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Wisconsin Department of Health Services
January 2014 P-00522R
Healthiest Wisconsin 2020 Baseline and Health Disparities ReportAmerican Indian Population
AMERICAN INDIAN POPULATION
Background• Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities
Report • Key points• Data quality
Data• Demographic characteristics• Risk factors• Health outcomes• Protective factors • Youth outcomes• Mental health
References
Links to additional reports and resources
Contacts
Chapter Outline
Chapter outline
2
AMERICAN INDIAN POPULATION
Report Overview
• This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf
• The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included.
• Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations.
• Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf
Report overview
3
AMERICAN INDIAN POPULATION
Report Format
Full Report• Format: PDF • Intended use: reference document
Chapters• Format: Annotated PowerPoint slide set• Intended uses: presentations to
– Decision-makers– Service providers– Community leaders– The public
Sample annotated slide
Report overview
4
AMERICAN INDIAN POPULATION
Report Outline
Executive Summary
Section 1: Introduction
Section 2: Demographic overview
Section 3: Health focus areas
Section 4: Infrastructure focus areas
Section 5: Data summaries by population
Section 6: Technical notes
Report overview
5
AMERICAN INDIAN POPULATION
Report Outline: Detail
Section 3: Health focus areas
• Alcohol and other drug use• Chronic disease prevention and management• Communicable diseases• Environmental and occupational health• Healthy growth and development• Injury and violence• Mental health• Nutrition and healthy foods• Oral health• Physical activity• Reproductive and sexual health• Tobacco use and exposure
Section 4: Infrastructure focus areas• Access to health services
Report overview
6
AMERICAN INDIAN POPULATION
Report Outline: Detail
Section 5: Data summaries by population
Racial/ethnic minority populationso American Indianso Asianso Blackso Hispanics
People of lower socioeconomic status People with disabilities Lesbian, gay, bisexual, and transgender populations Geography
Report overview
7
AMERICAN INDIAN POPULATION
Data notes
• Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf
• The 95% confidence intervals are denoted by error bars. Where
confidence intervals do not overlap, as shown in the example on
the right, differences are statistically significant. Larger confidence
intervals may indicate less reliable estimates that should be
interpreted with caution.
• Population estimates that are considered unreliable are excluded.
• Misclassification of racial/ethnic groups may affect the accuracy of rates.
• Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.
Report overview
Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach 8
AMERICAN INDIAN POPULATION
Factors that influence health
Social determinants
of health
Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach
Report overview
9
AMERICAN INDIAN POPULATION
Historical trauma• Historical trauma is the cumulative exposure to traumatic events
that not only affect the individual exposed, but continue to affect subsequent generations.
• Descendants of those who experienced the traumatic stressor may still exhibit symptoms.
• Populations affected by historical trauma include American Indians, African Americans/Blacks, Hispanics/Latinos, Asians, immigrants and refugees, war veterans, and families experiencing intergenerational poverty.
• Current manifestations may include:• Mistrust of health care, legal, and educational systems; • Higher rates of risk behaviors such as alcohol and drug abuse,
suicide, homicide, and domestic violence; and • Higher rates of chronic diseases.
Report overview
Sources: SAMHSA, Fact Sheet: Historical Trauma http://gainscenter.samhsa.gov/cms-assets/documents/93078-842830.historical-trauma.pdf, Texas Department of Health Services, Trauma Informed Care Training, http://www.dfps.state.tx.us/Training/Trauma_Informed_Care/page35.asp
10
AMERICAN INDIAN POPULATION
Key Points
Summary
• American Indians in Wisconsin are younger than the general population and more likely to live in rural areas.
• American Indians in Wisconsin are more likely to live in poverty, less likely to be in a married couple household, and less likely to have a college degree compared to Whites.
• Key health issues for American Indian adults include: consequences from alcohol use, tobacco use and exposure, asthma, diabetes, intentional injury, premature death from coronary heart disease, and cancer.
