non-Native Americans Research Articles

Context of substance initiation among urban Native Americans: an exploratory retrospective case-control study.

Addiction is a significant problem among many Native American groups but has rarely been examined in urban populations. In particular, little is known about the context in which urban Native Americans first use substances. This study compares cases (people with a history of addiction) to controls (people without a history of addiction) on demographics, substance use history, context of first substance use, and polysubstance use. In addition, this appears to be the first study to overcome the lack of Native American professionals by employing and training lay community members to identify criteria of substance use disorders in survey participants. Employing community members helped foster trust that enabled the revelation of sensitive and often illegal activity. As a result, the investigators were able to recruit participants who likely would not have engaged with traditional researchers. The trained Native American lay research assistants recruited community members and administered surveys. They first asked questions regarding the criteria for substance use disorders. Individuals who were determined to have met criteria for a substance use disorder in the past were classified as cases (n=38) and those who never met such criteria were classified as controls (n=42). They then asked demographic, substance use, and polysubstance use questions. Lastly, eight cases and eight controls were randomly selected for a second interview by a licensed drug and alcohol counselor (LDAC) who conducted a blinded assessment regarding the presence or absence of a history of a substance use disorder. Both groups reported a relatively young age of first substance use (age 16 years for cases and age 15 years for controls). Alcohol was the first substance most commonly used in both groups. Controls reported first benzodiazepine use at a younger age than cases but no other significant differences were found. Both groups reported first obtaining their first drug from family, friends, or at home (rather than a party, bar, or store). Most commonly, the location of their first use of drugs occurred at a friend's home, a party, a bar, or school rather than at their own home. Cases were marginally more likely to report that their first drug use occurred with a friend rather than with a family member when compared with controls. The majority of both groups reported that their first drug use occurred with other Native Americans rather than with non-Native Americans. Polysubstance use was common in both groups (43-45%). There were no significant differences between the groups regarding polysubstance use. The LDAC arrived at the same determination as the trained research assistants on all eight cases and eight controls.

Systemic sclerosis in Native Americans of the American Southwest.

Many indigenous non-Caucasian populations, including Native Americans, have been reported to have higher rates, distinct clinical phenotypes, increased complications, and greater severity of systemic sclerosis (SSc). However, little is known of SSc specifically in Native Americans of the American Southwest. This study compared the clinical and serologic manifestations and outcomes of SSc in Native Americans and non-Native Americans (non-Natives) of this region. This cross-sectional retrospective study included 137 SSc patients (109 [80%] were non-Native and 28 [20%] were Native Americans) followed over a mean of 11.5 ± 7.6 years. Participants were repetitively evaluated with medical history, physical examination, echocardiography, chest imaging, and serologic testing. Disease characteristics and outcomes were statistically compared between Native Americans and non-Native patients. The estimated prevalence of SSc in Native Americans was 40.0 cases/100 000 vs 17.1 cases/100 000 for non-Natives (odds ratio 2.34, 95% confidence interval [CI] 1.55-3.55, P < .001). The cohorts were similar in terms age, age of onset, limited vs diffuse cutaneous SSc, telangiectasias, gastroesophageal reflux disease, Raynaud phenomenon, serologies, interstitial lung disease, pulmonary arterial hypertension, scleroderma renal crisis, cancer prevalence, and overall mortality (all P > .05). However, for Native Americans, mortality specifically from fatal infections was 3.94-fold that of non-Natives (hazard ratio 6.88, 95% CI 1.37-34.64; P < .001). In Native Americans of the American Southwest, SSc is increased in prevalence but is phenotypically similar to SSc in non-Natives. However, mortality due specifically to infection is increased in Native Americans with SSc.

A critical discourse analysis of Trump's election campaign speeches

This article presents a study in critical discourse analysis of Trump's election campaign speeches. Trump's speeches against immigrants have raised controversy in the world in general and in the United States in particular. Such speeches against immigrants might motivate Native Americans to enter a racial conflict with Muslims and other non-native Americans. The study adopts Van Dijk's (1991, 1995; 2006) discourse strategies. Therefore, this study aims to show how Trump ideologically invested these discursive strategies in the positive discourse of US (Trump, the majority of American people) and the negative discourse of THEM (Obama, Obama administration, Clinton, immigrants, especially Muslims). Based on data analysis, the study found out that Trump ideologically invested the (12) discourse strategies in almost all of the selected speeches for political interests. The study is hoped to encourage politicians to stop using language that is full of racism and sectarianism, because such language has negative results on innocent civilians.

