Discussions with urban American Indian and Alaska Native parents: Keeping babies healthy and safe

Background: The majority of American Indians and Alaska Natives (AI/AN) reside in urban areas and experience striking disparities in infant mortality and maternal and child health (MCH) compared to the general population. Urban AI/ANs have unique exposures, barriers and experiences with regard to factors such as healthcare access, cultural identity and support systems.

Methods: With funding from the U.S. Department of Health and Human Services, Office of Minority Health we hosted discussions in partnership with urban Indian health organizations (UIHO) in Detroit, Sacramento, Salt Lake City, and Seattle with young AI/AN parents about keeping babies healthy and safe.

Results: Parents feel that a safe and stable environment is a priority for the baby. A strong native identity, native-specific resources, such as those offered at UIHO, and shared values among caregivers are supportive in breaking the unhealthy patterns described, such as alcohol and tobacco use, teen parenting and violence. Some of the barriers urban AI/AN parents experience are a lack of money, transportation and childcare, social isolation, stress, teen and single parenting, and conflicting family and community norms around topics such as nutrition, smoking, car seat use and safe sleep practices, especially across generations.

Conclusions: Study findings point to a lack of support as a significant barrier to keeping babies healthy and safe and provide unique insight into the connections between native identity and MCH for urban AI/ANs. Findings will inform the development of a campaign to increase awareness of and ultimately reduce infant mortality among AI/AN residing in urban areas and beyond.