11
AMERICAN INDIAN POPULATION
Key Points
Summary
• Key health issues for American Indian youth include: obesity, motor vehicle crashes, school violence, and teen pregnancy.
• Better data on American Indians are needed due to small sample size, racial misclassification, and data access issues.
12
AMERICAN INDIAN POPULATION
Data quality issues: American Indian population
Data on American Indians are limited due to five major issues:
• Data access
• Inconsistent measures used for race and ethnicity
• Racial misclassification
• Small population size
• Other data quality considerations
Data issues
13
AMERICAN INDIAN POPULATION
Demographic and socioeconomic data
14
AMERICAN INDIAN POPULATION
Demographic Characteristics
Wisconsin’s American Indian population is younger than the White population, more rural than other racial/ethnic groups, and increasing in numbers.
• Wisconsin's American Indian population, 2010: 48,511; 0.9% of state total
• Change in the American Indian population, 2000 to 2010: 13% increase
• Median age, 2010: American Indian, 30 years (Whites, 41.5 years)
The median age is the age at which half the population is older and half is younger.
• American Indians living in non-metropolitan counties: 41% (Whites, 33%)
Demographics and socioeconomic data
15Sources: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau.
AMERICAN INDIAN POPULATION
Socioeconomic data
Wisconsin’s American Indian population has higher poverty rates and less education compared to Whites.
• Median household income in Wisconsin, 2008-2010: American Indians, $35,000 (Whites, $53,000)
• Poverty rate, 2010: American Indian, 29% (Whites, 10%)
The poverty rate is the percent living below the federal poverty level.
• Bachelor’s degree or more education (age 25 and older), 2007-2010: American Indian, 11% (Whites, 27%)
• Married-couple households as a percent of family households, 2008-2010: American Indian, 52% (other racial/ethnic groups range from Blacks, 33% to Whites, 82%)
Source: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau.
16
Demographics and socioeconomic data
AMERICAN INDIAN POPULATION
American Indian population by county, Wisconsin, 2010
Source: U.S. Census, 2010.
American Indian population
American Indians as percent of total population
83.6%
17 - 614
615 - 1,713
1,714 - 3,538
3,539 - 5,968
0.1% - 2.4%
2.5% - 9.3%
9.4% - 16.1%
Demographics and socioeconomic data
17
AMERICAN INDIAN POPULATION
American Indian Tribes in Wisconsin
Source: Great Lakes Inter-Tribal Council, Inc.
Demographics and socioeconomic data
18
AMERICAN INDIAN POPULATION
Poverty rate by race/ethnicity, Wisconsin, 2010
Source: American Community Survey, 2010.
White Black Hispanic Lao/Hmong Other Asian American Indian
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
10% 39% 28% 25% 17% 29%
Total, 13%
Demographics and socioeconomic data
19
AMERICAN INDIAN POPULATION
Risk Factors in Youth and Adults
20
AMERICAN INDIAN POPULATION
Age-adjusted indicators of poor health status among Wisconsin adults by race/ethnicity, 2008-2011
Physical health
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 21
Fair or poor health Physical health not good on at least one day during past month
Of those with at least one day of poor health, percent whose poor health limited usual activities on
at least one day during past month
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
12% 35% 67%31% 49% 68%23% 42% 75%17% 46% 64%32% 78%
WhiteBlackHispanicAsianAmerican Indian
AMERICAN INDIAN POPULATION
Obesity among children (ages 2-4 years) enrolled in WIC, by race/ethnicity, Wisconsin, 2001 and 2010
White Black Hispanic Asian American Indian0%
5%
10%
15%
20%
25%
30%
35%
40%
10% 8% 16% 18% 18%12% 11% 18% 17% 27%
2001 2010
Source: Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance Survey 2010.Note: Based on >= 95th growth chart percentiles for Body Mass Index for age. WIC is the Supplemental Nutrition Program for Women, Infants, and Children.
