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Ethnogeriatrics

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Patterns of Health Risk: Influences on Quality of the Data

Indian Health Service Data

The primary source for American Indian health data is the Indian Health Service. This information is collected only from eligible (tribally enrolled, living on-or-near reservation of federally recognized tribes) members, who actually utilize IHS services. Therefore, IHS data may reflect “availability of services” rather than incidence and prevalence of illness, and may not include most of the 62% of American Indian who live off-reservation. (AoA, US DHHS, et al, 1996) Some American Indian elders who live off-reservation are able to utilize IHS services, sometimes traveling long distances to do so.

Mortality: Misidentification and Misclassification

Mortality for American Indian may be underestimated by 10% due to errors of misidentification of the race of the decedent, and/or misclassification in the cause of death (John, 1999, pg 71).

Regional Variability

Resources

Regional Trends in Indian Health is published on a periodic basis by the Indian Health Service and is available through the Indian Health Service Website.

Prevalence rates vary widely, especially in IHS data, from service area to service area and by tribal affiliation. For example, in 1998, 49.5% of adult Pima Indians (Arizona) had diabetes mellitus, and the Oklahoma Cherokee had 20.2% (McCabe & Cuellar, 1994, pg. 21). Higher prevalence of hypertension (31%) was reported by urban American Indians in Los Angeles than a national sample of elderly American Indian (19%) (Kramer, 1991; Los Angeles Co. AAA, 1989).

 

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American Indian

  • Description
  • Learning Objectives
  • Introduction and Overview
    • Demographics
      • Overview
      • Geography
      • Living Arrangements
      • Tribal Groupings
      • Age Groups
    • Historical Influence
    • Self-Determination
    • Religion
    • Spirituality and Healing
    • Definition of Terms
  • Patterns of Health Risk
    • Data Quality
      • Mortality
        • Leading Causes of Death
      • Morbidity and Functional Status
        • Heart Disease and Diabetes
      • Mental Health

Culturally Appropriate Care

  • Fund of Knowledge
    • Cohort Analysis
      • Cohort Experiences
      • Case Studies for Discussion
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    • Conflicting Expectations
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    • Respect and Rapport
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    • Language Assesment
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      • Client Background
      • Clinical Domains
      • Problem-Specific Information
      • Intervention-Specific Data
      • Outcome Criteria
  • Delivery of Care
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    • informed Consent
    • Surgery
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    • Biomedical Vs Traditional

Access & Utilization

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Learning Resources

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      • 1800 to 1849
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      • 1900 to 1949
      • 1953 to 1969: Policy of Termination and Relocation
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    • 2: Cultural Values
    • 3: Case Study, Dementia
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