miracle Prostate Cure and pretty much go to the market," he said.


A few supplements, such as ephedra, have been pulled off the market by the Food and Drug Administration because studies indicate health threats. (FDA officials were contacted several times regarding this story but declined to be interviewed.)


The validity of such studies often are hotly debated by people such as Duke, who believes herbal treatments are safer, cheaper and more effective than their synthetic counterparts. He maintains that each year synthetic drugs, taken as prescribed in a hospital setting, kill at least 140,000 Americans.


Duke, who retired from the U.S. Department of Agriculture after 30 years of tracking down medicinal plants, is fighting to have synthetic drugs tested against herbal alternatives.


Indeed, the tide might be shifting as medical institutions conduct more studies on herbs. The Mayo Clinic is studying how valerian — the same herb Brown’s grandmother used — affects fatigue in cancer patients. The University of Illinois is running drug trials on black cohosh and red clover. Other government-funded studies are under way.


"But it’s a difficult area," said Dr. Norman Farnsworth, a pharmaceutical researcher at the University of Illinois. "Some of the government-sponsored trials have failed" because plant extracts, which vary greatly from batch to batch, have not been correctly standardized.


Nevertheless, health-care professionals must consider alternative medicines in their many forms, said Bauer, because 60 percent of people are using them.


"If the majority have this as part of their health-care program, it’s not an alternative anymore. So we absolutely have to be a lot more savvy."


Meanwhile, Brown and other herbalists continue to bear a stigma.


"The bane of my existence is being the ‘voodoo queen,’ especially being black and an herbalist," she said.


"If I could just get past that image. This is not a carnival. This is very serious stuff . . . because we’re trying to help the way we’ve been helped."


Brown has pored over botanical texts and studied herbal guides published by Commission E, an arm of Germany’s federal drug agency.


But her grandmother began Brown’s lessons simply, as she had learned them, with herbs that grew in the woods surrounding their home.


"(She) said, ‘You’re going to become an expert at 10 herbs in front of you,’ " Brown recalled, plants such as dandelion root, red clover and goldenrod.


"If you had a cold, you’d go out there and get comfrey, mullein, yarrow — your wayside weeds."


Because they were poor and lived in an area accessible only by steep dirt roads, herbs often were the only treatment available. In her grandmother’s day, blacks were barred from white hospitals. So they continued the traditional healing that their ancestors brought over on slave ships.


"There was more than hair underneath the scarves that the slave women wore," Brown said. "They had herbs and roots and things to help heal people."


The West Virginia mountains also harbored many eastern Cherokee Indians, who fled there to escape going west on the Trail of Tears.


The escapees survived by marrying whites and blacks, and they passed on Indian medicine. That blending of herbal lore is prevalent throughout the world, Duke said.


"Whenever cultures mix, their herbal traditions get mixed," he said.


One of Brown’s favorite herbs, plantain, was called White Man’s Footsteps by Native Americans because it spread wherever white explorers went.


Shamans and healers worldwide made good use of plantain, which has been clinically proven to treat certain eye, throat and mouth infections. It is also a proven diuretic, which is no surprise to Brown, who has seen the herb cure kidney ailments.


"It’s so frustrating being an herbalist," she said. "We know these things work; it’s just hard trying to convince people.


"Herbalism is folk art, oldwives’ tales passed down, it’s true. But right now it is being scientifically proven."


She frets about the health of the 20 percent of Americans who can’t afford drugs or doctors to prescribe them.


"Herbs are the medicines of everyday man," she said. "You have choices. You can go ahead and suffer, or you might want to, for example, take some tea from this leaf."


Standing among her plants, she crushed some thyme and smelled its fragrance.


"Since the beginning of time, this information has been passed; we have just gotten away from it," she said.


"A lot of people are destroyed by a lack of knowledge."