Tribal Casino Labor Relations and Settler Colonialism

Sovereignty provides the legal basis for tribal casinos in the United States. However, since the industry’s rapid growth (valued at $34 billion for 2019), courts are now revisiting decades-old precedents in federal Indian law to reinterpret policies in ways that add new constraints to tribal sovereignty. Because tribal casinos often employ large numbers of non-Native Americans, tribal casino labor relations have become a new arena for contests over the boundaries of tribal sovereignty. This article investigates recent tribal casino labor relations court rulings (e.g. Little River, Soaring Eagle, and Pauma) through the lens of settler colonialism in order to understand new revisions to legal precedents. It argues that settler colonialism continues to underlie federal policies and that the growth of tribal casinos reveal that the federal government may intervene to undercut tribal sovereignty.

The Price of Mortgage Financing for Native Americans

We demonstrate that mortgage loans made to Native American primary borrowers are systematically more likely to be higher-priced than other mortgage loans. This difference is pronounced for mortgage loans on reservations: 27% of mortgage loans for properties on reservation lands with Native Americans as the primary borrower are higher-priced, while only 8.7% of mortgage loans nearby reservations made to non-Native American borrowers are higher-priced. Conditional on having a higher-priced loan, the rate spread facing Native Americans is also higher than non-Native Americans. These findings come from the 2010 to 2017 Home Mortgage Disclosure Act Data which is the most comprehensive, consistent series of mortgage loan data in the USA. We discuss the factors that may drive these outcomes.

The Ramapough Lunaape Nation: Facing health impacts associated with proximity to a Superfund site

Objective: To evaluate self-reported exposure to the Ringwood Mines/Landfill Superfund Site in relation to chronic health outcomes among members of the Ramapough Lunaape Turtle Clan nation and other local residents of Ringwood, New Jersey.Methods: Community surveys on personal exposure to the nearby Superfund site, self-reported health conditions, and demographics were conducted with 187 members of the Ramapough Lunaape Turtle Clan Nation and non-Native Americans residing in Ringwood, New Jersey from December 2015 to October 2016. Multiple logistic regression was performed to assess the association between ethnicity and a Superfund site exposure score developed for this study, as well as between exposure score and several chronic health conditions.Results: Native Americans were 13.84 times (OR 13.84; 95% CI 4.32, 44.37) more likely to face exposure opportunities to Superfund sites as compared to non-Native Americans in the same New Jersey borough. For the entire surveyed cohort, increased Superfund site exposure routes was significantly associated with bronchitis (OR 4.10; 95% CI 1.18, 14.23). When the analyses were restricted to Native Americans, the association between self-reported Superfund site exposure and bronchitis remained significant (OR 17.42; 95% CI 1.99, 152.45). Moreover, the association between greater exposure score and asthma in this same population also reached statistical significance (OR 6.16; 95% CI 1.38, 27.49).Conclusion: This pilot study demonstrated a significant association between being a Ringwood resident of Native American ethnicity and self-declared opportunities for Superfund site exposure. It also showed a strong association between self-reported Superfund site exposure and the prevalence of bronchitis and asthma.

Peripheral Artery Disease in Vulnerable Patient Populations: Outcomes of Orbital Atherectomy in Native Americans Compared to Non-Native Americans. A Single-Center Experience in Rural Oklahoma

