Posted: Wednesday, April 21, 2004 12:00 am
BILLINGS, Mont. (AP) - American Indians living in urban areas are far more likely than the general population to die from certain chronic diseases, a new national study indicates.
Compared with other ethnic groups, they are more likely to die from diabetes and alcohol-related causes, the study says.
In Billings, the study found diabetes-related deaths for Indians are 447 percent higher than all other races combined and alcohol-related deaths are 438 percent higher. The leading causes of death are accidents and cancer.
Compared with others living in Billings, American Indians experienced higher death rates for lung cancer (94 percent greater), chronic liver disease and cirrhosis (258 percent greater) and influenza and pneumonia (172 percent greater), based on data from 1990-1999.
The report, said to be the first to examine health disparities for Indians in urban areas, also found that urban Indians were at a higher overall risk for infant mortality, teenage pregnancies and premature deliveries.
The Urban Indian Health Institute combined figures from the 1990 and 2000 census with data from the National Center for Health Statistics in compiling the report. The study only looks at health problems for Indians in urban areas and how they compare with all other people living in those cities. It does not compare the rates with Indians living on reservations.
Health officials have long known that city-dwelling Indians face greater health problems than other people in those cities, but the study puts numbers behind those claims.
"We in Indian Country, and in urban Indian Country, have known this for years but we never had a comprehensive study to look at these things," said Donald Clayborn, director of the Helena Indian Alliance.
Although the study documents some strikingly high numbers - including rates for diabetes and cirrhosis - the problem could be even more serious because some cities underreport or misclassify urban Indian health information
"We believe these findings grossly underestimate the true extent of the problem," said Ralph Forquera, director of the Seattle-based institute. "Urban Indians may truly be experiencing a crisis in their health."
Nationwide, death rates among urban Indians were 38 percent higher for accidents compared with the general population, 126 percent higher for liver disease and 54 percent higher for diabetes, the study said.
Nearly 70 percent of Indians and Alaska Natives live in urban areas, according to the 2000 census, and the number continues to climb.
"There are more and more Native Americans moving to urban areas in search of employment," said Lita Pepion, a health systems analyst with the Indian Health Board of Billings Inc.
There are a number of reasons why Indians in urban settings suffer from poorer health, Forquera said.
"For some on the Indian reservation a lot of services are provided for free. But when they come to the cities, they might come to sliding scales and that might be a barrier for some people," he said. Lack of insurance or employment could also cause problems.
The report identified several risk factors for urban Indian populations. The number of mothers under the age of 18 was 80 percent higher than mothers across the country and premature deliveries were 13 percent higher.
The study also found higher rates of disability, poverty and unemployment among urban Indians.
AP-WS-04-21-04 1336EDT