Nutrition
22
AMERICAN INDIAN POPULATION
Age-adjusted rates of overweight and obesity among Wisconsin adults by race/ethnicity, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
63% 27%78% 44%67% 29%45% 71% 38%
WhiteBlackHispanicAsianAmerican Indian
Nutrition
23
AMERICAN INDIAN POPULATION
Rates of early initiation of alcohol and marijuana use among Wisconsin high school students, by race/ethnicity, 2007-2011
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.
Alcohol and other drugs
24
Had first drink before
age 13
Tried mari-juana before
age 13
0%
5%
10%
15%
20%
25%
30%
35%
40%
26% 14%29% 7%19% 6%23% 18%
White Black
Hispanic Asian
American Indian
AMERICAN INDIAN POPULATION
Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by race/ethnicity, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Binge drinking Heavy drinking0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
25% 9%15% 7%21% 28%
WhiteBlackHispanicAmerican Indian
Alcohol and other drugs
25
AMERICAN INDIAN POPULATION
Motor vehicle risk behaviors among Wisconsin high school students, by race/ethnicity, 2007-2011
Injury and violence
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.
Rarely or never wear seat belt Ride with someone who has been drinking alcohol
Drive after drinking alcohol0%
5%
10%
15%
20%
25%
30%
35%
40%
11% 26% 11%26% 27% 6%17% 29% 7%11% 26% 7%14% 34% 21%
White Black
Hispanic Asian
American Indian
26
AMERICAN INDIAN POPULATION
Exposure to school violence among Wisconsin high school students, by race/ethnicity, 2007-2011
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Injury and violence
27
Carry a weapon at school
Was in a fight at school in past 12
months
Was hit, punched, or kicked in past 12
months
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
17% 19% 24%10% 8% 16%14% 22%22% 23%
White Black
Hispanic Asian
American Indian
AMERICAN INDIAN POPULATION
Estimated prevalence of sexual risk behaviors among Wisconsin high school students by race/ethnicity, 2007-2011
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Reproductive and sexual health
28
Ever had sex-ual intercourse
Had inter-course before
age 13
Intercourse in last three months
Four or more lifetime part-
ners
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
70% 18% 47% 28%43% 7% 35% 12%32% 20% 9%50% 35% 20%
White Black
Hispanic Asian
American Indian
AMERICAN INDIAN POPULATION
Mental Health
29
AMERICAN INDIAN POPULATION
Protective factors among Wisconsin high school students, by race/ethnicity, 2007-2011
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS).
Strongly agree teachers care and give encour-
agement
Strongly agree belong at school
Get mostly A's and B's Strongly agree loved by family and get support
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
65% 74% 40% 89%59% 62% 28% 84%56% 67% 35% 85%61% 66% 41% 79%56% 66% 23% 73%
WhiteBlackHispanicAsianAmerican Indian
Mental health
30
AMERICAN INDIAN POPULATION
Depression among Wisconsin high school students, by race/ethnicity, 2007-2011
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS).
Felt sad/hopeless for at least 2 weeks and stopped doing usual activities0%
10%
20%
30%
40%
50%
60%
20% 28% 28% 32% 32%
White Black
Hispanic Asian
American Indian
Mental health
31
AMERICAN INDIAN POPULATION
Suicide risk during past 12 months among Wisconsin high school students, by race/ethnicity, 2007-2011
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS).
Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Considered suicide
Planned suicide Attempted suicide Suicide attempt with injury
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
13% 10% 5%17% 15% 12%14% 10%20% 13% 9%25% 22% 16%
White Black
Hispanic Asian
American Indian
Mental health
32
AMERICAN INDIAN POPULATION
Suicide deaths, age-adjusted rate per 100,000, by race/ethnicity, Wisconsin, 2008-2010
Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates..
Mental health
White Black Hispanic Asian American Indian0
2
4
6
8
10
12
14
16
13.1 7.2 5.9 9.9 14.0
Suicide rate
Ra
te p
er
10
0,0
00
po
pu
lati
on
33
AMERICAN INDIAN POPULATION
Health Outcomes
34
AMERICAN INDIAN POPULATION
Percentage of coronary heart disease deaths under the age of 75, by race/ethnicity and sex, Wisconsin, 2006-2010
Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.