Background/purposeAlthough the incidence of peripheral artery disease (PAD) and amputations is higher in Native Americans (NA) than Caucasians, the study of revascularization NA is limited, resulting in their under representation in clinical studies. Orbital atherectomy (OA) is widely utilized for endovascular revascularization of significantly calcified peripheral arteries and has been shown to improve limb salvage rates. Methods/materialsA cohort of 74 consecutive PAD subjects undergoing OA treatment was retrospectively analyzed via Kaplan Meier (KM) and Propensity Score Matched (PSM) analysis. ResultsA significant proportion of the subjects were NA (16.2%). Compared to the non-NA, the NA had higher numerical baseline rates of wounds, dialysis, chronic kidney disease (CKD), and critical limb ischemia, but were numerically less likely to smoke and had similar rates of diabetes. There were very high rates of severe calcification (100% vs. 87%) and pre-procedure diameter stenosis (99% vs. 95%) in both groups. The NA and non-NA had good angiographic outcomes, resulting in low rates of post-procedure residual diameter stenosis (10% vs. 11%). Lastly, KM analysis indicated high freedom from amputation in both groups at 1 year (89% vs. 95%), as well as in the PSM subjects (89% vs. 100%). ConclusionsDespite numerically higher rates of co-morbidities at baseline (e.g., CKD, dialysis, and presence of non-healing wounds), the NA underwent successful revascularization with OA, resulting in high freedom from amputation at 1-year. Given the small sample size of NA, these results may not be generalizable—thus, larger studies on NA are warranted.

The Ramapough Lunaape Nation: Facing Health Impacts Associated with Proximity to a Superfund Site.

This study aimedto evaluate self-reported exposure to the Ringwood Mines/Landfill Superfund Site in relation to chronic health outcomes among members of the Ramapough Lunaape Turtle Clan nation and other local residents of Ringwood, New Jersey. Community surveys on personal exposure to the nearby Superfund site, self-reported health conditions, and demographics were conducted with 187 members of the Ramapough Lunaape Turtle Clan Nation and non-Native Americans residing in Ringwood, New Jersey from December 2015 to October 2016. Multiple logistic regression was performed to assess the association between ethnicity and a Superfund site exposure score developed for this study, as well as between exposure score and several chronic health conditions. Native Americans were 13.84 times (OR 13.84; 95% CI 4.32, 44.37) more likely to face exposure opportunities to Superfund sites as compared to non-Native Americans in the same New Jersey borough. For the entire surveyed cohort, increased Superfund site exposure routes was significantly associated with bronchitis (OR 4.10; 95% CI 1.18, 14.23). When the analyses were restricted to Native Americans, the association between self-reported Superfund site exposure and bronchitis remained significant (OR 17.42; 95% CI 1.99, 152.45). Moreover, the association between greater exposure score and asthma in this same population also reached statistical significance (OR 6.16; 95% CI 1.38, 27.49). This pilot study demonstrated a significant association between being a Ringwood resident of Native American ethnicity and self-declared opportunities for Superfund site exposure. It also showed a strong association between self-reported Superfund site exposure and the prevalence of bronchitis and asthma.

Empathetic collective angst predicts perpetrator group members' support for the empowerment of the victimized group.

Although victimized groups have a need to recover diminished power, perpetrator groups are often reluctant to support actions that may undermine their own systemic advantages. We hypothesized that perpetrator group members' experience of empathetic collective angst-a group-based emotion focused on concern for the future vitality of an outgroup-mediates the relation between the perception of threat to the future of the victimized group and support for policies that may satisfy the group's empowerment. Across 5 studies and 3 distinct intergroup contexts (victimization of Aboriginal Canadians by non-Aboriginal Canadians, Native Americans by non-Native Americans, and French Canadians by Anglophone Canadians), we showed that perpetrator group members who perceive (Study 1) or are manipulated to perceive (Studies 2-5) that the victimized group is under existential threat (vs. secure) experience greater empathetic collective angst for the victimized group. In no study did perceived existential threat to the victimized group influence collective guilt-a group-based emotion focused on illegitimate harms committed against an outgroup. Empathetic collective angst mediated the relation between perceived existential threat and support for victimized group empowerment (e.g., self-determination). Study 4 found that the relation between empathetic collective angst and support for victimized group empowerment was stronger among perpetrator group members than bystander group members. A synthesis of the findings showed that the indirect effect was statistically significant across studies. Results suggest that, in the aftermath of victimization, empathetic collective angst motivates perpetrator group members to support policies that may satisfy victims' power needs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

2615. Increased Severity of Lower Respiratory Tract Infection Among Native American Compared with Non-Native American Children

