The Health Status of American Indians/Native Americans in Massachusetts

1. The Health Status of American Indians/Native Americans in Massachusetts Massachusetts Department of Public Health Center for Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology

2. National American Indian Heritage Month During National American Indian Heritage Month, we honor the generations of American Indians and Alaska Natives who have added to the character of our Nation. This month is an opportunity to celebrate their many accomplishments and their rich ancestry and traditions. George W. Bush , 2006

3. Native American Collaborators • Mashpee Wampanoag Tribe • Aquinnah Wampanoag Tribe • North American Indian Center of Boston

4. Indian Health Service Areas

5. Making History One of the first comprehensive reports on Native American health by a state

6. Making History in Massachusetts • First health report on American Indians • First statewide report to collaborate with Native Americans • First report to integrate information from federal, state and tribal data collections • First report to use Indian-driven data

7. American Indian Population by County Massachusetts: Census 2000 Source: U.S. Census 2000

8. Outline of Today’s Presentation • Socio-demographics • Survey Results • Behavioral Risk Factor Surveillance System • Mashpee Wampanoag Community Health Survey • NAICOBCommunity Health Survey • - Youth Risk Behavior Survey • Health Outcomes • - Births • - Deaths • Summary

9. Socio-Demographics

10. White Black Asian American Indian Other Two+ Race According to Census 2000 United States Massachusetts Source: Census 2000

11. American Indians in Race Combinations Census 2000 United States Massachusetts Source: U.S. Census 2000

12. 38,050 20,760 19,390 15,015 Different Counts of the American Indian/Alaska Native Population in Massachusetts: 2000 Census 2000 MDPH 2000 MARS 2000 Census 2000

13. Age Distribution of American Indians in Massachusetts: Census 2000 Massachusetts Overall American Indian 65+ 45-64 25-44 0-24 Source: U.S. Census 2000

14. American Indian and Alaska Native Tribes Massachusetts: Census 2000 Source: U.S. Census 2000 * Only federally recognized American Indian Tribe in Massachusetts

15. American Indian Population by City/Town Massachusetts: 2000 > 1% MA population <= 1% MA population Source: U.S. Census 2000

16. Source: U.S. Census 2000

17. • • • Source: U.S. Census 2000

18. Economic Indicators: 1999 Source: U.S. Census 2000

19. Socio-Demographic Indicators: 2000 Source: U.S. Census 2000

20. Less Than High School Education Massachusetts: 2000 Source: U.S. Census 2000, SF-4

21. Census 2000 Adjusted CountMassachusetts: 2000 Source: U.S. Census 2000

22. Survey Results

23. Health Status Findings Behavioral Risk Factor Surveillance Survey Massachusetts: 2001-2005 Source: Behavioral Risk Factor Surveillance System (BRFSS) 2001-2005

24. Access to Health Behavioral Risk Factor Surveillance Survey Massachusetts: 2001-2005 Source: Behavioral Risk Factor Surveillance System (BRFSS) 2001-2005

25. Health Status Indicators North American Indian Center of Boston Community Health Survey: 2002 Source: North American Indian Center of Boston Community Health Survey, 2002.

26. Health Status Indicators Mashpee Wampanoag Community Health Survey Massachusetts: 2002 Source: Wampanoag Community Health Survey, 2002.

27. The Health Status of High School Students Youth Risk Behavior Survey: 1993-2003 Source: Department of Education, YRBS: 1993-2003

28. The Health Status of High School Students Youth Risk Behavior Survey: 1993-2003 Source: Department of Education, YRBS: 1993-2003

29. Health Outcomes

30. Birth IndicatorsMassachusetts: 1999-2004 Source: Massachusetts Births 1999-2004

31. Birth IndicatorsMassachusetts: 1999-2004 Source: Massachusetts Births 1999-2004

32. American Indians (N=443) • Cancer (23%) • Heart Disease (22%) • Injuries & Poisonings (9%) • Stroke (5%) • Pneumonia & Influenza (4%) Massachusetts (N=611,825) • Heart Disease (28%) • Cancer (25%) • Stroke (6%) • CLRD1 (5%) • Injuries & Poisonings (4%) Leading Causes of Death (NCHS Ranking) Massachusetts: 1994-2004 1 Chronic Lower Respiratory Disease Source: Massachusetts Department of Public Health, Massachusetts Deaths 1994-2004

33. Underestimation in Mortality Rates for American Indians • Because it is more likely for race to be reported as Native American in the Census than it is in the death certificates, this results in a net underestimation of mortality • The number of deaths (numerator) and the population count (denominator) are inconsistent. • Race is self-reported on the Census; whereas, on death certificates, race may be reported by the family, the certifying physician, the funeral director, or other informant. • More than one race can be reported on the Census, whereas, currently, only single races are allowed on the death certificate • The American Indian population count (denominator) in mortality rates may be inaccurate because of the large number of mixed-race persons who are, in part, Native American.

34. All Cause Mortality Age-Adjusted Death Rates: 1994-2004 Adjusted Estimate Underestimate Age-adjusted to the 2000 US standard population. Source: Massachusetts Department of Public Health, Death certificates.

35. Summary

36. Summary The Health Status of American Indians/Native Americans in Massachusetts • Makes history in Massachusetts public health • A baseline by which we can track improvements in American Indian health • A much needed resource for American Indian groups to assess the health needs of their communities • Highlights the need for better methods of collection of race and ethnicity data • Starting point for research into the health of American Indians and the development of programs targeted to this population

37. How Can You Access this Report? • Hard Copies: (617) 624-5640 • (617) 624-5639 • TDD/TTY: (617) 624-6001 • DPH Website: • http://www.mass.gov/dph/pubstats.htm

38. Thank You