Across the northern border of the U.S., it is a little colder yet has a similar story of Native American people. Here the aboriginal peoples, or the original inhabitants of North America, are referred to as First Nations, Métis, and Inuit. Like many Native American tribes in the U.S., several Canadian tribes have formal treaties with the Canadian government which establish their right to self-govern on federally recognized reserves, or areas of land held by the Crown but set aside for the use of specific native tribes [1]. In 1973, the Supreme Court of Canada “established that Aboriginal rights in Canada pre-existed the 1763 Royal Proclamation, providing contexts both for the settlement of Aboriginal land claims, where land had not been ceded through treaties, and for Aboriginal self-government as an inherent right” via the Calder decision. With pressure by native political groups, the Canadian government began funding the Indian Community Self-Government Negotiation Program in 1986 [2]. There has been significant progress made in the realm of First Nation rights especially in comparison to other countries where many indigenous peoples are not formally recognized, but the struggle for sovereignty and fulfillment of treaties in Canada is still ongoing.
For a nation to transition from complete independence to control by another nation with different cultural values and, finally, slowly returned its sovereignty, it is logical to assume change in the original nation has occured. For example, many native people were drastically changed in Northern America with the introduction of Christianity, often by force, during British, French, and Spanish colonization [3]. Thus, policies enacted by the Canadian government after establishing control over the region have impacted the lives of aboriginal peoples. The most vulnerable of this population, aboriginal women, struggle with mental illness, poverty, substance abuse, trauma, etc. the most as a result of the intergenerational impact of Canadian policies. In fact, a significant number of aboriginal women feel intimidated by, suspicious of, or forgotten by Canadian government policy and healthcare [4].
Residential schools are one powerful example of a Canadian policy that changed aboriginal peoples lives forever. Children were taken by priests, social workers, and police to local schools where they were forced to assimilate to Western practices such as Christianity. The first known boarding school for Aboriginal youth in Canada began in 1620 by a Franciscan religious group known as the Récollets. The Bagot Commision Report of 1844 concluded that aboriginal communities were “half-civilized” states and could only become civilized through schooling to “acquire the manners, habits and customs of civilized life.” After 1830, children were the main focus of this forced assimilation, and before 1858, most of these residential schools required a suspicious amount of manual labor. Since the U.S. boarding school system for Indian children was so effective at acculturation, Canadian government decided to adopt the same policy in 1879 [5].
As a result of this forced change in their cultural identity, not only did many aboriginal peoples lose their traditional language and way of life but, in addition, the roles of aboriginal men and women in Canada today are different. In Inuit tribes, men would traditionally hunt, gather food, haul heavy materials, and build and maintain hunting equipment. Women were responsible for cooking, cleaning, sewing skins, fishing, fuel and food gathering, and child care. However, each gender was in control of his or her own sphere of work, and while at home together, both were considered equal. In Central Arctic Inuit tribes, men and women socialized and worked mostly in their same gender groups meaning a large portion of their community status was determined by members of the same gender. However, the order of authority is usually young to old and female to male, but it is common for older women to be considered above answering to young men. After marriage, an Inuit woman has little control over sex and procreation. A man may share his wife or trade her with other, and he may take another wife without consultation. However, both men and women can seek a divorce by leaving [6]. Generally, aboriginal women played a major role in passing down cultural and spiritual knowledge to the younger generation [7]. In Canadian boarding schools for aboriginal youth, female students were prepared to become wives and mothers, taking away their traditional leadership roles in favor of patriarchal leadership. Due to a strict Christian code of sexual morality, girls were often requested to remain at school until they were married. If they did not get married, they worked at the school as full-time unpaid labor until they were eighteen [5].
In this male dependent role, aboriginal women are drastically more vulnerable. Aboriginal women in Canada are more likely than average Canadian women to be human trafficked, exposed to drugs and alcohol, experience mental illness or domestic violence, and a myriad of chronic diseases. “Between 2000 and 2008, 153 cases of murder have been identified in NWAC’s
Sisters In Spirit database. These women represent approximately ten per cent of the total number of female homicides in Canada despite the fact that Aboriginal women make up only three per cent of the total female population in Canada” [10].
Today, compelling research exists demonstrating the direct relationship between colonialism and health inequality in aboriginal women. “The accumulative effect of the different aspects of colonialism—displacement, residential schools, poverty, sanatoriums, racism, and intergenerational trauma—has been linked to a wide range of health disorders” [7,8]. Many of these disorders are relatively new phenomena to aboriginal culture such as diabetes, hypertension, and cardiovascular disease. Cardiovascular disease is one of the most prevalent in aboriginal women. As a result of their strange nature, traditional medicinal approaches do not provide a basis for understanding these new diseases, and aboriginal youth with higher formal education tend to rely less on traditional manners of healing in favor of Western medicine [9].
While this problem seems to have dim prospects in terms of solutions, all hope is not lost. There is promising research demonstrating that this intergenerational cycle can be broken via ethically based policies and interventions. Caroline Tait while writing for the International Journal of Circumpolar Health calls for improved coordination between government ministries and human service sectors, consolidation of government jurisdiction for responsibility of Indigenous peoples, and changing attitudes from seeing impoverished Indigenous women in Canadian as “assests” rather than as “liabilities” [4]. Non profit organizations like the Native Women’s Association of Canada is one exemplary example of women who are fighting to raise awareness about the current status of Aboriginal women health disparities and have made progress in the form of lobbying, submits, outreach, and research [11].
Citations:
[1] Canada. Aboriginal Affairs and Northern Development Canada. Publications and Public Enquiries. Treaties with Aboriginal People in Canada. Ottawa: n.p., 2010.Canada.gc.ca. Web. 5 Feb. 2014. <http://www.aadnc-aandc.gc.ca/eng/1100100032291/1100100032292>.
[2] Bonesteel, Sarah. "Canada's Relationship with Inuit: A History of Policy and Program Development." Canada.gc.ca. Aboriginal Affairs and Northern Development Canada, 15 Sept. 2010. Web. 5 Feb. 2014. <http://www.aadnc-aandc.gc.ca/eng/1100100016900/1100100016908#chp14>.
[3] The Inupiat and the Chrisianization of Arctic Alaska, Ernest S. Burch, Jr.,
Etudes/Inuit/Studies, 1994, 18(1-2), pp. 81-108.
[4] Tait, Caroline L. "Resituating the Ethical Gaze: Government Morality and the Local Worlds of Impoverished Indigenous Women." International Journal of Circumpolar Health72.0 (2013): n. pag. US National Library of Medicine. Canadian Institutes of Health Research. Web. 5 Feb. 2014. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3754611/>.
[5] Tait CL. Fetal alcohol syndrome among Canadian Aboriginal peoples: review and analysis of the intergenerational links to residential schools. Ottawa, ON: Aboriginal Healing Foundation; 2003.
[6] Klein, Laura F., and Lillian A. Ackerman. Women and Power in Native North America. Norman: University of Oklahoma, 1995. Print.
[7] Medved, M. I., J. Brockmeier, J. Morach, and L. Chartier-Courchene. "Broken Heart Stories: Understanding Aboriginal Women's Cardiac Problems." Qualitative Health Research 23.12 (2013): 1613-625. Web. <http://qhr.sagepub.com/content/23/12/1613.long>.
[8] Moffatt, J., M. Mayan, and R. Long. "Sanitoriums and the Canadian Colonial Legacy: The Untold Experiences of Tuberculosis Treatment." Qualitative Health Research 23.12 (2013): 1591-599. Web. <http://qhr.sagepub.com/content/23/12/1591.long>.
[9] Medved, M. I., J. Brockmeier, J. Morach, and L. Chartier-Courchene. "Broken Heart Stories: Understanding Aboriginal Women's Cardiac Problems." Qualitative Health Research 23.12 (2013): 1613-625. Web. <http://qhr.sagepub.com/content/23/12/1613.long>.
[10] Native Women's Association of Canada. "What Their Stories Tell Us Research Findings from the Sisters In Spirit Initiative." Www.nwac.ca. N.p., n.d. Web. 6 Feb. 2014. <http://www.nwac.ca/files/reports/2010_NWAC_SIS_Report_EN.pdf>.
[11] Native Women's Association of Canada. "Welcome to the Native Women's Association of Canada Website." NWAC/l'AFAC. N.p., n.d. Web. 07 Feb. 2014. <http://www.nwac.ca/>.
Friday, June 27, 2014
Health Interventions by Native American Women
Last time, we explored a few examples of community based research [1] and intervention which were effective in addressing health issues faced by Native American women [2, 3]. This week, we will discuss how native women have and continue to be the forefront of advocacy and implementation of health resources and services through a few examples of interventions [4].