Attention Friends, Colleagues and Community Partners,

I am privileged and honored to share with you the link to the recently released “OUR CULTURES ARE OUR SOURCE OF HEALTH” public service announcements shared with us by the CDC’s Native Diabetes Wellness Program.  The link below will take you to the PSA spots and the attached Media Advisory shares information about the content and inspirational messages shared in these PSA’s. 

The UIHS Traditional Resources Program as part of our “Food Is Good Medicine” project has been one of 18 tribal community programs working with the NDWP to prevent type 2 diabetes in Indian County by promoting and honoring our tribal histories, cultures, traditions and traditional foods as a pathway to health and wellness. 

Please feel free to share this e-mail and link to these PSA’s with any and all of your family, friends, and colleagues in an effort to get the word out that “Our Cultures Are Our Source of Health”.  Along with our partners at CDC NDWP, we hope these messages will provide opportunities to discuss health in meaningful ways, with the strength of culture at the heart of the discussion. 


Paula Allen (Karuk/Yurok)
Traditional Resources Specialist

Effective February 2, 2013 my email address will change to:

United Indian Health Services, Inc.
Potawot Health Village
1600 Weeot Way  Arcata, Ca  95521

Native Organ Donation (health)

View of organ donation shifting in Native culture

PIERRE, S.D. (AP) – Jerry Clown knows that asking for help can be difficult when it means asking someone to make a sacrifice on your behalf.

In Clown's case, that sacrifice is the donation of a healthy kidney.

A member of the Cheyenne River Sioux Tribe, Clown was diagnosed with a rare autoimmune disease in 2001 while living in Eagle Butte. He has been receiving chemotherapy ever since. The disease, known as Wegener's granulomatosis, also triggered the onset of diabetes and caused his kidneys to fail in 2008.

Clown has been on dialysis for about five years now, and is patiently waiting for a kidney on an Avera transplant list.

Despite his condition, he makes a point of avoiding asking his friends and family members to consider being a donor.

“It's really hard for me to ask someone to be a donor, because it's a big sacrifice that they have to give up,” he said.

It's also difficult for Clown and many other Native Americans suffering from kidney disease to ask for help because in Native American circles, donating an organ is often viewed as not only a physical sacrifice, but a spiritual one as well.


Living organ donation in Native American communities is a current topic of research by Nancy Fahrenwald, an associate professor at South Dakota State University's College of Nursing.

Since 2003, Fahrenwald and a team of researchers, tribal elders and health care professionals have been working to bridge the gap between the decline in Native American health and living organ donation by distributing culturally relevant educational materials.

Fahrenwald's latest research will focus on collecting information from Native American dialysis patients on three reservations in South Dakota and providing educational materials about the process, benefits and risks of living kidney donation. She'll also focus on how to have a conversation about organ donation with family members.

“There are many people on dialysis who could still benefit from a transplant who have never talked to their family about considering being a living donor, or even about the possibility of getting a donor,” Fahrenwald said.

Her research will be funded by a five-year grant awarded to Sanford Research by the National Institute on Minority Health and Disparities. The grant will also bring health care professionals and tribal communities closer together with the establishment of a Collaborative Research Center for American Indian Health in Sioux Falls. Fahrenwald will serve as a principal investigator for the center's research on, culturally targeted education on living kidney donation.


“Culturally, Native Americans believe that when we leave this life and go onto the next, we need to have everything with us,” said Karla Abbott, nursing professor at Augustana College. “But with the increase in Native American health disparities – kidney disease, obesity, renal disease, and hypertension – we're going to need more organ and tissue donators.”

Abbott is a member of the Cheyenne River Sioux, and as a part of Fahrenwald's research team, she has a unique perspective. Abbott has taken special notice of the declining health of her people from the viewpoint of a health care professional and an enrolled tribal member.

More than 112,000 people are on the organ transplant list, and a disproportionate number of those are Native Americans, according to Fahrenwald. Chronic kidney disease is a major health problem in Native American communities, and compared to the county's white population, Native American's are 2.8 times more likely to experience End Stage Renal Disease related to diabetes, according to 2010 U.S. Renal Data.