Male Female0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
42% 19%73% 54%68% 48%71% 35%73% 50%
White Black
Hispanic Asian
American Indian
Chronic diseases
35
AMERICAN INDIAN POPULATION
Percentage of stroke deaths under the age of 75, by race/ethnicity and sex, Wisconsin, 2006-2010
Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.
Male Female0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
28% 15%66% 53%59% 46%68% 43%64% 40%
White Black
Hispanic Asian
American Indian
36
Chronic diseases
AMERICAN INDIAN POPULATION
Age-adjusted rates of high cholesterol and high blood pressure among Wisconsin adults, by race/ethnicity, 2009 and 2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Questions only asked in 2009 and 2011.Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Ever been told you have high cholesterol Ever been diagnosed with high blood pressure0%
10%
20%
30%
40%
50%
60%
31% 25%40% 39%28% 35%23% 38%
White Black
Hispanic American Indian
37
Chronic diseases
AMERICAN INDIAN POPULATION
Age-adjusted rates of diabetes and prediabetes among Wisconsin adults, by race/ethnicity, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Diabetes excludes women who were diagnosed during pregnancy, and does not differentiate between type 1 and type 2 diabetes. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Ever been diagnosed with diabetes Ever been told you have prediabetes0%
5%
10%
15%
20%
25%
7% 6%17% 7%10% 8%16%
WhiteBlackHispanicAmerican Indian
38
Chronic diseases
AMERICAN INDIAN POPULATION
Cancer incidence and mortality (all sites) by race/ethnicity, age-adjusted rate per 100,000, Wisconsin, 2010
Sources: Wisconsin Cancer Reporting System, Office of Health Informatics, Division of Public Health, Department of Health Services; and National Center for Health Statistics, Wisconsin mortality file 1995-2102, Vital Statistics Cooperative Program, 2013.Note: In this figure, racial groups include both Hispanics and non-Hispanics; Hispanics include all races.
Incidence Mortality0
100
200
300
400
500
600
436.9 171.4532.3 243.9322.8 95.0287.7 106.2503.6 229.7
White Black
Hispanic Asian
American Indian
Age-
adju
sted
rate
per
100
,000
pop
ulati
on
39
Chronic diseases
AMERICAN INDIAN POPULATION
Lung and bronchus cancer mortality by race/ethnicity, age-adjusted rate per 100,000, Wisconsin and United States, 2006-2010
Sources: Source: National Center for Health Statistics. Wisconsin mortality data file 1995-2010, Vital Statistics Cooperative Program, 2013.Note: In this figure, racial groups include both Hispanics and non-Hispanics; Hispanics include all races.
White Black Hispanic Asian American Indian0
10
20
30
40
50
60
70
80
90
100
46 70.4 15.3 13.8 85.950.2 53.5 21.3 25.5 33
WisconsinUnited States
Age
-adj
uste
d ra
te p
er 1
00,0
00 p
opul
ation
40
Chronic diseases
AMERICAN INDIAN POPULATION
Female breast cancer mortality by race/ethnicity, age-adjusted rate per 100,000, Wisconsin and United States, 2006-2010
White Black Hispanic Asian American Indian
0
5
10
15
20
25
30
35
21.1 29.1 6.7 9.8 23.222.1 30.8 14.8 11.5 12.5
WisconsinUnited States
Age
-adj
uste
d ra
te p
er 1
00,0
00 fe
mal
e po
pula
tion
Sources: Source: National Center for Health Statistics. Wisconsin mortality data file 1995-2010, Vital Statistics Cooperative Program, 2013.Note: In this figure, racial groups include both Hispanics and non-Hispanics; Hispanics include all races.
