The Health Status of American Indians/Native Americans in Massachusetts

The Health Status of American Indians/Native Americans

in Massachusetts

Massachusetts Department of Public HealthCenter for Health Information, Statistics, Research, and Evaluation

Division of Research and Epidemiology

Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

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


Native American Collaborators

• Mashpee Wampanoag Tribe

• Aquinnah Wampanoag Tribe

• North American Indian Center of Boston


Indian Health Service Areas


Making History

One of the first comprehensive reports on Native American health by a state


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


American Indian Population by CountyMassachusetts: Census 2000

Source: U.S. Census 2000


Outline of Today’s Presentation

1. Socio-demographics

2. Survey Results- Behavioral Risk Factor Surveillance System- Mashpee Wampanoag Community Health Survey- NAICOB Community Health Survey - Youth Risk Behavior Survey

3. Health Outcomes- Births- Deaths

4. Summary

Socio-Demographics


85%

2%4%4%0.2%

5%

Race According to Census 2000

2%5%4%

1%

12%

76%

United States Massachusetts

Source: Census 2000

White

Black

Asian

Other

American Indian

Two+


Alone39%

Four2%Three

10%

Two49%

American Indians in Race Combinations Census 2000

Two34%

Three5%

Four1%

Alone60%

United States Massachusetts



Different Counts of the American Indian/Alaska Native Population in

Massachusetts: 2000

19,390

38,05020,760

15,015

Census 2000

MDPH 2000

MARS 2000

Census 2000


33%

31%

23%

14%

39%

32%

21%

7%

-40% -20% 0% 20% 40%Percent (%)

Age Distribution of American Indians in Massachusetts: Census 2000

American Indian Massachusetts Overall

65+


45-64

25-44

0-24


American Indian and Alaska Native Tribes Massachusetts: Census 2000

Tribe (Self-Identified) NumberTallied

Percent of MA AIAN Population (Alone or in

Combination)Cherokee 4,037 10.6%

Canadian and Latin American 2,716 7.1%

WampanoagAquinnah Wampanoag* Mashpee Wampanoag

2,546 303 178

6.7%

Micmac 1,554 4.1%

Blackfeet 1,521 4.0%

Iroquois 1,464 3.8%

Nipmuc 710 1.9%

Abenaki Nation of Missiquoi 696 1.8%

Other Tribes 20,689 54.4%

Tribe Not Specified & Not Elsewhere Classified

2,117 5.6%

* Only federally recognized American Indian Tribe in MassachusettsSource: U.S. Census 2000


TOLLAND1.2%

MASHPEE3.1%

LAWRENCE2%

TISBURY: 1.4%

GAY HEAD (AQUINNAH)39.5%

OAK BLUFFS1.5%

American Indian Populationby Cities and Towns, Massachusetts 2000

American Indian Population by Town

> 1% of Total Population

<= 1% of total population

American Indian Population by City/Town Massachusetts: 2000


> 1% MA population

<= 1% MA population


Cities with the Largest American Indian PopulationsMassachusetts: Census 2000

City / Town American Indian(Alone)

City / Town American Indian (Alone, or in

Combination)

Boston 2,365 Boston 5,384

Worcester 769 Worcester 1,700

Lawrence 583 Springfield 1,473

New Bedford 579 New Bedford 1,288

Springfield 569 Lawrence 921

Mashpee 377 Brockton 876

Brockton 338 Cambridge 853

Lynn 332 Lynn 796

Cambridge 290 Lowell 676

Barnstable 283 Fall River 587



American Indian PopulationMassachusetts: Census 2000

City / Town American Indian (Alone)

City / Town American Indian (Alone, or in

Combination)

Mashpee 377 Mashpee 502

Aquinnah 126 Aquinnah 148


•••


Economic Indicators: 1999

$25,952

$66,365

$41,322

$15,889

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

Per Capita Income Mean Household Income

American IndianMassachusetts



Socio-Demographic Indicators: 2000

15.0%9.3%

61.7%

37.7%

21.0%28.0%

0%

20%

40%

60%

80%

100%

Less than High SchoolEducation

Persons Living BelowPoverty

Owner OccupiedHouseholds

American Indian

Massachusetts



Less Than High School Education Massachusetts: 2000

Source: U.S. Census 2000, SF-4

13.0%

23.0%

43.0%

23.0%

15.0%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

White Non-Hispanic

Black Non-Hispanic

Hispanic American Indian Massachusetts

Per

cen

tag

e


Census 2000 Adjusted CountMassachusetts: 2000

Race April 2000 Adjusted % Diff.