Here are Native American Women leaders taking action around the US:
STDS
HIV/AIDS is well known to disproportionately impact women of color within the United States, especially Native American Women. Furthermore, Native American women face elevated rates of STDs. For example, native women are 4 times more likely to report having Chlamydia than native men. However, men of all ethnicities generally have higher rates of HIV/AIDS than women, but this makes women more vulnerable as well because "HIV is anywhere from two to twenty times more efficiently transmitted from men to women" according to Irene Vernon who has published her findings in the American Indian Culture and Research Journal. Women living in the United States are not affected equally either. Of all women who reported AIDS contraction in 1998, certain ethnic groups were found to be more affected than others. For example, at this time 25.6 percent of African American women, 16.7 percent of Native American women, and 8.3% of white women reported contraction of AIDS [9]. To learn more HIV/AIDS prevalence in Native Americans, check out this fact sheet generated by the Centers for Disease Control and Prevention: http://www.cdc.gov/hiv/risk/racialEthnic/aian/
To lighten this story up a bit, there are some native women who have been able to find a healthy way to live even with HIV/AIDS and work to raise awareness in native communities. Native women such as Donnie Blackwolf (died of AIDS in December 1997), Shana Cozad, and Lisa Tiger are all known as women warriors. These women warriors have been exposed to HIV/AIDS and the many risk factors, such as poverty, child maltreatment, rape, etc., but serve as HIV/AIDS awareness and education advocates across the nation [4]. Furthermore, the National Native American AIDS Prevention Center, which has a board of directors primarily composed of women, was founded in 1987 to eliminate AIDS, promote advocacy, and provide resources/training. There is now an official National Women and Girls HIV/AIDS Awareness Day, which you can learn more about here http://www.womenshealth.gov/nwghaad/ that is supported by the National Indian Health Board (http://www.nihb.org/public_health/proj_hiv.php). Interestingly enough, the elected NIHB chairperson is a woman named Cathy Abramason. Girl power!
Health and Wellness
As we have discussed in earlier blogs, chronic diseases such as obesity and diabetes unequally affect Native Americans in comparison to the average US population. The American Indian Institute (Aii) established at the University of Oklahoma in 1951 is a non-profit research, service, and training organization that focuses on health and wellness in Native American communities. Aii hosts an annual Native Women and Men’s Wellness Conference in addition to many other programs. The Director, Officer Manager & Conference Planner, and Program & Conference Planner of the American Indian Institute, which are the top three positions, are all held by Native American Women [5].
Honoring Native Life, is an organization to prevent suicide in Native American populations of New Mexico. They provide a variety of hotline, education, and community based resources and aim to honor native life. It is interesting to note that 7 out of 8 members of the Honoring Native Life team are native american women, and all 8 are women [6].
We see a similar situation among Lakota women of the Pine Ridge reservation in South Dakota. In a makeshift camp named “Camp Zero Tolerance,” a group of Lakota women have set up to protest alcohol abuse in the neighboring town of Whiteclay. Whiteclay is a small town that sits on the outskirts of the dry Pine Ridge Indian Reservation and is not associated with the reservation. Whiteclay only has a population of 14 people, but it has 4 different liquor stores that sell “about 12,500 cans of beer per day or 4.9 cans per year” [7]. The protesters of Camp Zero Tolerance believe that the sale of liquor about 300 feet from the border of the reservation is a major problem that contributes to issues within the reservation, such as domestic violence, alcohol abuse, sexual assault, etc. [7].
Violence
In our last example today, there is an organization called the Mending of the Sacred Hoop which works to end violence against Native American women and children through restoring safety and sovereignty to local communities and sacredness and power of Native Women in tribal society. The organization was originally supported by and received funding from the U.S. Department of Justice, Office of Violence Against Women, after the passage of the Violence Against Women Act in 1994. Now, it is an independent and non-profit organization that is managed by staff dominated by Native American Women with the ratio of “Native American Woman” to “Other” being 4 to 1 [8].
While many of these interventions require ways to evaluate their efforts, the fact that they are run primarily by Native American women speaks highly of native women's strength and fortitude. Even when native women face the harshest of situations and worst of health statistics, they still do not give up. In fact, they go beyond helping themselves and work to help the community as a whole. Maybe, it is because of their strong cultural ties to community or because they are tired of the status quo . . . the reason likely differs from woman to woman. The main point: Native American woman are making a difference, and we can support these women by understanding their history, plight, and efforts. Thank you for taking the time to understand them with me by reading this blog.
Citations:
[1] Holkup, Patricia A., PhD, RN, Toni Tripp-Reimer, PhD, RN, RAAN, Emily Matt Salois, MSW, ACSW, and Clarann Weinert, SC, PhD, RN, FAAN. “Community-based Participatory Research: An Approach to Intervention Research With a Native American Community.” Advances in Nursing Science 27.3 (2004): 162-75. NCBI. Web.
[2] Hobfoll, Stevan E., Anita Jackson, Ivonne Hobfoll, Charles A. Pierce, and Sara Young. “The Impact of Communal-Mastery Versus Self-Mastery on Emotional Outcomes During Stressful Conditions: A Prospective Study of Native American Women.” American Journal of Community Psychology 30.6 (2002): 853-71. Springer.com. Web. 27 Feb. 2014.
[3] Gone, Joseph P. “A Community-based Treatment for Native American Historical Trauma: Prospects for Evidence-based Practice.” Spirituality in Clinical Practice 1.S (2013): 78-94. 2013. Web.
[4] Joe, Jennie Rose., and Francine C. Gachupin. Health and Social Issues of Native American Women. Santa Barbara: Praeger, 2012. Print.
[5] http://www.aii.outreach.ou.edu/
[6] http://honoringnativelife.org/
[7]http://wagingnonviolence.org/feature/pine-ridge-indian-reservation-women-lead-fight-against-alcohol/
[8] http://mshoop.org/
[9] Vernon, I. (2010). Facts and Myths of AIDS and Native American Women. American Indian Culture Research Journal, 24 (3), 93-110. http://aisc.metapress.com/content/a08g7n6h1804mp5p/
[10] http://www.nnaapc.org/about/board.htm
Here are Native American Women leaders taking action around the US:
STDS
HIV/AIDS is well known to disproportionately impact women of color within the United States, especially Native American Women. Furthermore, Native American women face elevated rates of STDs. For example, native women are 4 times more likely to report having Chlamydia than native men. However, men of all ethnicities generally have higher rates of HIV/AIDS than women, but this makes women more vulnerable as well because "HIV is anywhere from two to twenty times more efficiently transmitted from men to women" according to Irene Vernon who has published her findings in the American Indian Culture and Research Journal. Women living in the United States are not affected equally either. Of all women who reported AIDS contraction in 1998, certain ethnic groups were found to be more affected than others. For example, at this time 25.6 percent of African American women, 16.7 percent of Native American women, and 8.3% of white women reported contraction of AIDS [9]. To learn more HIV/AIDS prevalence in Native Americans, check out this fact sheet generated by the Centers for Disease Control and Prevention: http://www.cdc.gov/hiv/risk/racialEthnic/aian/
To lighten this story up a bit, there are some native women who have been able to find a healthy way to live even with HIV/AIDS and work to raise awareness in native communities. Native women such as Donnie Blackwolf (died of AIDS in December 1997), Shana Cozad, and Lisa Tiger are all known as women warriors. These women warriors have been exposed to HIV/AIDS and the many risk factors, such as poverty, child maltreatment, rape, etc., but serve as HIV/AIDS awareness and education advocates across the nation [4]. Furthermore, the National Native American AIDS Prevention Center, which has a board of directors primarily composed of women, was founded in 1987 to eliminate AIDS, promote advocacy, and provide resources/training. There is now an official National Women and Girls HIV/AIDS Awareness Day, which you can learn more about here http://www.womenshealth.gov/nwghaad/ that is supported by the National Indian Health Board (http://www.nihb.org/public_health/proj_hiv.php). Interestingly enough, the elected NIHB chairperson is a woman named Cathy Abramason. Girl power!
Health and Wellness
As we have discussed in earlier blogs, chronic diseases such as obesity and diabetes unequally affect Native Americans in comparison to the average US population. The American Indian Institute (Aii) established at the University of Oklahoma in 1951 is a non-profit research, service, and training organization that focuses on health and wellness in Native American communities. Aii hosts an annual Native Women and Men’s Wellness Conference in addition to many other programs. The Director, Officer Manager & Conference Planner, and Program & Conference Planner of the American Indian Institute, which are the top three positions, are all held by Native American Women [5].
Honoring Native Life, is an organization to prevent suicide in Native American populations of New Mexico. They provide a variety of hotline, education, and community based resources and aim to honor native life. It is interesting to note that 7 out of 8 members of the Honoring Native Life team are native american women, and all 8 are women [6].
We see a similar situation among Lakota women of the Pine Ridge reservation in South Dakota. In a makeshift camp named “Camp Zero Tolerance,” a group of Lakota women have set up to protest alcohol abuse in the neighboring town of Whiteclay. Whiteclay is a small town that sits on the outskirts of the dry Pine Ridge Indian Reservation and is not associated with the reservation. Whiteclay only has a population of 14 people, but it has 4 different liquor stores that sell “about 12,500 cans of beer per day or 4.9 cans per year” [7]. The protesters of Camp Zero Tolerance believe that the sale of liquor about 300 feet from the border of the reservation is a major problem that contributes to issues within the reservation, such as domestic violence, alcohol abuse, sexual assault, etc. [7].
Violence
In our last example today, there is an organization called the Mending of the Sacred Hoop which works to end violence against Native American women and children through restoring safety and sovereignty to local communities and sacredness and power of Native Women in tribal society. The organization was originally supported by and received funding from the U.S. Department of Justice, Office of Violence Against Women, after the passage of the Violence Against Women Act in 1994. Now, it is an independent and non-profit organization that is managed by staff dominated by Native American Women with the ratio of “Native American Woman” to “Other” being 4 to 1 [8].