41
Chronic diseases
AMERICAN INDIAN POPULATION
Cervical cancer incidence by race/ethnicity, age-adjusted rate per 100,000, Wisconsin, 2006-2010
Source: Wisconsin Cancer Reporting System, Office of Health Informatics, Division of Public Health, Wisconsin Department of Health Services.Note: In this figure, racial groups include both Hispanics and non-Hispanics; Hispanics include all races.
White Black Hispanic Asian American Indian0
2
4
6
8
10
12
14
16
18
20
5.3 9.8 9.9 6.9 18.6
Rate
per
100
,000
fem
ale
popu
latio
n
42
Chronic diseases
AMERICAN INDIAN POPULATION
Prostate cancer mortality by race/ethnicity, age-adjusted rate per 100,000, Wisconsin and United States, 2006-2010
White Black Hispanic Asian American Indian
0
10
20
30
40
50
60
24.1 42.1 12.6 34.821.2 50.9 19.1 10.1 16.9
WisconsinUnited States
Age
-adj
uste
d ra
te p
er 1
00,0
00 m
ale
pop
ulati
on
Source: National Center for Health Statistics, Wisconsin mortality file 1995-2102, Vital Statistics Cooperative Program, 2013.Note: Rate not displayed when based on fewer than 10 cases. In this figure, racial groups include both Hispanics and non-Hispanics; Hispanics include all races.
43
Chronic diseases
AMERICAN INDIAN POPULATION
Alcoholic liver disease deaths by race/ethnicity, age-adjusted rate per 100,000, Wisconsin, 2008-2010
Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.Note: WISH suppresses small numbers (when cell size is less than 5) to comply with Wisconsin vital records data privacy guidelines; this means a rate may not be presented for every population group.
Alcoholic liver disease deaths0
5
10
15
20
25
30
4.2 3.9 4.5 24.4
WhiteBlackHispanicAmerican Indian
Age-
adju
sted
rate
per
100
,000
pop
ulati
on
44
Chronic diseases
AMERICAN INDIAN POPULATION
Unintentional injury deaths (leading causes) by race/ethnicity, age-adjusted rates per 100,000, Wisconsin, 2008-2010
Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.Note: WISH suppresses small numbers (when cell size is less than 5) to comply with Wisconsin vital records data privacy guidelines.
Falls Motor vehicle crashes Poisoning0
5
10
15
20
25
14 10 89 9 186 7 77 8 X14 22 19
WhiteBlackHispanicAsianAmerican Indian
Ag
e-a
dju
ste
d r
ate
pe
r 1
00
,00
0 p
op
ula-
tion
Injury and violence
45
AMERICAN INDIAN POPULATION
Births to teens ages 15-19 as a percent of all births, by race/ethnicity, Wisconsin, 2000-2010
Per
cen
t o
f al
l bir
ths
Source: Wisconsin Department of Health Services, Division of Public Health, Office of Health Informatics: Births to Teens in Wisconsin, 2010. January 2012.
Black American Indian
Hispanic Laotian/Hmong White Other Asian0%
5%
10%
15%
20%
25%
30%
25% 22% 19% 24% 7% 6%20% 16% 13% 12% 5% 3%
20002010
46
Reproductive and sexual health
AMERICAN INDIAN POPULATION
Confirmed cases of invasive Streptocococcus pneumoniae and group B streptococcal (GBS) disease, rate per 100,000, by race/ethnicity, Wisconsin, 2007-2011
Source: Wisconsin Public Health Information Network, Wisconsin Electronic Disease Surveillance System.Note: Data were not available for Hispanics.