Total Population 6,349,097 6,396,100 0.7%

White 5,367,286 5,393,584 0.5%

Black 343,454 351,882 2.5%

American Indian 15,015 15,484 3.1%

Asian 240,613 243,171 1.1%

Two or more races 146,005 148,640 1.8% Ethnicity Hispanic 428,729 441,974 3.1%


Survey Results


Health Status Findings Behavioral Risk Factor Surveillance Survey

Massachusetts: 2001-2005

65.4%

31.1%29.6%

78.3%

18.8%12.6%

0%

20%

40%

60%

80%

100%

Fair/Poor Health Current Smoker Engage in leisurephysical activity

American Indian

Massachusetts

Source: Behavioral Risk Factor Surveillance System (BRFSS) 2001-2005


Access to Health Behavioral Risk Factor Surveillance Survey

Massachusetts: 2001-2005

73.8%

18.8%18.4%

83.4%

7.9%8.2%

0%

20%

40%

60%

80%

100%

No Health Insurance Could not see Doctor dueto cost

Mammogram in last 2years

American Indian

Massachusetts

Source: Behavioral Risk Factor Surveillance System (BRFSS) 2001-2005


Health Status Indicators North American Indian Center of Boston

Community Health Survey: 2002

46.5%

33.7%

20.6%

76.9%

16.7%9.6%

0%

20%

40%

60%

80%

100%

15+ days poor emotionalhealth

Obese Dental visit past year

American Indian

Massachusetts

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


Health Status Indicators Mashpee Wampanoag Community Health Survey

Massachusetts: 2002

36.8%32.6%

10.7%

27.8%23.1%

5.5%

0%

20%

40%

60%

80%

100%

Diabetes High Blood Pressure High Cholesterol

Mashpee WampanoagMassachusetts

Source: Wampanoag Community Health Survey, 2002.


The Health Status of High School Students Youth Risk Behavior Survey: 1993-2003

11.6%

29.3%

51.3%

43.5%

9.0%7.7%

29.1%29.7%

0%

20%

40%

60%

80%

100%

Current Smoker Alcohol Before Age13

Lifetime CocaineUse

Overweight

Pe

rce

nt


Source: Department of Education, YRBS: 1993-2003


24.5%30.3%

9.2%8.7%

0%

20%

40%

60%

80%

100%

Member of Gangs Attempted Suicide

Pe

rce

nt


Source: Department of Education, YRBS: 1993-2003

The Health Status of High School Students Youth Risk Behavior Survey: 1993-2003

Health Outcomes


27.6%

12.6%

6.6%8.8%

6.0%7.4%

0%

10%

20%

30%

40%

50%

Low Birthweight Teen Births Smoking duringpregnancy

American Indian

Massachusetts

Source: Massachusetts Births 1999-2004

Birth IndicatorsMassachusetts: 1999-2004


Birth IndicatorsMassachusetts: 1999-2004

50.2%

64.0%67.5%

28.3%

84.0%75.8%

0%

20%

40%

60%

80%

100%

Breastfeeding Prenatal Care Begun in1st Trimester

Public Pay

American Indian

Massachusetts

Source: Massachusetts Births 1999-2004


Leading Causes of Death (NCHS Ranking) Massachusetts: 1994-2004

Massachusetts (N=611,825)

1. Heart Disease (28%)

2. Cancer (25%)

3. Stroke (6%)

4. CLRD1 (5%)

5. Injuries & Poisonings (4%)

American Indians (N=443)

1. Cancer (23%)

2. Heart Disease (22%)

3. Injuries & Poisonings (9%)

4. Stroke (5%)

5. Pneumonia & Influenza (4%)

1 Chronic Lower Respiratory Disease Source: Massachusetts Department of Public Health, Massachusetts Deaths 1994-2004


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.


All Cause MortalityAge-Adjusted Death Rates: 1994-2004

956.7

392.8498.2

987.0

810.3

0

200

400

600

800

1,000

1,200

1,400

1,600

White non-Hispanic

Black non-Hispanic

Hispanic American Indiannon-Hispanic

American Indian(AlternativeEstimate)

De

ath

s p

er

10

0,0

00

po

pu

lati

on

Age-adjusted to the 2000 US standard population. Source: Massachusetts Department of Public Health, Death certificates.

Adjusted Estimate

Underestimate

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

Summary


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

Thank You

Documents

The Health Status of American Indians/Native Americans in Massachusetts