171020 Health and Health-Influencing Behaviors of Urban American Indians and Alaska Natives: Findings from the Behavioral Risk Factor Surveillance System

Sunday, October 26, 2008

Rachel Brucker, RN MPH , Urban Indian Health Institute, Seattle Indian Health Board, Seattle, WA
Maile Taualii, PhD , Native Hawaiian EPI Center, Papa Ola Lokahi, Honolulu, HI
Ralph Forquera, MPH , Urban Indian Health Institute, Seattle Indian Health Board, Seattle, WA
Background: More than half of American Indians and Alaska Natives (AIAN) live in urban areas, however most current surveillance activities do not include urban AIAN as a separate population, leading to a scarcity of information about their health and factors that influence health. The Behavioral Risk Factor Surveillance System (BRFSS) was analyzed to learn more about AIAN living in selected urban areas.

Methods: BRFSS results from 34 areas served by the network of urban Indian health organizations affiliated with the Indian Health Service were analyzed using aggregated data from 2001 through 2005. Responses from AIAN were compared to non-AIAN. Additional analyses stratified respondents into those reporting incomes above and below 200% of the federal poverty level (FPL).

Results: Differences existed between urban AIAN and non-AIAN in terms of access to healthcare, risk behaviors, and certain health outcomes. Income played a role in explaining some disparities, but major differences still existed between AIAN and non-AIAN in similar income groups. Among urban AIAN, prevalence of reported diabetes (9.5% among those >200% FPL vs. 9.6% among those <200% FPL), hypertension (18.3% vs. 18.6%), obesity (30.6% vs. 30.9%), and smoking (24.8% vs. 26.0%) were not associated with income. This was not the case among non-AIAN, where those with lower incomes had higher rates of these health problems.

Conclusion: The relationship between income and certain health indicators appeared to be different among urban AIAN compared with non-AIAN. Factors in addition to income differences must exist to explain the significant health disparities faced by this population.

Learning Objectives:
1. Describe major health disparities faced by urban American Indians and Alaska Natives that are reported in BRFSS. 2. Identify areas where income and health outcomes may be associated differently among urban American Indians and Alaska Natives than they are among the general population. 3. Describe other factors besides income that may help explain identified health disparities. 4. Understand the need for better surveillance related to the health needs of urban American Indians and Alaska Natives.

Keywords: American Indians, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was involved with all aspects of this analysis and will be responsible for preparing the presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.