Streptococcus pneumoniae Streptococcal disease, group B0
2
4
6
8
10
12
14
16
18
7.0 4.014.4 6.92.8 1.517.0 10.0
White Black
Asian American Indian
Rate
per
100
,000
pop
ulati
onCommunicable diseases
47
AMERICAN INDIAN POPULATION
References1. 2010 Census Briefs: The American Indian and Alaska Native Population:
http://www.census.gov/prod/cen2010/briefs/c2010br-10.pdf2. University of Wisconsin Population Health Institute. County Health Rankings, 2013.
http://www.countyhealthrankings.org/our-approach 3. Center for Urban Population Health. Milwaukee Health Report, 2011.
http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf 4. LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health
Inequalities in the United States. Joint Center for Political and Economic Studies. http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf
5. Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/
6. Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf
7. Great Lakes Inter-Tribal Epidemiology Center, Data Challenges and Strategies, 2012, unpublished.
8. U.S. Department of Health and Human Services, Gaps and Strategies for Improving AI/AN/NA Data, 2007. http://aspe.hhs.gov/hsp/07/AI-AN-NA-data-gaps/index.htm
48
References
AMERICAN INDIAN POPULATION
9. American Community Survey. http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_10_3YR_S0201&prodType=table
10. American Community Survey Glossary. http://factfinder2.census.gov/help/en/american_factfinder_help.htm#glossary/glossary.htm
11. Centers for Disease Control and Prevention (CDC). Obesity Prevalence Among Low-Income, Preschool-Aged Children - United States, 1998-2008. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5828a1.htm
12. CDC. Fact sheets - Underage drinking. http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm
13. National Institute on Drug Abuse. Drug Facts: Marijuana. http://www.drugabuse.gov/publications/drugfacts/marijuana
14. CDC. Teen Drivers: Fact Sheet. http://www.cdc.gov/motorvehiclesafety/teen_drivers/teendrivers_factsheet.html
15. CDC. Understanding School Violence. http://www.cdc.gov/violenceprevention/pdf/schoolviolence_factsheet-a.pdf
16. CDC. About School Violence. http://www.cdc.gov/VIOLENCEPREVENTION/youthviolence/schoolviolence/index.html
17. CDC. Sexual Risk Behavior: HIV, STD and Teen Pregnancy Prevention. http://www.cdc.gov/HealthyYouth/sexualbehaviors/
49
References
AMERICAN INDIAN POPULATION
18. CDC. School Connectedness: Strategies for Increasing Protective Factors Among Youth. http://www.cdc.gov/healthyyouth/adolescenthealth/pdf/connectedness.pdf
19. CDC. Youth Risk Behavior Surveillance System. http://apps.nccd.cdc.gov/youthonline/App/Default.aspx
20. Office of Adolescent Health. Mental Health. http://www.hhs.gov/ash/oah/adolescent-health-topics/mental-health/home.html
21. Keenan-Miller D, Hammen CL, Brennan PA. Health outcomes related to early adolescent depression. Journal of Adolescent Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2034364/
22. CDC. Mortality Among Teenagers Aged 12-19 Years: United States, 1999-2006. http://www.cdc.gov/nchs/data/databriefs/db37.htm
23. National Institute of Mental Health. Many Teens Considering Suicide Do Not Receive Specialized Mental Health Care. 2012. http://www.nimh.nih.gov/news/science-news/2012/many-teens-considering-suicide-do-not-receive-specialized-mental-health-care.shtml
24. CDC. Health Inequalities Report, 2011. http://www.cdc.gov/mmwr/pdf/other/su6001.pdf
25. CDC. Disparities in Premature Mortality Between High- and Low-Income U.S. Counties. http://www.cdc.gov/pcd/issues/2012/11_0120.htm
26. CDC. Racial/Ethnic and Socioeconomic Disparities in Multiple Risk Factors for Heart Disease and Stroke --- United States, 2003. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5405a1.htm
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References
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27. DHS. Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. Accessed August 2012. http://www.dhs.wisconsin.gov/wish/
28. CDC. Stroke Facts. http://www.cdc.gov/stroke/facts.htm29. Siegel R, et al. CA: A Cancer Journal for Clinicians: Cancer Statistics, 2013. http://
onlinelibrary.wiley.com/doi/10.3322/caac.21166/pdf30. CDC. Vital Signs: Racial Disparities in Breast Cancer Severity — United States, 2005–