“Some of this is due to genetics, but a lot of it is change in lifestyle,” Abbott said. “Colonization changed our whole way of life. We were a people that lived by the water. We were very active. But all of those (environmental) changes have really led to our health demise.”

During past research projects, Fahrenwald and her team used traditional storytelling and educational media to present the idea of organ donation to Native American communities in a respectful way. They reached out to native college students with technology-based media and spoke with tribal elders about what kind of messages they wanted to convey.

Fahrenwald consulted traditional healers, who acknowledged that diseases that lead to kidney failure are very real in their communities. The healers concluded that through prayer and ceremony, the spirits of the people who chose to donate or receive an organ could be at rest.

Storytelling was used to encourage Native American people to help each other through the Lakota virtue of generosity. Abbott said that in the old days, one's place in society was not determined by what you owned, but by what you gave away.

“For a successful organ donation, you have to have a good match,” Abbott said. “In order for Native Americans to have successful kidney transplants, you need Native Americans donating organs and getting tested. This isn't just limited to kidneys, but renal disease is our biggest problem bay far.”

These past research projects have helped set up Fahrenwald's new work – talking to dialysis patients to gather their opinions about what needs to be improved in the realm of education and what information they would find useful.

“It takes time to build relationships. I'm not a tribal member, but as a researcher, I need to honor tribal members' time and not conduct research for the sake of research,” Fahrenwald said. “We need to conduct research that makes a difference for the tribe.”

So far it seems that her research has indeed been making a difference. Fahrenwald's previous study with Native American college students resulted in 20 percent of all participants registering as organ donors.

The goal of her research in 2013 will be to bring resources to dialysis centers on reservations that lack adequate patient and family education. Normally patients like Jerry Clown would have to travel to larger cities like Bismarck or Rapid City for that kind of information.

Clown hopes that more education will help people understand the process of being a donor. Until then, he has yet to find a donor match.

“I would really appreciate if a lot of people were donors, because people that are on dialysis, they want to live longer and keep living,” Clown said. “There's hope when someone says, `I would like to get tested, Jerry, what kind of blood type are you?”'


Information from: Pierre Capital Journal,

Historical Trauma (health/information)

Dr. Maria Yellow Horse Braveheart, PhD, conceptualized historical trauma in the 1980's, as a way to develop stronger understanding of why life for many Native Americans is not fulfilling "the American Dream". This site exists to begin a collaboration of community advocates, allies, teachers, and students of historical trauma towards a stronger understanding of unresolved historical grief. 

What is historical trauma? Historical trauma is cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma. Native Americans have, for over 500 years, endured physical, emotional, social, and spiritual genocide from European and American colonialist policy. Contemporary Native American life has adapted, such that, many are healthy and economically self-sufficient. Yet a significant proportion of Native people are not faring as well. 

Our purpose is to heal from the historical unresolved grief that many indigenous individuals and communities are struggling with. Historical unresolved grief is the grief that accompanies the trauma. (Brave Heart, 1995,1998, 1999, 2000) The historical trauma response is a constellation of features in reaction to massive group trauma. This response is observed among Lakota and other Native populations, Jewish Holocaust survivors and descendants, Japanese American internment camp survivors and descendants. (Brave Heart, 1998, 1999, 2000) 

Full information at:

Youth Obesity (health)

Obese Kids May Face Immediate Health Woes, Study Finds

Higher rates of ADHD, asthma and learning problems seen in overweight children, study shows

