Abstract
In the USA, some race-ethnic minorities are unjustly relegated to the margins of society. As a consequence, these groups are more frequently found to have risk profiles associated with adverse health than individuals from the majority group (non-Hispanic Whites). Limited research has been devoted to investigating how American Indians and Alaska Natives (AIANs) differ from other race-ethnic minorities and the majority group with regard to prevalence and risk for self-care, independent living, and ambulatory disabilities. Our investigation attempts to quantify both of these tracks by accounting for race-ethnic and poverty status. Our cross-sectional analysis used nationally representative data from the American Community Survey (ACS) 5-year (2009–2013) Public Use Microdata Sample (PUMS) file to address this literature gap. We selected survey participants from the four states with the largest concentration of AIANs in the USA (Arizona, California, New Mexico, and Oklahoma). We used information on 2,428,233 individuals to generalize prevalence of and risk for disability to 49,994,332 individuals in the Southwest US. We found disability (self-reported) prevalence differed between our six race-ethnic groups in statistically significant and complex ways. Population-weighted logistic regression analyses adjusting for age, sex, and citizenship found AIANs have a higher risk for disability than non-Hispanic Whites, non-Hispanic Asians, and Hispanics. In order to impact public health and build a more equitable society, efforts should continue to identify health disparities. Researchers should continue to advance conceptual frameworks on plausible causal mechanisms between markers of social stratification and disablement processes.
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References
Braveman P Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27:167–94.
Nagi SZ. An epidemiology of disability among adults in the United States. The Milbank Memorial Fund Quarterly. Health and Society. 1976:439–67.
Verbrugge LM, Jette AM The disablement process. Soc Sci Med. 1994;38(1):1–14.
Lawton MP, Nahemow L. Ecology and the aging process. In: Eisdorfer C, Lawton MP, editors. The psychology of adult development and aging. Washington, DC: American Psychological Association; 1973.
Ostfeld RS, Glass GE, Keesing F. Spatial epidemiology: an emerging (or re-emerging) discipline. Trends Ecol Evol. 2005;20(6):328–36.
Freedman VA, Grafova IB, Schoeni RF, Rogowski J. Neighborhoods and disability in later life. SSM. 2008;66(11):2253e67.
Cummins S, Curtis S, Diez-Roux AV, Macintyre S Understanding and representing ‘place’in health research: a relational approach. Soc Sci Med. 2007;65(9):1825–38.
Hox JJ Applied multilevel analysi s. Amsterdam: TT-Publikaties; 1995.
Raudenbush SW, Bryk AS. Hierarchical linear models: applications and data analysis methods. Second ed. Thousand Oaks, California: Sage Publications; 2002.
Raudenbush SW, Bryk AS, Cheong Y, et al. HLM 6: hierarchical linear and nonlinear modeling. Lincolnwood, IL: Scientific Software International, Inc.; 2004.
Adler NE, Rehkopf DH US disparities in health: descriptions, causes, and mechanisms. Annu. Rev. Public Health. 2008;29:235–52.
Kilbourne AM, Switzer G, Hyman K, Crowley-Matoka M, Fine MJ Advancing health disparities research within the health care system: a conceptual framework. Am J Public Health. 2006;96(12):2113.
Wang S, Lewis Jr CM, Jakobsson M, Ramachandran S, Ray N, Bedoya G, Ruiz-Linares A Genetic variation and population structure in Native Americans. PLoS Genet. 2007;3(11):e185.
Young TK The health of Native Americans: toward a biocultural epidemiology. New York: Oxford University Press; 1994.
Braun KL, LaCounte C The historic and ongoing issue of health disparities among native elders. Generations. 2014;38(4):60–9.
Brockie TN, Heinzelmann M, Gill J A framework to examine the role of epigenetics in health disparities among Native Americans. Nursing Res Pract. 2013;2013. doi:10.1155/2013/410395.
Garrett MD, Baldridge D, Benson W, Crowder J, Aldrich N Mental health disorders among an invisible minority: depression and dementia among American Indian and Alaska Native elders. The Gerontologist. 2015;55(2):227–36. doi:10.1093/geront/gnu181.
Gone JP, Trimble JE American Indian and Alaska Native mental health: diverse perspectives on enduring disparities. Annu Rev Clin Psychol. 2012;8:131–60.
Lynch MJ, Stretesky PB Native Americans, environmental harms, and justice. Am Indians at Risk. 2013;439.
Rodriguez JE, Campbell KM, Adelson WJ Poor representation of blacks, latinos, and native Americans in medicine. Fam Med. 2015;47(4):259–63.
Norris, T., Vines, P. L., & Hoeffel, E. M. (2012). The American Indian and Alaska Native Popualtion: 2010. US Census Briefs, C2010BR-10.
Burrows NR, Geiss LS, Engelgau MM, Acton KJ Prevalence of diabetes among Native Americans and Alaska Natives, 1990-1997: an increasing burden. Diabetes Care. 2000;23(12):1786–90.
Harjo TC, Perez A, Lopez V, Wong ND Prevalence of diabetes and cardiovascular risk factors among California Native American adults compared to other ethnicities: the 2005 California Health Interview Survey. Metab Syndr Relat Disord. 2011;9(1):49–54.
Denny CH, Holtzman D, Goins RT, Croft JB Disparities in chronic disease risk factors and health status between American Indian/Alaska Native and White elders: findings from a telephone survey, 2001 and 2002. Am J Public Health. 2005;95(5):825.
Murray CJ, Kulkarni S, Ezzati M Eight Americas: new perspectives on US health disparities. Am J Prev Med. 2005;29(5):4–10.
Ni, C. F., Wilkins-Turner, F., Liebert, D. E., Ellien, V., & Harrington, C. (2014). Native Americans with disabilities: a comparison of male and female eastern tribal members. Rev Disabil Stud Int J, 7(1).
Flores G, Tomany-Korman SC Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics. 2008;121(2):e286–98.
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The authors have no conflicts of interest with the journal. Because the manuscript only uses secondary data, no human contact was made. There are no IRB protocols to disclose as the investigation only used publicly available and de-identified data.
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Siordia, C., Bell, R.A. & Haileselassie, S.L. Prevalence and Risk for Negative Disability Outcomes Between American Indians-Alaskan Natives and Other Race-Ethnic Groups in the Southwestern United States. J. Racial and Ethnic Health Disparities 4, 195–200 (2017). https://doi.org/10.1007/s40615-016-0218-z
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DOI: https://doi.org/10.1007/s40615-016-0218-z