2009. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6145a5.htm?s_cid=mm6145a5_w
31. Journal of the National Cancer Institute. Racial and Ethnic Disparities in the Receipt of Cancer Treatment. http://jnci.oxfordjournals.org/content/94/5/334.long
32. National Cancer Institute. Fact Sheet: Cancer Health Disparities. http://www.cancer.gov/cancertopics/factsheet/disparities/cancer-health-disparities
33. United States Cancer Statistics. 1999-2008 Incidence and Mortality Web-based Report. http://apps.nccd.cdc.gov/uscs/toptencancers.aspx
34. CDC. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses - United States, 2000—2004. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a3.htm
35. CDC. Racial/Ethnic Disparities and Geographic Differences in Lung Cancer Incidence -- 38 States and the District of Columbia, 1998-2006. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5944a2.htm
36. American College of Chest Physicians. Racial Disparities in Lung Cancer. http://69.36.35.38/accp/article/chest-physician/racial-disparities-lung-cancer
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References
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37. Bliss A, et al. Lung Cancer Incidence Among American Indians and Alaska Natives in the United States, 1999–2004. http://onlinelibrary.wiley.com/doi/10.1002/cncr.23738/pdf/
38. Wingo PA, et al. Breast Cancer Incidence Among American Indian and Alaska Native Women: U.S., 1999–2004. http://onlinelibrary.wiley.com/doi/10.1002/cncr.23725/pdf
39. Jemal A, et al. The National Cancer Institute. Annual report to the nation on the status of cancer, 1975–2009, featuring the burden and trends in Human Papillomavirus (HPV)–associated cancers and HPV. http://jnci.oxfordjournals.org/content/early/2013/01/03/jnci.djs491.full.pdf+html
40. CDC. Cervical Cancer. http://www.cdc.gov/cancer/cervical/41. PubMed Health. Prostate cancer. http://
www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001418/42. National Institutes of Medicine, Medline Plus. Alcoholic Liver Disease. http://
www.nlm.nih.gov/medlineplus/ency/article/000281.htm43. CDC. CDC WONDER. http://wonder.cdc.gov/44. DHS. Wisconsin Interactive Statistics on Health: Injury-related Mortality Module.
http://www.dhs.wisconsin.gov/wish/main/InjuryMortality/InjuryMortality_home.htm45. CDC. Birth Rates for the United States: Teenagers Reach Historic Lows for All Age and
Ethnic Groups. http://www.cdc.gov/nchs/data/databriefs/db89.pdf46. National Center for Health Statistics. Child Trends analysis of 1990-2009 Natality
microdata files from Centers for Disease Control and Prevention. http://datacenter.kidscount.org/data/acrossstates/Rankings.aspx?loct=3&by=v&order=d&ind=4&dtm=252&tf=38
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References
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47. CDC. The Pink Book: Pneumococcal disease. http://www.cdc.gov/vaccines/pubs/pinkbook/pneumo.html
48. The Mayo Clinic. Group B strep disease. http://www.mayoclinic.com/health/group-b-strep/DS01107/DSECTION=risk-factors
49. CDC. Perinatal Group B Streptococcal Disease After Universal Screening Recommendations—United States, 2003—2005. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5628a1.htm
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References
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Links to additional reports and resources
• Great Lakes Inter-Tribal Council Epidemiology Center: http://www.glitc.org/programs/epi-home
• United States National Library of Medicine: American Indian Health: http://americanindianhealth.nlm.nih.gov/
• Indian Health Services(IHS): http://www.ihs.gov/
• Wisconsin Tribal Health Centers (DHS website listing): http://www.dhs.wisconsin.gov/localhealth/counties/tribal.htm
• Centers for Disease Control and Prevention (CDC). American Indian & Alaska Native Populations: http://www.cdc.gov/minorityhealth/populations/REMP/aian.html
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Links
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Contacts
Evelyn Cruz, Minority Health OfficerWisconsin Division of Public Health, Office of Policy and Practice AlignmentE-mail: [email protected]
Karl Pearson, DemographerWisconsin Division of Public Health, Office of Health InformaticsE-mail: [email protected]
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Contacts