Indian Health Focus: Women

80 Pages·1999·2.3 MB·English

Indian Health Focus
1998-99
U.S. Department ofHealth and Human Services
Indian Health Service
Office ofPublic Health
Office ofProgram Support
Program Statistics Team

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Indian Health Focus
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Women
1998-99
Indian Health Service
Michael H.Trujillo, MD, MPH, MS
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Office ofPublic Health c >, „r
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Gary Hartz, PE i
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Phillip L. Smith,
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Program StatisticsTeam
Edna L. Paisano
Team Leader

Table of Contents
Introduction 1 Chart 4 Births ofHigh Birthweight
(4,000 Grams or More)
Summary ofData Shown 2 as Percent ofTotal Live Births
by Age ofMother 14
Sources and Limitation ofData 5
Table 4 Births ofHigh Birthweight
Population Statistics 5 (4,000 Grams or More)
by Age ofMother 15
Vital Event Statistics 5
Chart 5.1 Birth Order by Age ofMother:
Patient Care Statistics 6 American Indians and
Alaska Natives 16
Sources ofAdditional Information 7
Chart 5.2 Birth Order by Age ofMother:
US. All Races 16
CHARTS & TABLES Chart 5.3 Birth Order by Age ofMother:
U.S.White 17
Chart 1 Population by Age and Sex,
1990 Census 9 Table 5 Number and Percent
Distribution ofLive Births 18
Table 1 Age and Sex Percent Distribution .10
. .
Chart 6 Family PlanningVisit Rates 19
Chart 2 Employment Status by Sex 11
Table 6 Number and Rate of
Chart 3 Births ofLow Birthweight (Under Family PlanningVisits 19
2,500 Grams) as Percent of Total
Live Births byAge ofMother 11 Chart 7 Live Births with Prenatal Care
Beginning in First Trimester,
Table 2 Selected Economic Profiles for Calendar Years 20
the United States, 1990 Census ... .12
Table 7 Live Births with Prenatal Care
Table 3 Births ofLow Birthweight Beginning in FirstTrimester,
(Under 2,500 Grams) Calendar Years 21
by Age ofMother 13
Table ofContents
Chart 8 Mothers Who Smoked Chart 14 Death Rates for Leading Causes:
During Pregnancy 22 Females 32
Table 8 Percent ofMothers Who Smoked Table 14 Leading Causes ofDeath
During Pregnancy for All Births by Sex 33
and Low Weight Births by
Age ofMother 23 Chart 15 Alcoholism Death Rates
by Age and Sex 34
Chart 9 Mothers Who Drank
During Pregnancy 24 Table 15 Alcoholism Death Rates
byAge and Sex 35
Table 9 Percent ofMothers Who Drank
During Pregnancy by Chart 16 Drug-Related Death Rates
Age ofMother 25 by Age and Sex 36
Chart 10 Births Rates with Table 16 Drug-Related Death Rates
Diabetic Mother 26 by Age and Sex 37
Table 10 Rate ofLive Births with Diabetic Chart 17 Accident Death Rates
Mother by Age ofMother 26 byAge and Sex 38
Chart 11.1 First Cesarian Delivery 27 Table 17 Accident Death Rates
by Age and Sex 39
Chart 11.2 Vaginal Births After
Previous Cesarian Delivery 27 Chart 18 Suicide Death Rates
by Age and Sex 40
Table 11 Rates ofFirst Cesarian Delivery
andVaginal Birth After Table 18 Suicide Death Rates
Previous Cesarian Delivery byAge and Sex 41
by Age ofMother 28
Chart 19 Homicide Death Rates
Chart 12 Life Expectancy at Birth, byAge and Sex 42
Females, Calendar Years 29
Table 19 Homicide Death Rates
Chart 13 Deaths by Age and Sex 30 by Age and Sex 43
Number and Percent Distribution
ofDeaths by Age and Sex 31
Table ofContents
Chart 20 Chronic Liver Disease Chart 26 Age-Adjusted Breast Cancer
and Cirrhosis Death Rates Death Rates for Females 56
by Age and Sex 44
Table 26 Age-Adjusted Breast Cancer
Table 20 Chronic Liver Disease Death Rates for Females 56
and Cirrhosis Death Rates
byAge and Sex 45 Chart 27 Age-Adjusted Cervical Cancer
Death Rates for Females 57
Chart 21 Diabetes Mellitus Death Rates
by Age and Sex 46 Table 27 Age-Adjusted Cervical Cancer
Death Rates for Females 57
Table 21 Diabetes Mellitus Death Rates
by Age and Sex 47 Chart 28 Pneumonia and Influenza
Death Rates by Age and Sex 58
Chart 22 Heart Diseases Death Rates
by Age and Sex 48 Table 28 Pneumonia and Influenza
Death Rates by Age and Sex 59
Table 22 Heart Diseases Death Rates
by Age and Sex 49 Chart 29 Leading Causes of
Hospitalization for Females 60
Chart 23 Cerebrovascular Diseases
Death Rates by Age and Sex 50 Table 29 Ten Leading Causes of
Hospitalization by Sex 61
Table 23 Cerebrovascular Diseases
Death Rates by Age and Sex 51 Chart 30 Leading Causes ofFemale
Ambulatory MedicalVisits 62
Chart 24 Malignant Neoplasm Death Rates
by Age and Sex 52 Table 30 Number ofAmbulatory Medical
Clinical Impressions for Leading
Table 24 Malignant Neoplasm Death Rates Major Categories by Sex 63
by Age and Sex 53
Chart 25 Death Rates, Leading Cancer Sites: Glossary of icd-9 Codes 65
Females 54
Methods used to Rank Leading
Table 25 Twenty Leading Sites Sites of Cancer Deaths 69
for Cancer Deaths for
Female Decedents 55