While many of these interventions require ways to evaluate their efforts, the fact that they are run primarily by Native American women speaks highly of native women's strength and fortitude. Even when native women face the harshest of situations and worst of health statistics, they still do not give up. In fact, they go beyond helping themselves and work to help the community as a whole. Maybe, it is because of their strong cultural ties to community or because they are tired of the status quo . . . the reason likely differs from woman to woman. The main point: Native American woman are making a difference, and we can support these women by understanding their history, plight, and efforts. Thank you for taking the time to understand them with me by reading this blog.
Citations:
[1] Holkup, Patricia A., PhD, RN, Toni Tripp-Reimer, PhD, RN, RAAN, Emily Matt Salois, MSW, ACSW, and Clarann Weinert, SC, PhD, RN, FAAN. “Community-based Participatory Research: An Approach to Intervention Research With a Native American Community.” Advances in Nursing Science 27.3 (2004): 162-75. NCBI. Web.
[2] Hobfoll, Stevan E., Anita Jackson, Ivonne Hobfoll, Charles A. Pierce, and Sara Young. “The Impact of Communal-Mastery Versus Self-Mastery on Emotional Outcomes During Stressful Conditions: A Prospective Study of Native American Women.” American Journal of Community Psychology 30.6 (2002): 853-71. Springer.com. Web. 27 Feb. 2014.
[3] Gone, Joseph P. “A Community-based Treatment for Native American Historical Trauma: Prospects for Evidence-based Practice.” Spirituality in Clinical Practice 1.S (2013): 78-94. 2013. Web.
[4] Joe, Jennie Rose., and Francine C. Gachupin. Health and Social Issues of Native American Women. Santa Barbara: Praeger, 2012. Print.
[5] http://www.aii.outreach.ou.edu/
[6] http://honoringnativelife.org/
[7]http://wagingnonviolence.org/feature/pine-ridge-indian-reservation-women-lead-fight-against-alcohol/
[8] http://mshoop.org/
[9] Vernon, I. (2010). Facts and Myths of AIDS and Native American Women. American Indian Culture Research Journal, 24 (3), 93-110. http://aisc.metapress.com/content/a08g7n6h1804mp5p/
[10] http://www.nnaapc.org/about/board.htm
Wednesday, June 4, 2014
Health Interventions for Native American Women
Recent studies have demonstrated that the most successful
interventions for Native American women’s health have taken community
partnering into consideration. This makes sense considering that most
Native American cultures focus on the betterment of the community rather
than on a single individual [2]. Partnering with Native American
communities allows for more culturally sensitive approaches[3]—an
important aspect because many surveyed native women claim that more
cultural awareness and professionalism is required by doctors, nurses,
and implementers of health interventions [8]. Therefore, by involving
the community as a whole intervention programs take a step towards
health improvement and cultural reclamation. Below are some successful
examples of health interventions in populations of Native American women
that involve community partnership.
(1) Physical Activity
There are higher rates of obesity, diabetes, and heart disease in Native American women compared to non-Hispanic white women [1]. Furthermore, rates of physical activity are lower among Native American women than among non-Hispanic white women. However, social environmental factors such as community interaction are significantly associated with rate of physical activity. Research interventions to increase physical activity in Native American suggest that “results emphasize importance of support from family, friends, and communities” [4]. Other suggested interventions for increasing physical activity in native women include: providing exercise facilities, improving existing programs and facilities, developing exercise programs/classes specifically for women, and improving community security. Overall though, increasing social support via the community correlates with the greatest increases in physical activity [4].
(2) Breast Cancer Awareness
Native American women have lower breast cancer screening and 5-year survival rates than non-Hispanic white women in the US. Native women have themselves recommended interventions such as the “buddy system,” a system of partnering community members together to provide mentorship and motivation [8]. An organization called the Circle of Sisters, which is a breast cancer education initiative and offers free mammography for Native American women, has found its most promising results in community partnerships. The organization conducted a small audit of its intervention community-based programs and found that they increased native women’s understanding of: (1) chances of being diagnosed with breast cancer, (2) association of breast cancer with pregnancy complications, and (3) that breast cancer can be detected early. Furthermore, the percent of women intending to get a mammogram after the intervention had increased [6].
(3) Alcohol Consumption
Research to reduce alcohol consumption and dependency in Native American women and to prevent fetal alcohol spectrum disorders have associated community involvement with successful interventions. According to a review of evidence based approaches for reducing alcohol consumption in native women by The American Journal of Drug and Alcohol Use, “Studies presently reviewed suggest that to create a successful prevention/treatment program, it is important to incorporate community members in all aspects of project design and implementation” [7]. More studies are required but it is clear that respect for community and social identity is necessary to implement successful health interventions [7].
(4) Reproductive Health and Sexual violence
A Native Teen Voices study conducted in Minnesota asked urban native youth for recommendations to reduce health and sexual violence. Many of their answers included involving knowledgeable, trusted family and community leaders in addition to more comprehensive sex education in schools and increased access to contraceptive resources [9]. Other studies have demonstrated success in community based youth development programs for reducing sexual violence and increasing reproductive health [9,10]. Furthermore, the National Institute of Justice was mandated by The Violence Against Women Act of 2005 to conduct a national baseline study on violence against Native American women living on tribal lands. They found that barriers to helping victims of sexual violence included: “fear of being blamed, fear of prejudice, geographic isolation, lack of services available, conflict between Western approaches to intervention and American Indian values,” etc. [11]. At this time they are currently conducting research on intervention methods but have emphasized the importance of involving women of the community in creation of prevention and intervention methods [11].
As one can see from these examples, community based research [12] and intervention is an effective approach to health issues of Native American women [2, 3]. Thus, community involvement should be considered in any health intervention being applied to native women. Despite forced cultural, religious, and economic assimilation of Native American people which has shaped cultural practices and social structure, Native American women are a strong, persevering, and influential social group. Next week, we will discuss how native women have and continue to be the forefront of advocacy and implementation of health resources and services[1].
Right in our backyard, there are thousands of women at risk for diabetes, cancer, alcoholism, substance abuse, domestic abuse, heart disease, obesity, etc. However, as members of sovereign yet domestically dependent nations, they are often forgotten. The plight of these Native American women can teach us about the health and social effects of external pressures on women of once independent cultures. In other words, Native American women have experienced war, death, acculturation, racism, loss of land, sustenance shortage, and the “give and take” of sovereignty.
Overall, these obstacles have forced many Native Americans away from their traditional beliefs/practices and into a cycle of health and social inequalities. However, there is hope for the health of Native American women. A recent study of health-risk behavior in the Cheyenne River Sioux tribe by Han 1994 “found that women who were more traditionally engaged in terms of lifestyle and language fluency were healthier than less traditional women” [1]. Thus, the healing journey for many Native American women entails reclaiming native heritage, identity, and spirituality while also addressing historical trauma (i.e. harmful psycho-social legacy of boarding schools) [3].
Citations:
[1] Joe, Jennie Rose., and Francine C. Gachupin. Health and Social Issues of Native American Women. Santa Barbara: Praeger, 2012. Print.
[2] Hobfoll, Stevan E., Anita Jackson, Ivonne Hobfoll, Charles A. Pierce, and Sara Young. “The Impact of Communal-Mastery Versus Self-Mastery on Emotional Outcomes During Stressful Conditions: A Prospective Study of Native American Women.” American Journal of Community Psychology 30.6 (2002): 853-71. Springer.com. Web. 27 Feb. 2014.
[3] Gone, Joseph P. “A Community-based Treatment for Native American Historical Trauma: Prospects for Evidence-based Practice.” Spirituality in Clinical Practice 1.S (2013): 78-94. 2013. Web.
[4] Thompson, J. “Personal, Social, and Environmental Correlates of Physical Activity in Native American Women.” American Journal of Preventive Medicine 25.3 (2003): 53-60.Elsevier Inc. 2003. Web.
[5] Kitayama, S., Markus, H. R., Matsumoto, H., & Norasakkunkit, V. (1997). Individual and collective processes in the construction of the self: Self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology, 72, 1245–1267.
[6] Chilton, Janice A., Cheryl Downing, Melissa Lofton, Mike Hernandez, Beth W. Allen, Richard A. Hajek, and Beverly Gor. “Circle of Sisters: Raising Awareness of Native American Women to Breast Cancer.” Journal of Health Care for the Poor and Underserved 24.3 (2013): 1167-179. 3 Aug. 2013. Web.
[7] Montag, Annika, John D. Clapp, Dan Calac, Jessica Gorman, and Christina Chambers. “A Review of Evidence-Based Approaches for Reduction of Alcohol Consumption in Native Women Who Are Pregnant or of Reproductive Age.” The American Journal of Drug and Alcohol Abuse 38.5 (2012): 436-43. 2012. Web.
[8] Ndikum-Moffor, Florence M., Stacy Braiuca, Christine Makosky Daley, Byron J. Gajewski, and Kimberly K. Engelman. “Assessment of Mammography Experiences and Satisfaction Among American Indian/Alaska Native Women.” Women’s Health Issues 23.6 (2013): E395-402. 2013. Web.
[9] Rutman, Shira, Maile Taualii, Dena Ned, and Crystal Tetrick. “Reproductive Health and Sexual Violence Among Urban American Indian and Alaska Native Young Women: Select Findings from the National Survey of Family Growth (2002).” Maternal and Child Health Journal 16.S2 (2012): 347-52. Springer Science+Business Media. 19 Aug. 2012. Web.