By Kathleen Doheny
HealthDay Reporter
THURSDAY, Jan. 17 (HealthDay News) -- Obese children -- already known to be at higher risk for heart disease and other ills in adulthood -- may also experience more immediate problems, including asthma, learning disabilities and attention-deficit/hyperactivity disorder, according to a new study.
"Childhood obesity not only has long-term impact in terms of future heart disease, diabetes and other problems that we have been hearing so many things about," said study author Dr. Neal Halfon, director of the Center for Healthier Children, Families and Communities at the University of California, Los Angeles.
"It also has an immediate impact on the health, mental health and development of children," said Halfon, a professor of pediatrics, public health and public policy.
But which comes first -- obesity or the other health concerns -- is unclear. Also unknown is whether additional factors might play a role in both conditions.
For the study, Halfon used weight and other health-related data from the 2007 U.S. National Survey of Children's Health on nearly 43,300 kids aged 10 to 17.
Fifteen percent of the children were overweight and 16 percent were obese. The analysis turned up an association between obesity and 19 measures of general health, psychosocial functioning and specific health disorders.
Childhood obesity has tripled in the past 30 years in the United States, according to the U.S. Centers for Disease Control and Prevention. About 12.5 million children and teens (17 percent) are obese. Other childhood-onset health conditions such as attention-deficit/hyperactivity disorder (ADHD), asthma and learning disabilities have increased during the same period, suggesting some common links.
Halfon used standard definitions of overweight and obesity based on body mass index (BMI), a measurement of height and weight. Overweight is a BMI of 25 to 29.9 (in the 85th to 94th percentile); obesity is a BMI of 30 or more (95th percentile or higher).
The study, published online, will appear in the January/February print issue of the journalAcademic Pediatrics.
Compared to normal-weight children, obese kids were more than twice as likely to have health considered poor, fair or good, versus very good or excellent, Halfon said.
The obese children were also more likely to have activity restrictions, to repeat grades, to miss school, to internalize problems, to have behavioral conditions such as ADHD or conduct disorder, or learning disabilities. Problems with muscles, bones and joints were also more common, as were asthma, allergies, headache and ear infections.
Overall, the obese children were almost twice as likely to have three or more mental health, developmental or physical health problems as normal-weight youngsters.
For overweight kids, the effect was less pronounced, Halfon found. They were 1.3 times as likely as normal-weight kids to report three or more health conditions.
Although the study establishes a link between obesity and other health problems, the research doesn't prove a cause-and-effect relationship. And it's not clear which way the association goes.
"Is the obesity causing all these problems?" Halfon said. "It could go either way, both ways or be related to other factors."
For instance, toxic stress early in life could drive some of the health conditions, he noted.
Halfon said his large, national study echoes some evidence found in smaller studies.
So far, experts have focused on long-term problems related to obesity in childhood, Halfon said. Now, they should consider more immediate effects, he noted.
Another expert agreed.
The new study ''points out the need to care for the whole child and not to focus [only] on the physical health of these children," said Dr. Rachel Gross, attending pediatrician at the Children's Hospital at Montefiore Medical Center in New York City.
One limit of the study, she said, is that it collected information only at one point in time, which makes it difficult to determine which came first, obesity or the other problems.
Given the findings, what can a concerned parent do? "A good place to start is to begin to think about healthy habits for the whole family," said Gross. She suggests working together to make small changes that will help with weight control.
For instance, a family can eat healthy meals together or vow to eat more fruits and vegetables daily.
Also, she said research studies are needed at younger ages to pinpoint more precisely the links between weight and other health problems.
More information
For more information on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.
SOURCES: Neal Halfon, M.D., M.P.H., professor, pediatrics, public health and public policy, and director, Center for Healthier Children, Families and Communities, University of California, Los Angeles; Rachel Gross, M.D., attending pediatrician, Children's Hospital, Montefiore Medical Center, and assistant professor, pediatrics, Albert Einstein College of Medicine, New York City; January/February 2013, Academic Pediatrics

Native Healers (health)

Sanford Health, the Sioux Falls, S.D.-based hospital group, is hiring two traditional American Indian healers to help train its medical staff and cater to its American Indian patients.
The Associated Press reports that Sanford will hire a Lakota/Dakota and an Ojibwe to serve as consultants. They'll serve as advisers to health care workers developing training on American Indian culture and consult with medical staff on when traditional healing ceremonies may be appropriate.
Sanford officials said the hospital group may be the largest private-sector health system serving American Indian communities.

