American Indian and Alaska Native men's health: Needs for interventions and services

Background: Only recently has male health been of interest to policy makers despite their historic lower life expectancy. Male disparities in mental health, substance abuse and cardiovascular health depict long-term risks such as being a veteran, violence, lifestyle and occupational exposures. Native American males have some of the highest risks yet few interventions exist to address their health concerns.

Method: Over a six month period, an extensive literature review was conducted to identify the extent of interventions with a sufficient evidence base for American Indian and Alaska Native (AIAN) men's health.

Results: Few intervention trials with sufficient numbers of AIAN existed for major health risk factors including physical activity, diet, obesity, and diabetes. Some alcohol, substance abuse and tobacco prevention and treatment, mental health and suicide prevention programs were available for a small number of specific tribes. Many studies reported that their programs were culturally appropriate for AIAN male populations yet most of these had zero or small numbers of AIAN males.

Conclusions: Policy makers must prioritize AIAN men's health to significantly diminish health disparities. Federal agencies and associations publishing best practices need to scrutinize studies to ensure that claims of cultural appropriateness are justified given the inclusion of sufficient AIAN numbers. Huge gaps exist in the evidence base for interventions for AIAN males. Cultural appropriateness needs to be critically examined because AIAN populations are extremely diverse in both language and practices. Studies addressing AIAN male gaps require a wider range of included tribal representatives.