[10] Smith, M. U., Rushing, S. C., & Native STAND Curriculum Development Group. (2011). Native STAND (students together against negative decisions): Evaluating a school-based sexual risk reduction intervention in Indian boarding schools. The Health Education Monograph, 28(2), 67–74. Available from: http://www.indiana.edu/*aids/
[11] Crossland, C., J. Palmer, and A. Brooks. “NIJ’s Program of Research on Violence Against American Indian and Alaska Native Women.” Violence Against Women 19.6 (2013): 771-90. 2013. Web.
[12] Holkup, Patricia A., PhD, RN, Toni Tripp-Reimer, PhD, RN, RAAN, Emily Matt Salois, MSW, ACSW, and Clarann Weinert, SC, PhD, RN, FAAN. “Community-based Participatory Research: An Approach to Intervention Research With a Native American Community.” Advances in Nursing Science 27.3 (2004): 162-75. NCBI. Web.
(1) Physical Activity
There are higher rates of obesity, diabetes, and heart disease in Native American women compared to non-Hispanic white women [1]. Furthermore, rates of physical activity are lower among Native American women than among non-Hispanic white women. However, social environmental factors such as community interaction are significantly associated with rate of physical activity. Research interventions to increase physical activity in Native American suggest that “results emphasize importance of support from family, friends, and communities” [4]. Other suggested interventions for increasing physical activity in native women include: providing exercise facilities, improving existing programs and facilities, developing exercise programs/classes specifically for women, and improving community security. Overall though, increasing social support via the community correlates with the greatest increases in physical activity [4].
(2) Breast Cancer Awareness
Native American women have lower breast cancer screening and 5-year survival rates than non-Hispanic white women in the US. Native women have themselves recommended interventions such as the “buddy system,” a system of partnering community members together to provide mentorship and motivation [8]. An organization called the Circle of Sisters, which is a breast cancer education initiative and offers free mammography for Native American women, has found its most promising results in community partnerships. The organization conducted a small audit of its intervention community-based programs and found that they increased native women’s understanding of: (1) chances of being diagnosed with breast cancer, (2) association of breast cancer with pregnancy complications, and (3) that breast cancer can be detected early. Furthermore, the percent of women intending to get a mammogram after the intervention had increased [6].
(3) Alcohol Consumption
Research to reduce alcohol consumption and dependency in Native American women and to prevent fetal alcohol spectrum disorders have associated community involvement with successful interventions. According to a review of evidence based approaches for reducing alcohol consumption in native women by The American Journal of Drug and Alcohol Use, “Studies presently reviewed suggest that to create a successful prevention/treatment program, it is important to incorporate community members in all aspects of project design and implementation” [7]. More studies are required but it is clear that respect for community and social identity is necessary to implement successful health interventions [7].
(4) Reproductive Health and Sexual violence
A Native Teen Voices study conducted in Minnesota asked urban native youth for recommendations to reduce health and sexual violence. Many of their answers included involving knowledgeable, trusted family and community leaders in addition to more comprehensive sex education in schools and increased access to contraceptive resources [9]. Other studies have demonstrated success in community based youth development programs for reducing sexual violence and increasing reproductive health [9,10]. Furthermore, the National Institute of Justice was mandated by The Violence Against Women Act of 2005 to conduct a national baseline study on violence against Native American women living on tribal lands. They found that barriers to helping victims of sexual violence included: “fear of being blamed, fear of prejudice, geographic isolation, lack of services available, conflict between Western approaches to intervention and American Indian values,” etc. [11]. At this time they are currently conducting research on intervention methods but have emphasized the importance of involving women of the community in creation of prevention and intervention methods [11].
As one can see from these examples, community based research [12] and intervention is an effective approach to health issues of Native American women [2, 3]. Thus, community involvement should be considered in any health intervention being applied to native women. Despite forced cultural, religious, and economic assimilation of Native American people which has shaped cultural practices and social structure, Native American women are a strong, persevering, and influential social group. Next week, we will discuss how native women have and continue to be the forefront of advocacy and implementation of health resources and services[1].
Right in our backyard, there are thousands of women at risk for diabetes, cancer, alcoholism, substance abuse, domestic abuse, heart disease, obesity, etc. However, as members of sovereign yet domestically dependent nations, they are often forgotten. The plight of these Native American women can teach us about the health and social effects of external pressures on women of once independent cultures. In other words, Native American women have experienced war, death, acculturation, racism, loss of land, sustenance shortage, and the “give and take” of sovereignty.
Overall, these obstacles have forced many Native Americans away from their traditional beliefs/practices and into a cycle of health and social inequalities. However, there is hope for the health of Native American women. A recent study of health-risk behavior in the Cheyenne River Sioux tribe by Han 1994 “found that women who were more traditionally engaged in terms of lifestyle and language fluency were healthier than less traditional women” [1]. Thus, the healing journey for many Native American women entails reclaiming native heritage, identity, and spirituality while also addressing historical trauma (i.e. harmful psycho-social legacy of boarding schools) [3].
“As individuals become meaningful, well-functioning participants in a given cultural system, they gradually develop a particular set of psychological processes that are attuned to and therefore support and reproduce the prevalent patterns of this cultural system . . . psychological processes and a cultural system are mutually constitutive.” -Kitayama, Markus, Matsumoto, & Norasakkunkit, [5]
Citations:
[1] Joe, Jennie Rose., and Francine C. Gachupin. Health and Social Issues of Native American Women. Santa Barbara: Praeger, 2012. Print.
[2] Hobfoll, Stevan E., Anita Jackson, Ivonne Hobfoll, Charles A. Pierce, and Sara Young. “The Impact of Communal-Mastery Versus Self-Mastery on Emotional Outcomes During Stressful Conditions: A Prospective Study of Native American Women.” American Journal of Community Psychology 30.6 (2002): 853-71. Springer.com. Web. 27 Feb. 2014.
[3] Gone, Joseph P. “A Community-based Treatment for Native American Historical Trauma: Prospects for Evidence-based Practice.” Spirituality in Clinical Practice 1.S (2013): 78-94. 2013. Web.
[4] Thompson, J. “Personal, Social, and Environmental Correlates of Physical Activity in Native American Women.” American Journal of Preventive Medicine 25.3 (2003): 53-60.Elsevier Inc. 2003. Web.
[5] Kitayama, S., Markus, H. R., Matsumoto, H., & Norasakkunkit, V. (1997). Individual and collective processes in the construction of the self: Self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology, 72, 1245–1267.
[6] Chilton, Janice A., Cheryl Downing, Melissa Lofton, Mike Hernandez, Beth W. Allen, Richard A. Hajek, and Beverly Gor. “Circle of Sisters: Raising Awareness of Native American Women to Breast Cancer.” Journal of Health Care for the Poor and Underserved 24.3 (2013): 1167-179. 3 Aug. 2013. Web.
[7] Montag, Annika, John D. Clapp, Dan Calac, Jessica Gorman, and Christina Chambers. “A Review of Evidence-Based Approaches for Reduction of Alcohol Consumption in Native Women Who Are Pregnant or of Reproductive Age.” The American Journal of Drug and Alcohol Abuse 38.5 (2012): 436-43. 2012. Web.
[8] Ndikum-Moffor, Florence M., Stacy Braiuca, Christine Makosky Daley, Byron J. Gajewski, and Kimberly K. Engelman. “Assessment of Mammography Experiences and Satisfaction Among American Indian/Alaska Native Women.” Women’s Health Issues 23.6 (2013): E395-402. 2013. Web.
[9] Rutman, Shira, Maile Taualii, Dena Ned, and Crystal Tetrick. “Reproductive Health and Sexual Violence Among Urban American Indian and Alaska Native Young Women: Select Findings from the National Survey of Family Growth (2002).” Maternal and Child Health Journal 16.S2 (2012): 347-52. Springer Science+Business Media. 19 Aug. 2012. Web.
[10] Smith, M. U., Rushing, S. C., & Native STAND Curriculum Development Group. (2011). Native STAND (students together against negative decisions): Evaluating a school-based sexual risk reduction intervention in Indian boarding schools. The Health Education Monograph, 28(2), 67–74. Available from: http://www.indiana.edu/*aids/
[11] Crossland, C., J. Palmer, and A. Brooks. “NIJ’s Program of Research on Violence Against American Indian and Alaska Native Women.” Violence Against Women 19.6 (2013): 771-90. 2013. Web.
[12] Holkup, Patricia A., PhD, RN, Toni Tripp-Reimer, PhD, RN, RAAN, Emily Matt Salois, MSW, ACSW, and Clarann Weinert, SC, PhD, RN, FAAN. “Community-based Participatory Research: An Approach to Intervention Research With a Native American Community.” Advances in Nursing Science 27.3 (2004): 162-75. NCBI. Web.