Veteran Care (health)

Dec. 6, 2012, 9:30 a.m. EST

VA and Indian Health Service Announce National Reimbursement Agreement

Native Veterans Able to Access Care Closer to Home

WASHINGTON, Dec 06, 2012 (BUSINESS WIRE) -- American Indian and Alaska Native Veterans will soon have increased access to health care services closer to home following a recent Department of Veterans Affairs and Indian Health Service (IHS) joint national agreement.

"There is a long, distinguished tradition of military service among tribes," said Secretary of Veterans Affairs Eric K. Shinseki. "VA is committed to expanding access to native Veterans with the full range of VA programs, as earned by their service to our Nation."

"The President has called on all Cabinet Secretaries to find better ways to provide our military families with the support they deserve, and that is exactly what we are doing today," said Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services. "American Indian and Alaska Native Veterans benefit from this agreement, which provides increased options for health care services."

As a result of the national agreement, VA is now able to reimburse the IHS for direct care services provided to eligible American Indian and Alaska Native Veterans. While the national agreement applies only to VA and IHS, it will inform agreements negotiated between the VA and tribal health programs. VA copayments do not apply to direct care services provided by IHS to eligible American Indian and Alaska Native Veterans under this agreement.

"The VA and IHS, in consultation with the federally-recognized tribal governments, have worked long and hard to come to an equitable agreement that would ensure access to quality health care would be made available to our Nation's heroes living in tribal communities," said Dr. Robert Petzel, undersecretary for health, Veterans Health Administration. "This agreement will also strengthen VA, IHS and tribal health programs by increasing access to high-quality care for Native Veterans, particularly those in highly rural areas."

"This reimbursement agreement between the VA and the IHS will help improve health care services for American Indian and Alaska Native Veterans and further the IHS mission and federal responsibility of raising the health status of American Indians and Alaska Natives to the highest level possible," said Dr. Yvette Roubideaux, director of the Indian Health Service. "This IHS-VA agreement will allow our federal facilities to work with the VA more closely as we implement this critical provision in the recently reauthorized Indian Health Care Improvement Act, passed as part of the Affordable Care Act."

The agreement between the two agencies marks an important partnering achievement for VA and the IHS and is consistent with the Administration's goal to increase access to care for Veterans.

To view the national agreement, please visit:
. To find out additional information about American Indian and Alaska Native Veteran programs, please visit: and .

SOURCE: U.S. Department of Veterans Affairs


        U.S. Department of Veterans Affairs 
        Office of Public Affairs 
        Media Relations 


Copyright Business Wire 2012

Natives & Stroke (health)

American Indian and Alaska Native Heart Disease and Stroke Facts

·   Heart Disease is the first and stroke the sixth leading cause of death Among American Indians and Alaska Natives.*

·   The heart disease death rate was 20 percent greater and the stroke death rate 14 percent greater among American Indians and Alaska Natives (1996–1998) than among all U.S. races (1997) after adjusting for misreporting of American Indian and Alaska Native race on state death certificates.*

·   The highest heart disease death rates are located primarily in South Dakota and North Dakota, Wisconsin, and Michigan.

·   Counties with the highest stroke death rates are primarily in Alaska, Washington, Idaho, Montana, Wyoming, South Dakota, Wisconsin, and Minnesota.

·   American Indians and Alaska Natives die from heart diseases at younger ages than other racial and ethnic groups in the United States. Thirty–six percent of those who die of heart disease die before age 65.

·   Diabetes is an extremely important risk factor for cardiovascular disease among American Indians.§

·   Cigarette smoking, a risk factor for heart disease and stroke, is highest in the Northern Plains (44.1%) and Alaska (39.0%) and lowest in the Southwest (21.2%) among American Indians and Alaska Natives.