BackgroundLower respiratory tract infection (LRTI) is the leading cause of pediatric hospitalizations in the United States, with significant morbidity and mortality. Native American children are at increased risk for severe illness during LRTI. Yet, the reasons for this increased risk are poorly understood. Socio-economic status and/or a genetic predisposition have been postulated as possible causes. In addition, the spectrum of LRTI presentations has not been adequately described in this patient population. The objective of this study was to define the clinical presentations of LRTI and highlight the differences between Native American and non-native American previously healthy patients under the age of 24 months.MethodsWe performed a retrospective chart review during the 2017–2018 respiratory season. We reviewed 357 medical records, and included 192 patients in the analysis that were full term, previously healthy, and met our inclusion criteria. We recorded demographic information, clinical and laboratory data, and outcomes.ResultsOf 192 patients, 39 were Native American and 153 were non-native American. We found no differences in gestational age, gender or age (median age was 5 and 7 months, respectively) between groups. We found no difference in rates of vaccination, upper respiratory symptoms, cough, wheezing, crackles, increased work of breathing or peripheral white blood cell count at presentation. In addition, we found no differences in antibacterial use or length of antimicrobial therapy during hospitalization. Native American children had a statistically significant higher length of hospitalization (P = 0.01) as well as days of oxygen supplementation (mean 4.9 vs. 3 days; P = 0.006) compared with non-native Americans. Furthermore, Native American children had a significantly higher percentage of PICU admissions (28% vs. 10.4%; P = 0.008) as well as intubation rate (26% vs. 8%; P = 0.04) compared with non-native Americans.ConclusionNative American children had increased length of hospitalization associated with severe illness including longer oxygen supplementation, higher PICU admission rate and need for mechanical ventilatory support.Disclosures All authors: No reported disclosures.

Cognitive dietary restraint, disinhibition, and hunger are associated with 24-h energy expenditure.

Background:Higher energy expenditure (EE) is associated with greater food intake, possibly because the human body senses EE and modifies eating behaviors to regulate food intake and ultimately achieve energy balance. As eating behaviors are also influenced by social and cultural factors, any association between EE and eating behavior may differ between ethnicities and sexes.Objective:To assess relationships between EE and eating behavior constructs of the Three-Factor Eating Questionnaire (TFEQ).Subjects/Methods:307 healthy adults (201M/106F, 160 Native Americans) completed the TFEQ and had measures of 24-h EE in a whole-room calorimeter during energy balance. Body composition was assessed by DXA.Results:On average, adjusted 24-h EE was lower (β=−229 kcal/day, CI: −309-−148, p<0.001) but cognitive restraint (Δ=+1.5; CI: 0.5–2.5, p=0.003) and disinhibition (Δ=+2.1, CI: 1.3–2.8, p<0.001) scores were higher in women compared to men. In Native Americans, adjusted 24-h EE (β=+94 kcal/day, CI: 48–139, p<0.001) and disinhibition scores (Δ=+1.0, CI: 0.1–2.0, p=0.003) were higher compared to other ethnicities. Higher 24-h EE associated with lower cognitive restraint in women (ρ=−0.20, p=0.04), but not men (p=0.71; interaction term p=0.01) with no ethnic differences. Greater 24-h EE associated with higher disinhibition (ρ=0.20, p=0.001) and hunger cues (ρ=0.16, p=0.004) with no gender differences. These associations were primarily present in non-Native Americans (ρ=0.23, p=0.006 and ρ=0.25, p=0.003) but not observed in Native Americans (both p>0.40).Conclusions:Higher EE is associated with psychological constructs of eating behaviors that favors overeating including lower cognitive restraint, higher dietary disinhibition, and greater susceptibility to hungers cues, supporting the existence of energy-sensing mechanisms influencing human eating behavior. These associations were observed in ethnicities other than Native Americans, possibly explaining the contradictory relationships reported between EE and weight change in different ethnic groups. We propose that increased EE may alter eating behaviors, potentially leading to uncontrolled overeating and weight gain.

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Burn injury outcome differences in Native Americans