Understanding Māori Women
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| A carving of Tāne nui a Rangi, a Māori god, sited at the entrance to the forest aviary at Auckland Zoo. |
Māori women are generally portrayed as lesser than men by scientific anthropologists due the traditionally Christian European lens with which they analyze Māori culture. For example, under English law established in colonial New Zealand, the husband/father is considered the head of the household with all children, spouses, and property belonging to the man of the home. Until 1985, a husband was not legally accountable for raping his wife in New Zealand because she was considered his property. When missionaries arrived, they re-wrote Māori myths to reflect values more similar to Christianity, such as the traditionally domestic role of women. Many scientific anthropologists will blame pre-colonial Māori view of women as the reason Māori did not participate in treaty making. However, the reason why most treaties between the Māori and the British colonial government (representatives of the Crown) were signed by men is due to the influence of Christianity and the low regard for women that Crown representatives seeking signatories had of women in politics. “154 years after the signing of the Treaty, is the gravamen of a claim recently lodged against the Crown before the Waitangi Tribunal. According to Denese Henare: Māori women [have seen] that injustice and said to each other, ‘... There's something wrong with the way the Crown continues to perpetuate this attitude of no value in Maori women’” [2]. Scholars who write from experience with Māori culture generally agree that Maori women were an important, valuable asset to society and considered equal to men [3, 6]. We can see that it was the Crown who viewed Māori women negative via New Zealand adoption laws in the 1900's. In many cases, children were taken from Māori mothers who were deemed “unfit” to be a parent. Abuse of adoption laws was common in New Zealand until the late 1900's [2].
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| Group of Maori women including Maggie and Bella Papakura, ca1900s |
Citations:
[1] Heuer, Berys. Maori Women. Wellington: Published for the Polynesian Society by A.H. & A.W. Reed, 1972. Print.
[2] Mikaere, Annie. MAORI WOMEN: CAUGHT IN THE CONTRADICTIONS OF A COLONISED REALITY. Te Piringa - Faculty of Law. The University of Waikato - Te Whare Wānanga O Waikato, n.d. Web. 03 Aug. 2010. <http://www.waikato.ac.nz/law/
[3] Salmond, Anne. "THE STUDY OF TRADITIONAL MAORI SOCIETY: THE STATE OF THE ART." The Journal of the Polynesian Society 92.3 (1983): 309-31.Www.jstor.org. Web. 20 Feb. 2014. <http://www.jstor.org/stable/
[4] Fanslow, J., E. Robinson, S. Crengle, and L. Perese. "Juxtaposing Beliefs and Reality: Prevalence Rates of Intimate Partner Violence and Attitudes to Violence and Gender Roles Reported by New Zealand Women." Violence Against Women 16.7 (2010): 812-31. July 2010. Web. <http://vaw.sagepub.com/
[5] Brewer, Naomi, Barry Borman, Diana Sarfati, Mona Jeffreys, Steven T. Fleming, Soo Cheng, and Neil Pearce. "Does Comorbidity Explain the Ethnic Inequalities in Cervical Cancer Survival in New Zealand? A Retrospective Cohort Study." BMC Cancer 11.1 (2011): 132. 12 Apr. 2011. Web. <http://www.biomedcentral.com/
[6] http://www.kaupapamaori.com/
[7] Cameron, Graham. "Pōwhiri Have a Purpose; and It Is Not to Dominate Women."Wordpress.com. N.p., 7 Jan. 2014. Web. <http://grahamcameron.
Health Status of Māori Women in New Zealand
Famous for their ka mate haka, or “the haka,” war dance used by the
New Zealand All Blacks rugby team since 1905, the Māori are the
indigenous people of New Zealand [1]. Despite this international
presence, Māori women today face significant health disparities. As a
country, New Zealand’s infant death rate is 5.2 deaths per 1,000 births.
This is high compared to Great Britain but low compared to the United
States. The interesting part though is that Māori women have higher
rates of neonatal death (i.e. stillbirth) and infant death within the
first year of life than do New Zealand European women. Pregnant/recently
pregnant Māori women also have a greater risk of dying from birth
related complications [2].
Furthermore, the incidence of breast cancer is far higher in Māori women than in other New Zealand ethnic groups. Even more concerning is that incidence seems to be increasing faster in Māori women. For example, breast cancer rates for Māori women rose between 1981 and 1986 from 123 to 210 per 1000,000 women per year while the rate for European/other New Zealand women rose in the same time period from 114 to 170 per 100,000 women per year. Thus, there seems to be not only a drastic difference in breast cancer incidence but in growth rate as well. Even though New Zealand has maintained a free national breast screening programme since 1998, Māori women use this free screening less than non-Māori women [3].
In addition to breast cancer, Māori women of New Zealand also face elevated risk of cervical cancer. In 2005, the incidence rates for cervical cancer were the following: European women 5.6 per 100,000 women, Pacific Islander women 16.3 per 100,000 women, and Māori women 9.0 per 100,000 women. Māori women have a higher overall mortality rate of 6.5 per 100,00 women compared to European women 1.4 per 100,000 women. Studies that have adjusted these results for socio-economic position, urban or rural residence, and stage at diagnosis found that these adjustments did little to account for the drastic differences. A study published in BMC cancer found that comorbidity contributes to survival disparities for cervical cancer. For instance, compared to non-Māori New Zealand women, Māori women have higher rates of chronic diseases (i.e. cardiovascular and diabetes), respiratory diseases, and smoking. However, the study said that comorbidity accounts “for only a moderate proportion of the ethnic differences in survival,” meaning that other factors such a health care treatment may play a role [4].
Finally, the last health disparity we will touch on today is the rate of intimate partner violence. Māori women have a 57.% lifetime prevalence of physical and/or sexual intimate partner violence (more than 1 in 2) compared to European women who have a prevalence of 34.3% (approximately 1 in 3). These results are similar to the higher prevalence of intimate partner violence experienced among indigenous populations in the United States, Canada, and Australia when compared with European ethnic groups [5]. Similar results have been found in other independent reports [6].
The quote above was provided by both men and women of the Māori Task force as they explored cases of domestic violence in Māori culture. As one can see from the quote, many Māori agree that there is no traditional reasoning for the abuse or mistreatment of women. However, it should be noted that the Maori culture does contain different expectations for men and women in certain situations. For example, New Zealand Parliament’s longest serving female MP Annette King and her colleague Maryan Street were asked to move from the front bench during the start of a powhiri, or Māori welcoming ceremony in 2014. As a result, the Speaker of Parliament has called for modernization of Maori protocols [8]. Maybe, there is more to explore in the direction of gender roles in Māori culture. Now we are faced with some big questions: Where do these health disparities originate? What are their contributing factors?
Different researchers have related these health disparities between Māori women and non-Māori women of New Zealand to a range of reasons such as limited access to primary health care and limited finances [2], a less healthy lifestyle among Māori women compared to non-Māori women [3], colonization processes such as racism, exploitation of resources, seizure of land, introduction of alcohol, and disease [5], and connotation of diseases like Human Papillomavirus which leads to cervical cancer with shame and stigma in cultural communities [9]. Next week, we will explore the reasons for these health disparities further and strategies to mitigate them such as addressing attitudes, poverty, racism, colonization, and engaging men.
Works Cited:
[1] Lai, Jessica Christine. "Indigenous Cultural Heritage and Intellectual Property Rights." Chapter 2 Māori Culture in the Contemporary World. Switzerland: Springer International, 2014. N. pag. Springer.com. Web. 13 Feb. 2014. <http://link.springer.com/
[2] Filoche, Sara, Susan Garrett, James Stanley, Sally Rose, Bridget Robson, C. Elley, and Bev Lawton. "Wāhine Hauora: Linking Local Hospital and National Health Information Datasets to Explore Maternal Risk Factors and Obstetric Outcomes of New Zealand Māori and Non-Māori Women in Relation to Infant Respiratory Admissions and Timely Immunisations." BMC Pregnancy and Childbirth 13.1 (2013): 145. 10 July 2013. Web. <http://www.biomedcentral.com/
[3] Mckenzie, Fiona, Lis Ellison-Loschmann, Mona Jeffreys, Ridvan Firestone, Neil Pearce, and Isabelle Romieu. "Healthy Lifestyle and Risk of Breast Cancer for Indigenous and Non-indigenous Women in New Zealand: A Case Control Study." BMC Cancer 14.1 (2014): 12. 10 Jan. 2014. Web. <http://www.biomedcentral.com/
[4] Brewer, Naomi, Barry Borman, Diana Sarfati, Mona Jeffreys, Steven T. Fleming, Soo Cheng, and Neil Pearce. "Does Comorbidity Explain the Ethnic Inequalities in Cervical Cancer Survival in New Zealand? A Retrospective Cohort Study." BMC Cancer 11.1 (2011): 132. 12 Apr. 2011. Web. <http://www.biomedcentral.com/
[5] Fanslow, J., E. Robinson, S. Crengle, and L. Perese. "Juxtaposing Beliefs and Reality: Prevalence Rates of Intimate Partner Violence and Attitudes to Violence and Gender Roles Reported by New Zealand Women." Violence Against Women 16.7 (2010): 812-31. July 2010. Web. <http://vaw.sagepub.com/
[6] Schluter, P. J., J. Paterson, and M. Feehan. "Prevalence and Concordance of Interpersonal Violence Reports from Intimate Partners: Findings from the Pacific Islands Families Study." Journal of Epidemiology & Community Health 61.7 (2007): 625-30. July 2007. Web. <http://www.ncbi.nlm.nih.gov/
[7] Kruger, Tamati, Mereana Pitman, Tahuaroa McDonald, Dennis Mariu, Alva Pomare, Teina Mita, Matehaere Maihi, and Keri Lawson-Te Aho. TRANSFORMING WHANAU VIOLENCE. Rep. Second Maori Taskforce on Whanau Violence, Sept. 2004. Web. <http://www.nzfvc.org.nz/
[8] NZ Herald. "Speaker Calls for Maori Protocols to Be Modernised." The New Zealand Herald. N.p., 4 Jan. 2014. Web. <http://www.nzherald.co.nz/
[9] Maar, Marion, Ann Burchell, Julian Little, Gina Ogilvie, Alberto Severini, Jinghao Mary Yang, and Ingeborg Zehbe. "A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women." Women's Health Issues 23.5 (2013): E319-325. 26 June 2013. Web. <http://ac.els-cdn.com/
Furthermore, the incidence of breast cancer is far higher in Māori women than in other New Zealand ethnic groups. Even more concerning is that incidence seems to be increasing faster in Māori women. For example, breast cancer rates for Māori women rose between 1981 and 1986 from 123 to 210 per 1000,000 women per year while the rate for European/other New Zealand women rose in the same time period from 114 to 170 per 100,000 women per year. Thus, there seems to be not only a drastic difference in breast cancer incidence but in growth rate as well. Even though New Zealand has maintained a free national breast screening programme since 1998, Māori women use this free screening less than non-Māori women [3].