* Indian Health Service. Trends in Indian Health, 2000—2001. Rockville, Maryland: U.S. Department of Health and Human Services, 2004.

Casper ML, Denny CH, Coolidge JN, Williams GI Jr, Crowell A, Galloway JM, Cobb N. Atlas of Heart Disease and Stroke Among American Indians and Alaska Natives. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and Indian Health Service, 2005.

SS Oh, JB Croft, KJ Greenlund, C Ayala, ZJ Zheng, GA Mensah, WH Giles. Disparities in Premature Deaths from Heart Disease—50 States and the District of Columbia. MMWR 2004;53:121–25.

§ Howard BV, Lee ET, Cowan LD, et al. Rising tide of cardiovascular disease in American Indians: the Strong Heart Study. Circulation. 1999;99: 2389–2395.

CDC. Surveillance for health behaviors of American Indians and Alaska Natives: findings from the Behavioral Risk Factor Surveillance System, 1997–2000. In: CDC Surveillance Summaries (August 1). MMWR 2003;52(No. SS–7).

CDC Activities to Reduce the Burden of Heart Disease and Stroke Among American Indians and Alaska Natives

Atlas of Heart Disease and Stroke Among American Indians and Alaska Natives
 - This atlas is the first in a series of atlases to focus on a specific racial or ethnic group. It contains county level heart disease and stroke mortality maps (1995–1999) as well as state level surveillance data on heart disease and stroke risk factors (2001–2003). This information can help health professionals and concerned citizens tailor prevention policies and programs to communities with the greatest burden and risk.  Available at:

CDC Funded State Heart Disease and Stroke Prevention Programs - 
CDC currently funds health departments in 32 states and the District of Columbia to develop, implement, and evaluate programs that promote heart–healthy and stroke–free communities; prevent and control heart disease, stroke, and their risk factors; and eliminate disparities among populations. These programs emphasize the use of education, policies, environmental strategies, and systems changes to address heart disease and stroke in various settings and to ensure quality of care. The programs in Alaska, Kansas, Maine, Minnesota, Montana, Nebraska, Oklahoma, Virginia, and Wisconsin are currently collaborating with American Indian and Alaska Native communities. For more information, visit

The WISEWOMAN program provides low–income, under insured and uninsured women aged 40–64 years with chronic disease risk factor screening, lifestyle intervention, and referral services in an effort to prevent cardiovascular disease. CDC funds 15 WISEWOMAN projects, which operate on the local level in states and tribal organizations. Projects provide standard preventive services including blood pressure and cholesterol testing, and programs to help women develop a healthier diet, increase physical activity, and quit using tobacco. WISEWOMAN funds two programs working with Alaska Native women as well as programs serving American Indian women in Nebraska, Nevada, and South Dakota. For more information, visit

REACH 2010 - 
REACH 2010 is designed to eliminate disparities in cardiovascular disease as well as immunizations, breast and cervical cancer screening and management, diabetes, HIV/AIDS, and infant mortality. REACH 2010 supports community coalitions in designing, implementing, and evaluating community–driven strategies to eliminate health disparities. The activities of these community coalitions include continuing education on disease prevention for health care providers, health education and health promotion programs that use lay health workers to reach community members, and health communications campaigns. REACH funds core capacity building projects in American Indian and Alaska Native communities in Albuquerque, NM; Oklahoma City and Talihina, OK; Anchorage, AK; and Nashville, TN. For more information, visit

For More Information

For more information on heart disease and stroke among American Indians and Alaska Natives, visit the following Web sites.

Ø  CDC's Cardiovascular Health Program

Ø  Indian Health Service

Ø  Native American Cardiology Program

Ø  American Heart Association*

Ø  American Stroke Association*

Ø  National Heart, Lung, and Blood Institute