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American Indians in cities face unique challenges to their health

By Garnce Burke
Fresno, California (AP) 3-08

Urban American Indians face a health problem unseen by other races, researchers said during March: As they become wealthier, their rates of binge drinking and tobacco use stay the same or even rise.

The nonprofit Urban Indian Health Institute also said diabetes and obesity rates were about the same for urban Indians, whether they were rich or poor. Among other races, people with higher incomes tend to have fewer of those health problems than poorer people.

“When Indian folks drink, it appears to have nothing to do with how much money they have, and that’s not true for any other racial group,” said Maile Taualii, the institute’s scientific director. “There seems to be a sense of hopelessness, a sense that diabetes, alcoholism and other health problems are inevitable in the community, and it doesn’t have to be that way.”

The Seattle-based institute, which gets federal money to track disease trends among native people, analyzed data from a random digit-dial telephone survey conducted between 2001 and 2005 by the U.S. Centers for Disease Control and Prevention in 34 cities from New York to Helena, Mont.

More than half of the roughly 2.5 million American Indians in the United States live in cities, according to the 2000 Census. Yet rarely have medical studies focused on the population’s health as compared to other city dwellers, or to illness rates among Indian people living on tribal lands.

The report offers a detailed analysis of responses from the 3,224 American Indian and Alaska Natives and 178,983 non-Indians surveyed.

Overall, fewer Indian respondents reported drinking than people of other races. But among those who did drink, more American Indians reported an episode of binge drinking – or consuming five or more drinks in one go – at least once in the previous month.

Of higher-income respondents – defined as those earning more than $38,700 for a family of four – 46 percent of American Indians reported one episode of binge drinking in the previous month, compared with 25.3 percent for people of other ethnic backgrounds.

Taualii said the results of the study – and data showing that native people in some cities reported having more difficulty getting health care than urbanites of other backgrounds – show special attention must be paid to the health disparities for urban Indians.

Federal law requires taxpayer-funded tribal clinics, but the Bush administration has been pushing for those services to be cut off in urban areas. For the third year in a row, Bush’s 2009 budget proposal calls for the Urban Indian Health Programs’ funding to be cut.

Unlike American Indians who live in rural areas or reservations, “urban Indians have access to publicly and privately financed health care services like other Americans,” said Christin Baker, a spokeswoman for the White House’s Office of Management and Budget.

Newman Washington, who runs drug and alcohol programs at a government-funded Indian clinic in Wichita, Kan., said tight finances already make it difficult to meet the needs of patients from nearby tribes, including the Kickapoo, Potawatomi, Iowa, and Sac and Fox.

Clients trying to detox from alcohol often have to wait two months to be admitted to a hospital bed, or travel 75 miles to Ponca City, Okla., to be seen in an inpatient facility, Washington said.

“People go away and get an education, but then they come back home and have a really hard time changing their behavior,” said Washington, a member of the Eastern Shoshone tribe of Wyoming. “Whenever you start looking at the core, there’s some shame and guilt that people are carrying around from past generations.”

Officials at the U.S. Department of Health and Human Services, which oversees the urban clinics, did not return messages seeking comment on the study. Staff members for the Senate Indian Affairs Committee were examining the report, a spokesman for its leader, Sen. Byron Dorgan, D-N.D., said Wednesday.

Rep. Nick Rahall, D-W.V., said in a statement that the report “makes it clear that far too many disparities exist between those Native Americans living on A bill approved by the Senate last week would boost programs at the federally funded Indian Health Service, prompt new construction and modernization of health clinics on reservations and attempt to recruit more Indians into health professions.