In addition to breast cancer, Māori women of New Zealand also face elevated risk of cervical cancer. In 2005, the incidence rates for cervical cancer were the following: European women 5.6 per 100,000 women, Pacific Islander women 16.3 per 100,000 women, and Māori women 9.0 per 100,000 women. Māori women have a higher overall mortality rate of 6.5 per 100,00 women compared to European women 1.4 per 100,000 women. Studies that have adjusted these results for socio-economic position, urban or rural residence, and stage at diagnosis found that these adjustments did little to account for the drastic differences. A study published in BMC cancer found that comorbidity contributes to survival disparities for cervical cancer. For instance, compared to non-Māori New Zealand women, Māori women have higher rates of chronic diseases (i.e. cardiovascular and diabetes), respiratory diseases, and smoking. However, the study said that comorbidity accounts “for only a moderate proportion of the ethnic differences in survival,” meaning that other factors such a health care treatment may play a role [4].
Finally, the last health disparity we will touch on today is the rate of intimate partner violence. Māori women have a 57.% lifetime prevalence of physical and/or sexual intimate partner violence (more than 1 in 2) compared to European women who have a prevalence of 34.3% (approximately 1 in 3). These results are similar to the higher prevalence of intimate partner violence experienced among indigenous populations in the United States, Canada, and Australia when compared with European ethnic groups [5]. Similar results have been found in other independent reports [6].
“There is nothing in the Māori world that promotes and encourages the idea of whānau violence. No one can point to an ideological belief that talks about women being lower in the social order. Mana tangata is female in nature. Life itself is symbolised by women. Hence the terms like te whare tangata where humankind originates from.” -Second Māori Taskforce on Whānau Violence [7]
The quote above was provided by both men and women of the Māori Task force as they explored cases of domestic violence in Māori culture. As one can see from the quote, many Māori agree that there is no traditional reasoning for the abuse or mistreatment of women. However, it should be noted that the Maori culture does contain different expectations for men and women in certain situations. For example, New Zealand Parliament’s longest serving female MP Annette King and her colleague Maryan Street were asked to move from the front bench during the start of a powhiri, or Māori welcoming ceremony in 2014. As a result, the Speaker of Parliament has called for modernization of Maori protocols [8]. Maybe, there is more to explore in the direction of gender roles in Māori culture. Now we are faced with some big questions: Where do these health disparities originate? What are their contributing factors?
Different researchers have related these health disparities between Māori women and non-Māori women of New Zealand to a range of reasons such as limited access to primary health care and limited finances [2], a less healthy lifestyle among Māori women compared to non-Māori women [3], colonization processes such as racism, exploitation of resources, seizure of land, introduction of alcohol, and disease [5], and connotation of diseases like Human Papillomavirus which leads to cervical cancer with shame and stigma in cultural communities [9]. Next week, we will explore the reasons for these health disparities further and strategies to mitigate them such as addressing attitudes, poverty, racism, colonization, and engaging men.
Works Cited:
[1] Lai, Jessica Christine. "Indigenous Cultural Heritage and Intellectual Property Rights." Chapter 2 Māori Culture in the Contemporary World. Switzerland: Springer International, 2014. N. pag. Springer.com. Web. 13 Feb. 2014. <http://link.springer.com/
[2] Filoche, Sara, Susan Garrett, James Stanley, Sally Rose, Bridget Robson, C. Elley, and Bev Lawton. "Wāhine Hauora: Linking Local Hospital and National Health Information Datasets to Explore Maternal Risk Factors and Obstetric Outcomes of New Zealand Māori and Non-Māori Women in Relation to Infant Respiratory Admissions and Timely Immunisations." BMC Pregnancy and Childbirth 13.1 (2013): 145. 10 July 2013. Web. <http://www.biomedcentral.com/
[3] Mckenzie, Fiona, Lis Ellison-Loschmann, Mona Jeffreys, Ridvan Firestone, Neil Pearce, and Isabelle Romieu. "Healthy Lifestyle and Risk of Breast Cancer for Indigenous and Non-indigenous Women in New Zealand: A Case Control Study." BMC Cancer 14.1 (2014): 12. 10 Jan. 2014. Web. <http://www.biomedcentral.com/
[4] Brewer, Naomi, Barry Borman, Diana Sarfati, Mona Jeffreys, Steven T. Fleming, Soo Cheng, and Neil Pearce. "Does Comorbidity Explain the Ethnic Inequalities in Cervical Cancer Survival in New Zealand? A Retrospective Cohort Study." BMC Cancer 11.1 (2011): 132. 12 Apr. 2011. Web. <http://www.biomedcentral.com/
[5] Fanslow, J., E. Robinson, S. Crengle, and L. Perese. "Juxtaposing Beliefs and Reality: Prevalence Rates of Intimate Partner Violence and Attitudes to Violence and Gender Roles Reported by New Zealand Women." Violence Against Women 16.7 (2010): 812-31. July 2010. Web. <http://vaw.sagepub.com/
[6] Schluter, P. J., J. Paterson, and M. Feehan. "Prevalence and Concordance of Interpersonal Violence Reports from Intimate Partners: Findings from the Pacific Islands Families Study." Journal of Epidemiology & Community Health 61.7 (2007): 625-30. July 2007. Web. <http://www.ncbi.nlm.nih.gov/
[7] Kruger, Tamati, Mereana Pitman, Tahuaroa McDonald, Dennis Mariu, Alva Pomare, Teina Mita, Matehaere Maihi, and Keri Lawson-Te Aho. TRANSFORMING WHANAU VIOLENCE. Rep. Second Maori Taskforce on Whanau Violence, Sept. 2004. Web. <http://www.nzfvc.org.nz/
[8] NZ Herald. "Speaker Calls for Maori Protocols to Be Modernised." The New Zealand Herald. N.p., 4 Jan. 2014. Web. <http://www.nzherald.co.nz/
[9] Maar, Marion, Ann Burchell, Julian Little, Gina Ogilvie, Alberto Severini, Jinghao Mary Yang, and Ingeborg Zehbe. "A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women." Women's Health Issues 23.5 (2013): E319-325. 26 June 2013. Web. <http://ac.els-cdn.com/
Western vs. Traditional Medicine
Last week, we explored the great disparity in health between U.S.
citizens and Native Americans, especially among Native American women
[1,2]. Even though Native Americans live within U.S. borders, they are
members of their own sovereign nations. As a reminder, for various
reasons, many tribes signed treaties with the U.S. exchanging large
quantities of land for healthcare, education, and other various
guarantees [3]. These are NOT government handouts. These are legal
trades between two nations. In addition to greatly reducing the amount
of land that tribes have to thrive on and increasing tribal dependency
on the U.S., these treaties allowed for the introduction of western
medicine via the Indian Health Service (IHS).
This week, we will explore how the cultural role and well-being of Native American women is influenced by the introduction of western medicine in a few case studies. To begin, many Native Americans feel that there is a big difference between Western medicine and traditional medicinal approaches. Dr. Everett Rhoades who was the first Native American to oversee the Indian Health Service says, “Physicians are taught to concentrate on abnormal physiology so much that we’ve nearly forgotten that wellness is more than an absence of illness; in reality, it’s a tangible harmony in yourself.” This statement demonstrates the core belief of many Native American medicinal practices. Traditionally, treating a patient involves more than alleviating his or her symptoms but also the healing of the spirit[4]. The men and women of the tribe who practiced this powerful form of healing were highly regarded.
Rose Mesteth of Oglala Lakota, who reside on the Pine Ridge Reservation in South Dakota, is a member of a long line of female healers. Her mother and grandmother before her used herbs and plants to treat the sick. According to Rose, it was women who treated the sick with medicinal plants and restored spiritual balance in many tribes. However, with the introduction of Western medicine, native youth in the community are regarding her traditional healing role as less effective. Rose mentioned in an interview, “This healing will eventually die. Most of the younger generations are just not interested in this. They are too close-minded and have been indoctrinated with the idea that ‘the white way is the right way’” [5]. In Rose’s case, she has filled a more influential role in her community via the practice of traditional medicine. However, she stands to lose this influence if Lakota youth lose faith in her practices in favor of Westernized medicine.