INTRODUCTION
The Indian Health Service (IHS) is an agency of the Department of Health and Human Services. The IHS goal is to
assure that comprehensive, culturally acceptable personal and public health services are available and accessible
to American Indian and Alaska Native people. The mission of the IHS, in partnership with American Indian and
Alaska Native people, is to raise their physical, mental, social, and spiritual health to the highest level.
The IHS has carried out its responsibilities through developing and operating a health services delivery system
designed to provide a broad-spectrum program of preventive, curative, rehabilitative, and environmental services.
This system integrates health services delivered directly through IHS facilities, purchased by IHS through
contractual arrangements with providers in the private sector, and delivered through Tribally-operated programs
and urban Indian health programs.
The IHS is concerned with the health ofAmerican Indians and Alaska Natives of all ages. The IHS presents an
overview of the health status of Indians in its annual publication, Trends in Indian Health. However, IHS recognizes
that there are segments and conditions of the Indian population that require special attention, such as infants,
youth, women, the elderly, and injuries. This publication examines the health status of Indian women. It is based
on data published in the IHS publications 1998-99 Trends in Indian Health and 1998-99 Regional Differences
in Indian Health.
The population of interest for this publication is American Indian and Alaska Native women residing in the IHS
service area. The IHS service area comprises the geographic areas in which IHS has responsibility (counties on
and near reservations). Approximately 60 percent ofAmerican Indians and Alaska Natives in the U.S. reside in
the IHS service area. In 1999, there were 1.49 million Indians in the IHS service area compared to 2.44 million
in the entire U.S.
Summary of Data Shown
American Indian and Alaska Native women comprise Indian women, 12.7 percent oflive births with birth-
51 percent ofthe IHS service population, as is true for weight reported are ofhigh birthweight, compared
U.S. All Races and White women in their population to 10.3 percent for U.S. All Races women and 11.5
groups. However, Indian women are considerably percent for U.S. White women.
younger than their counterparts in these populations.
According to the 1990 Census, 49.6 percent ofIndian Family planning occurs at widely different rates
women are younger than 25 years ofage and 6.5 among the IHS Areas. Indian women ofchildbearing
percent are older than 64 years.The comparable per- age (15 to 44 years) have family planningvisits in
centages for U.S. All Races women are 34.8 and 14.6, the California Area at a rate of268.7 visits per 1,000
and for U.S. White women are 33.4 and 15.7. Indian women (15 to 44 years).This, the lowest rate, is in
women generally have a lower social and economic sharp contrast to the highest rate of 838.1 in Alaska.
status than women in the general U.S.population.
Accordingto the 1990 Census, 13.4percent ofIndian Indian women generally begin prenatal care later than
women aged 16 and older were unemployed in con- women in the U.S.All Races population. Prenatal care
trast to 6.2 and 5.0 percent for the U.S. All Races and begins in the first trimester for 66.5 percent ofIndian
White populations, respectively. live births, whereas this percentage for the general
population is 81.3. None ofthe IHS Areas reach the
Indian women give birth to children at younger ages US. All Races rate; Alaska is closest at 77.4.The
than do women in the general U.S.population. For Navajo rate of53.5, the lowest Area rate, is only 66
Indian women, 45.7 percent are under age 20 when percent ofthe U.S. All Races rate.
they have their first child.This compares to 24.9 per-
cent for U.S.All Races mothers and 22.3 percent for Indian women are more likely to exhibit risky
U.S. White mothers. Despite the large number of behaviors duringpregnancy than their counterparts
young mothers, low birthweight (under 2,500 grams) in the U.S.All Races population. For example, 20.4
occurs at lower rates among Indian women than it percent ofIndian women report that they smoke
does for women in the U.S. All Races and White pop- duringpregnancy. Women in the U.S. All Races
ulations. For Indian women, 6.0 percent oflive births population, in contrast, smoke at a lower rate during
with reported birthweight are oflow birthweight, pregnancy, i.e., 13.9 percent.There appears to be a
just below the level for the White population (6.2 per- relationship between smoking and low birthweight
cent).The percentage for U.S. All Races population is births. Ofall Indian low weight births, 29.0 percent
considerably higher at 7.3. High birthweight births are to women who report smoking duringpregnancy.
(4,000 grams or more) are a relatively greater problem Alcohol consumption is another risky behavior more
for Indian women than are low weight births. For prevalent among Indian pregnant women. Indian