Studies of Substance Abuse with Interventions for the Youth of Native American Indian Communities #4

Purpose of the Study

The purpose of this section is to briefly familiarize the reader with the structural world in which many Native American Indians live. As is the case with cultural variations among American Indian tribes, great diversity in such things as income and employment also exists. But when talking about poverty, social statistics that denote averages can be very illuminating. In fact, some statistical averages show that American Indians in this country suffer the entire range of harmful conditions that are present in most Third World countries. Some examples will help clarify. Statistics on life expectancy are the best testimonial to the harshness and deprivation that many American Indians tolerate. The average life span of the American Indian is about eight to ten years below the national average. Premature death occurs in many forms. The maternal mortality rate for American Indians is around 11 per 100,000 live births. This rate is approximately 40 percent higher than the U.S. average maternal mortality rate. While the infant mortality rate for American Indians has decreased by approximately 85 percent since the 1970s, infant deaths still average a rate of 11 for every 1,000 live births. Further, the post neonatal death rate, which records infant deaths that occur from 28 days to 11 months after birth, is approximately 40 percent higher for American Indians than the U.S. population in general. If an American Indian lives beyond one year of age, the probability that he or she will die prematurely from other causes is also higher than it is for the U.S. population as a whole. For example, the Indian Health Service and Centers for Disease Control estimate that Indian deaths from motor vehicle accidents are more than three times higher than the national average. Deaths from alcoholism are almost six times higher, with deaths specifically caused by chronic liver disease and cirrhosis averaging five to six times higher than the U.S. averages. Death rates from pneumonia and influenza are more than double the national rates, and deaths from tuberculosis are nearly four times as high. Death rates from homicide and suicide are almost double the national averages and can be as much as eight times higher in some reservation communities. Social and economic characteristics on average still lag behind those of the population in general. From 50 to 60 percent of all American Indian children drop out of school before completing the twelfth grade, compared to only 20 to 25 percent of all other races combined. Unemployment averages around 50 percent, with some reservations experiencing unemployment rates as high as 80 to 90 percent. Nearly one of every four American Indian families has an income below the poverty level. Let's illustrate this another way. In 1999, half of all Indian families had an annual income of less than $18,000. During that same year, half of all White families in the United States had an annual income of almost $31,000 (Snipp and Summers, 2001). In addition, one of the most visible signs of deprivation in reservation communities is reservation housing. Again, although living conditions vary considerably, running water, central heating, indoor plumbing, and electricity are not always present. In fact, approximately 20 to 30 percent of housing in some reservation communities lacks both indoor plumbing and electricity. While many of these conditions appear to be getting better, many seem to be getting worse. While a more detailed breakdown of these average characteristics would reveal conditions far worse on some tribal levels, these national averages are quite revealing indicators of the harsh reality that many Native American Indians live with.

Most Native American Indians do not reside on remote reservations, well removed from the rest of America. In reality, the majorities (63%) live in urban areas, and only 22% of Native Americans live on reservations and tribal trust lands (U.S. Census Bureau, 2001b). The American Indian population is a young one, with a median age of 28.0, 34% being under 18 years old. In contrast, the median age for the overall U.S. population is 35.3, with 26% younger than 18 (U.S. Census Bureau, 2001a). About 10,000 American Indian and Alaskan Native children today attend federal boarding schools. First started in the 1870s as a method of forcibly assimilating Indians into American society, the aim of boarding schools was to systematically “kill the Indian, save the man” (Richard Pratt, founder of the first off-reservation boarding school in 1879, as cited in Kelley, 1999, section 3, para. 1). Intergenerational historical trauma, social disorganization and grief have been the result.

The mission of federal Indian boarding schools has greatly changed, and 52 remain open today (44 on reservations and 8 in off-reservation locations). Although some similarities and commonalities among Native American groups do exist, there is significant heterogeneity among communities and individuals according to tribal-specific factors; degree of Indian ancestry or blood quantum; residential pattern; and cultural affiliation, identity, and participation. When considering the issue of substance use and misuse, it is important to take into consideration the diversity of American Indians and Alaskan Natives and the implications it has for the development and implementation of prevention efforts.

Although the official terminology as set by the federal government’s Office of Management and Budget dictates that this collective group be referred to as American Indian/Alaskan Native (Robbin, 2000), it is common practice to also use the terms American Indian, Indian, Native American, and Native. Most generally, these terms are used to identify American Indians and/or Alaskan Natives. In contrast, when Alaskan Native is used alone, it generally refers only to Indians of that region. In this study, these terms are used interchangeably, but every effort is made to distinguish between regional and cultural groups when appropriate. In working with Native American Indians, community confidentiality is often considered equal in importance to the protection provided to individuals. Therefore, in most instances individual tribes and communities are not specifically referenced, and instead more general terms are used.