Dr. Lori Arviso Alvord, Stanford trained, was the first Navajo woman to become a board certified surgeon. She was inspired by the difficulties involved in seeing a doctor on the reservation—long hours, crowded hospitals, long driving distances, etc. Even though her college advisers at the University of New Mexico discouraged from attending medical school and told her “not to get her hopes up,” she succeeded. She still faces the same blatant disrespect and undermining of her decisions as a doctor today and feels that it is because she is a native women practicing in a white male dominated field. However, among the Navajo people, she is now known as an influential and good healer. To the Navajo, being a good surgeon does not necessarily mean you are a good healer. To be a good healer requires one to take mind, body, soul, and environmental influence into account enveloped in the word “hózhó,” which closely translates to “everything in beauty.” Dr. Alvord learned how to incorporate harmony, peace, balance into her practice from her Navajo medicine practicing mentors[5]. As a result of mixing traditional and western medicine rather than completely disregarding her tribe’s beliefs, Dr. Lori Avord is now a well-respected and influential member of her tribe. This is a stark contrast from how she is treated in the realm of western medicine even after earning her medical doctorate.
As you can see from the case studies of Lori and Rose, the influence of women among their respective nations is greatly enhanced via traditional medicine. Whether one practices traditional medicine mostly like Rose or combines its inherent nature with western medicine like Lori, the practice of traditional medicine gives women a place in society. While western medicine can threaten that role in some cases such as via the youth of Rose’s society, it can sometimes be used in harmony and enhance that role such as in Lori’s case. However, even in Lori’s case, her position was more revered among her own nation rather than in the U.S. where western medicine is solely practiced.
Next week, we will explore this perspective from a more statistical perspective. In future weeks, we will also explore other indigenous peoples who are sovereign, such as in Canada, and indigenous populations which fight for sovereignty but are still currently citizens within arbitrarily assigned colonial borders.
Sources:
[1]Promoting Wellness in Native American Communities Through Exercise, Disease Prevention and Traditional Healing. (2013). 42nd Annual Meeting of the Association of American Indian Physicians (AAIP). Santa Clara, CA.
[2] U.S. Department Of Health And Human Services. National Tribal Budget Recommendations for the Indian Health Service Fiscal Year 2013 Budget. Publication. U.S. Department Of Health And Human Services, 2013. Web. 16 Jan. 2014.
[3] Kappler, Charles Joseph. Indian Affairs: Laws and Treaties. Washington, D.C.: Govt. Print. Off., 1904.Digital.library.okstate.edu. Web. 16 Jan. 2014.
[4] Crow, Kelly. “The New Medicine Men.” Oklahoma Today 4 Nov. 1999: 50-57.Digital.library.okstate.edu. Web. 22 Jan. 2014.
[5] Pascale, Jordan. “Alternative Methods Still Important to Native Healers.” Cojmc.unl.edu. University of Nebraska Lincoln, n.d. Web. 23 Jan. 2014.
This week, we will explore how the cultural role and well-being of Native American women is influenced by the introduction of western medicine in a few case studies. To begin, many Native Americans feel that there is a big difference between Western medicine and traditional medicinal approaches. Dr. Everett Rhoades who was the first Native American to oversee the Indian Health Service says, “Physicians are taught to concentrate on abnormal physiology so much that we’ve nearly forgotten that wellness is more than an absence of illness; in reality, it’s a tangible harmony in yourself.” This statement demonstrates the core belief of many Native American medicinal practices. Traditionally, treating a patient involves more than alleviating his or her symptoms but also the healing of the spirit[4]. The men and women of the tribe who practiced this powerful form of healing were highly regarded.
 |
| Rose Mesteth on Native Daughters project website |
Rose Mesteth of Oglala Lakota, who reside on the Pine Ridge Reservation in South Dakota, is a member of a long line of female healers. Her mother and grandmother before her used herbs and plants to treat the sick. According to Rose, it was women who treated the sick with medicinal plants and restored spiritual balance in many tribes. However, with the introduction of Western medicine, native youth in the community are regarding her traditional healing role as less effective. Rose mentioned in an interview, “This healing will eventually die. Most of the younger generations are just not interested in this. They are too close-minded and have been indoctrinated with the idea that ‘the white way is the right way’” [5]. In Rose’s case, she has filled a more influential role in her community via the practice of traditional medicine. However, she stands to lose this influence if Lakota youth lose faith in her practices in favor of Westernized medicine.
Dr. Lori Arviso Alvord, Stanford trained, was the first Navajo woman to become a board certified surgeon. She was inspired by the difficulties involved in seeing a doctor on the reservation—long hours, crowded hospitals, long driving distances, etc. Even though her college advisers at the University of New Mexico discouraged from attending medical school and told her “not to get her hopes up,” she succeeded. She still faces the same blatant disrespect and undermining of her decisions as a doctor today and feels that it is because she is a native women practicing in a white male dominated field. However, among the Navajo people, she is now known as an influential and good healer. To the Navajo, being a good surgeon does not necessarily mean you are a good healer. To be a good healer requires one to take mind, body, soul, and environmental influence into account enveloped in the word “hózhó,” which closely translates to “everything in beauty.” Dr. Alvord learned how to incorporate harmony, peace, balance into her practice from her Navajo medicine practicing mentors[5]. As a result of mixing traditional and western medicine rather than completely disregarding her tribe’s beliefs, Dr. Lori Avord is now a well-respected and influential member of her tribe. This is a stark contrast from how she is treated in the realm of western medicine even after earning her medical doctorate.
As you can see from the case studies of Lori and Rose, the influence of women among their respective nations is greatly enhanced via traditional medicine. Whether one practices traditional medicine mostly like Rose or combines its inherent nature with western medicine like Lori, the practice of traditional medicine gives women a place in society. While western medicine can threaten that role in some cases such as via the youth of Rose’s society, it can sometimes be used in harmony and enhance that role such as in Lori’s case. However, even in Lori’s case, her position was more revered among her own nation rather than in the U.S. where western medicine is solely practiced.
Next week, we will explore this perspective from a more statistical perspective. In future weeks, we will also explore other indigenous peoples who are sovereign, such as in Canada, and indigenous populations which fight for sovereignty but are still currently citizens within arbitrarily assigned colonial borders.
Sources:
[1]Promoting Wellness in Native American Communities Through Exercise, Disease Prevention and Traditional Healing. (2013). 42nd Annual Meeting of the Association of American Indian Physicians (AAIP). Santa Clara, CA.
[2] U.S. Department Of Health And Human Services. National Tribal Budget Recommendations for the Indian Health Service Fiscal Year 2013 Budget. Publication. U.S. Department Of Health And Human Services, 2013. Web. 16 Jan. 2014.
[3] Kappler, Charles Joseph. Indian Affairs: Laws and Treaties. Washington, D.C.: Govt. Print. Off., 1904.Digital.library.okstate.edu. Web. 16 Jan. 2014.
[4] Crow, Kelly. “The New Medicine Men.” Oklahoma Today 4 Nov. 1999: 50-57.Digital.library.okstate.edu. Web. 22 Jan. 2014.
[5] Pascale, Jordan. “Alternative Methods Still Important to Native Healers.” Cojmc.unl.edu. University of Nebraska Lincoln, n.d. Web. 23 Jan. 2014.
Native American Women - Changing Roles and Resulting Health Effects
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| http://www.colorado.edu/ |
In many Native American tribes there was an equal division of labor and power between men and women [1]. For example, in eastern Plain tribes women lacked the political power such as treaty signing but owned the house (lodge or tipi), all the house contents, the farming fields and seeds, farming implements, and right to sell surplus crops. On bison hunts, women would decide where to break camp and had the right to divorce. An unkind husband may be left with only his horse and weapons since the wife owned the home. Women were also held in high esteem for their role in healing [2]. However, these roles were flexible in categories ranging from the sexual orientation to occupation. In fact, unlike Europeans, pre-colonial Native American tribes did not assign tasks based on gender. Women who wanted to pursue a traditionally male path, such as hunting, manufacturing weapons, or engaging in warfare, was free to do so [1].
For eastern Plains tribes, it wasn't until the late 1800's that these roles began to change due to influence by the U.S. government [2]. Children were sent to boarding schools where they were unable to speak their own language or practice their cultural faith [3]. Here, women were taught to focus on housekeeping and rearing children while men were taught blacksmithing and agriculture [2,3]. Even at home, Native Americans were prohibited from cultural practices. For example, in place of the Sun Dance, a traditionally female centered ritual, the Lakota people were forced into Christianity which traditionally worships a male God. This introduction of Western culture forced Native American women in more subservient and dependent roles. “Native American women experience the highest rate of violence of any group in the United States,” which is an important indicator for just how far their status has dropped [3].
As you will recall from past blogs, the U.S. traded Native American land for the promise of health care, which eventually led to the formation of the Indian Health Service (IHS). This representation of Western medicine essentially caused more problems than it solved by the late 1900's and only further served to reduce the power of Native American women.
Between the 1960 and 1970, the Indian Health Service (IHS) allegedly sterilized at least 25 percent of Native American women. Horror stories such as a young girls sterilized while undergoing appendectomies were not uncommon according to Bertha Medicine Bull, a prominent medicine woman of the Northern Cheyenne Tribe [4]. The Government Accounting Office (GAO) released an official report in 1976 verifying that the IHS performed 3,406 sterilizations between 1973 and 1976 [5]. The GAO report also confirmed that the IHS did not follow necessary regulations of consent and that the consent forms used did not adhere to The Department of Health, Education, and Welfare regulations [4]. Another study found between 1972 and 1978 sterilization procedures on the Navajo reservation alone increased from 15.1% to 30.7% of total female surgeries [6]. Many believe that the 25% statistic is too low. Mary Ann Bear Comes out conducted a survey on the Northern Cheyenne Reservation and found “the data indicated that the same rate of sterilizations would reduce births among this group by more than half over a five year period” [4]. The harsh truth is that most of these sterilizations were performed by physicians in the IHS and were, thus, financed by the U.S. government [5].
Why did these sterilizations occur? According to a 1973 study by the Health Research Group and interviews between 1974 and 1975 by Doctor Bernard Rosenfeld, “the majority of physicians were white, Euro-American males who believed that they were helping society by limiting the number of births in low-income, minority families” [4].
After Native American women were essentially left with only the role of housekeeper and child bearer [1,3] due to U.S. pressure to assimilate, this too was taken from many of them via forced sterilizations. For example, as a result of these forced sterilizations, Native American women were gravely affected. Marriages were ended, friendships were lost, rates of marital problems increased along with alcoholism, drug use, and psychological issues [4].
Not all hope is lost though, men and women who attempt to preserve native culture and re-establish the tribe’s traditional roles and unite together can empower Native American women step by step. For example, while in the Lakota tribe, most women still fill the role of child bearers, women’s positions in their own family lives are improving by reviving religious and medicinal roles through “organized clubs, guilds, parent-teacher associations, and the community and tribal council” [3]. Furthermore, the health disparities between Native American people and the U.S. population, which can worsen social stress on vulnerable populations such as Native American women, can be reduced by funding research to increase participation and offering culturally sensitive health education programs [7]. As I alluded to in my last blog post, preserving traditional healing practices allows Native women to protect their power through knowledge. A way to empower these women further is to give them control of IHS clinics and the combining of western and traditional medical practices. This is actually a legal right of sovereign tribes through the Indian Health Determination Act (Public Health Law 638).
Citations:
[1] Joe, Jennie Rose., and Francine C. Gachupin. Health and Social Issues of Native American Women. Santa Barbara: Praeger, 2012. Print.
[2] Wishart, David J. "Native American Gender Roles." Encyclopedia of the Great Plains. University of Nebraska Lincoln, 2011. Web. 30 Jan. 2014. <http://plainshumanities.unl.edu/encyclopedia/doc/egp.gen.026>.
[3] Collins, Julie. The Status of Native American Women: A Study of the Lakota Sioux.Artsci.drake.edu. Drake University, 2005. Web. 30 Jan. 2014. <http://artsci.drake.edu/dussj/2005/collins.pdf>.
[4] Lawrence, Jane. "The Indian Health Service and the Sterilization of Native American Women." The American Indian Quarterly 24.3 (2000): 400-19. Muse.jhu.edu. 2000. Web. 29 Jan. 2014.
[5] Rutecki, Gregory W., MD. Forced Sterilization of Native Americans: Late Twentieth Century Physician Cooperation with National Eugenic Policies. The Center for Bioethics and Human Dignity. Trinity International University, 08 Oct. 2010. Web. 29 Jan. 2014. <http://cbhd.org/content/forced-sterilization-native-americans-late-twentieth-century-physician-cooperation-national->.
[6] H. Temkin-Greener, S. J. Kunitz, D. Broudy, M. Haffner, “Surgical fertility regulation among women on the Navaho Indian Reservation, 1972-1978.” American Journal of Public Health 71 (1981) 403-407.
[7] Warne, D. "Research and Educational Approaches to Reducing Health Disparities Among American Indians and Alaska Natives."Journal of Transcultural Nursing 17.3 (2006): 266-71. Web. 30 Jan. 2014. <http://www.ndsu.edu/fileadmin/pharmpr/Warne_TCN.pdf>.
[8] Pascale, Jordan. “Alternative Methods Still Important to Native Healers.” Cojmc.unl.edu. University of Nebraska Lincoln, n.d. Web. 23 Jan. 2014.
Native American Women of Sovereign Nations
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Photo by Dean Eyre, Edited by Kaipo Lucas and Lillian McBee
Why is this blog important?
“Shhhh, we can’t talk too much about Native Americans in class because it is not applicable,” says the teacher again. I heard this in my U.S. History class. I heard this in my international history class. When can we talk about them then? To be honest, Native American people are a vital part of both U.S. and international history. True fact: the winners of the war write the history, and because indigenous people of the United States did not defeat Manifest Destiny, we don’t learn much about them in any high school class. By completely ignoring them, we can do nothing but prolong the cultural assimilation forced upon them during colonial times and cultural appropriation still existing today (i.e. Halloween costumes, mascots, fashion, etc). I am writing this blog to increase my own understanding and awareness of Native American issues especially concerning women’s roles in health and healing. Hopefully, this blog will find a place in your heart as well.
Background:
There are 566 federally recognized American Indian/Alaska Native (AI/AN) tribes as of 2014, which accounts for about 2 million people[1]. A large majority of these people live on reservations and in rural communities[2]. Most reservations are located within the 30% of U.S. counties most sparsely populated. As a result of this isolation, many AI/AN people have to travel a great distance to the closest significant service center or market[3].
Since 1778, the U.S. government has negotiated trades, rights, and benefits with various Native American peoples in the form of treaties. Many of these treaties exchanged land to the United States in return for continual health care and other services. Congress ended treaty making with Native American tribes in 1871; however, all past treaties are still considered to be “the supreme law of the land” under the U.S. Constitution[4,5,6]. The Indian Health Service (IHS) is responsible for representing all federally recognized tribes[7]. However, even with government provided health care, AI/AN people have some of the worst tangible health outcomes. For example, AI/AN peoples have higher rates of alcoholism, stroke, infant mortality, hypertension, heart disease, diabetes, end stage renal disease, suicide, etcerea[8].
“We know that Native Americans die of illnesses like diabetes, pneumonia, flu – even tuberculosis at far higher rates than the rest of the population…And closing these gaps is not just a question of policy, it’s a question of our values – it’s a test of who we are as a Nation.”
-President Barack Obama, December 16, 20104
To compare, Medicare spent $11,018 per a beneficiary in 2009 while the IHS spent $3,348 per a beneficiary in 2010. While these are not in the same year, the IHS has historically had a lower budget per a beneficiary than Medicare, Veteran care, Medicaid, and federal employees[4]. Because of below standard health statistics and contrast in spending, many believe that the yearly IHS budget of $4.3 billion is not enough. According to the 42nd Annual Meeting of the Association of American Indian Physicians, it is believed that the IHS needs a yearly budget of $27 billion to run effectively[8].
Difficulty in accessing these rural areas has limited health care research such as maternal and child health via low response rates. These rates were usually due to the inability to contact respondents, but once found, respondents had equal response rates to non-white Hispanics[3]. Furthermore, AI/AN women are more likely than U.S. women to be raped/sexually assaulted, undergo family violence, or drink during pregnancy resulting in fetal alcohol spectrum disorders[4]. Why are Native American women more likely to be victims today? The IHS, a government run institution, brings western medicine to reservations, but can there be a conflict of interest? Traditionally, AI/AN women have enjoyed rights similar to men depending on the specific tribe and have held powerful positions especially in medicinal roles as healers[8]. As this blog continues, we will explore the questions above via the health and societal role of Native American women.
Sources:
[1] Bureau of Indian Affairs. “Indian Affairs: Frequently Asked Questions.” Indian Affairs. US Department of The Interior, 16 Jan. 2014. Web. 16 Jan. 2014.
[2] The Office of Minority Health. “American Indian/Alaska Native Profile.” Minority Health. The Department of Health and Human Services, 17 Sept. 2012. Web. 13 Jan. 2014.
[3] Rochat, Roger. “The Challenges of Conducting Research to Improve the Health of American Indians and Alaska Natives.” Maternal and Child Health Journal 12.S1 (2008): 126-27.
[4] U.S. Department Of Health And Human Services. National Tribal Budget Recommendations for the Indian Health Service Fiscal Year 2013 Budget. Publication. U.S. Department Of Health And Human Services, 2013. Web. 16 Jan. 2014.
[5] Bureau of Indian Affairs. “Indian Affairs: Frequently Asked Questions.” Indian Affairs. US Department of The Interior, 16 Jan. 2014. Web. 16 Jan. 2014.
[6] Kappler, Charles Joseph. Indian Affairs: Laws and Treaties. Washington, D.C.: Govt. Print. Off., 1904. Digital.library.okstate.edu. Web. 16 Jan. 2014.
[7] Spieler, Lauren. “American Indians and Alaska Natives: Breastfeeding Disparities and Resources.” Breastfeeding Medicine 5.5 (2010): 219-20. 2010. Web. 16 Jan. 2014.
[8] Promoting Wellness in Native American Communities Through Exercise, Disease Prevention and Traditional Healing. (2013). 42nd Annual Meeting of the Association of American Indian Physicians (AAIP). Santa Clara, CA.
[9] Pascale, Jordan. “Alternative Methods Still Important to Native Healers.” Native Daughters Alternative Methods Still Important to Native Healers Comments. University of Nebraska Lincoln, n.d. Web. 16 Jan. 2014.
See this original blog and other blogs about women's health at this link: http://stanford.edu/class/humbio129/cgi-bin/blogs/blog/2014/01/16/women-of-landlocked-sovereign-nations-background/
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