ObjectiveNative Americans (NAs) have worse healthcare outcomes over some measures than non-Native Americans (non-NAs) (i.e., lower life expectancy, higher heart disease and psychiatric disease rates). Little data exists to show if there are differences in the hospital course of burned NAs versus non-NA patients. The purpose of this study is to analyze the epidemiology, clinical course, and outcomes of NA burn injury in Arizona. MethodsWe conducted a retrospective database review of all burn center burn admissions from 2000 to 2015. This initial dataset of 12,724 patients included all initial presentations for burns, non-burns, and readmissions. From this database, we extracted all patients who were new admissions for burn injuries only. This resulted in 10,521 patients of which 9555 patients were non-NA patients and 966 were NA patients. The burn center collects sixty-eight data points to populate our burn database; of these data points, we reviewed twenty-nine to assess if differences existed. ResultsStatistically significant differences exist between the two groups with regard to age, geographic locality at time of burn, circumstances surrounding the injury, etiology of the injury, method of transport to the regional burn center, total length of stay, Injury Severity Score on admission, total percent total body surface area burned, month of year of burn injury, hospital charges, payor source for medical costs, and the final disposition. NA burn patients were more often burned at recreational than occupational sites and while participating in non-work related activities. Burn etiologies in NA patients were more frequently due to contact and flame. NA burn patients tended to have greater hospital length of stays and greater charges, and were less likely to be discharged home. ConclusionsOur data demonstrate that NAs have a different experience with the healthcare system than non-NAs after a burn injury. The majority of these issues revolve around socioeconomic differences between the two groups.

Abstract TP415: Coated-Platelet Levels Are Elevated Among Native American Veterans With Vascular Risk Factors and Silent Brain Infarction

Background: Coated-platelets, a subset of procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin, are elevated in patients with incident and recurrent stroke/TIA and mild cognitive impairment. We now report the association between coated-platelets and brain imaging correlates of vascular cognitive impairment in a pilot study of cognitive impairment among Native Americans Veterans. Methods: Coated-platelets, reported as percentage of cells converted to coated-platelets, were assayed in 60 Native American veterans with ≥2 vascular risk factors. The Montreal Cognitive Assessment (MoCA) and the Beck Depression Inventory-II were administered to screen for cognitive impairment and depression. Brain CT or MRI performed within 12 months of enrollment were reviewed for silent brain infarction (SBI), small vessel disease and/or atrophy. SBI was defined as focal, ≥ 3mm, cavitary lesion with T1 hypointensity and T2 hyperintensity features on MRI or hypodense on CT and not associated with stroke history or focal neurologic findings. Differences in mean coated-platelet levels by imaging results were determined using the Kruskal-Wallis test. Results: MoCA scores were abnormal (&lt;26) in 23 of 51 subjects (44%, 95%CI: 30%-59%) after excluding 9 with depression. Brain imaging was available for 36 subjects (97% male, mean age 63 range 50-86). Twelve (33%, 95%CI: 19%-51%) had normal results, 19 (53%, 35%-70%) had small vessel disease and/or atrophy, and 5 (14%, 5%-30%) had SBI. Median coated-platelets were significantly higher among those with SBI (51%, IQR 48%-59%) versus those without SBI having either normal results (36.5%, IQR 30.5%-48.1%) or small vessel disease and/or atrophy (33.6%, IQR 24.4%-47.3%), overall p=0.045. Conclusion: Platelet procoagulant potential is increased among Native American veterans with vascular risk factors and SBI versus those with normal scans or with small vessel disease and/or atrophy. These results suggest a role for coated-platelets as a biomarker of SBI in vascular cognitive impairment, and are consistent with previous findings of increased risk of ischemic stroke among non-Native Americans. Further studies are warranted to confirm these results and explore mechanisms involved.

Ethnic differences in medicinal plant use among University students: a cross-sectional survey of self-reported medicinal plant use at two Midwest Universities.

BackgroundNumerous surveys of medicinal plant use among college students abound, but none compare use between students enrolled in two different Universities with significantly different ethnic compositions. The objective of this study is to compare medicinal plant use between two different ethnic college populations and explore differences between student medicinal plant users and non-users for comparison with previous research.MethodsStudents (n = 721) at a large research university (n = 498) and a Pan-Tribal University for Native Americans (n = 233) completed surveys in October 2011 to assess past year medicinal plant use. The Mann-Whitney U test, Chi Square test, and General Linear Model were used to compare demographics and self-reported use of medicinal plants among students at both Universities and between past year users and non-users.ResultsOver 23 % of university students surveyed reported past year medicinal plant use. Users were more likely to use commercial tobacco products and to report poorer health than non-users. While Native American student medicinal plant users reported significantly higher rates of commercial tobacco use, lower self-assessment of health, and less use of prescription medicine than non-Native users, no significant differences in prevalence of medicinal plant use were found between University student populations.ConclusionsResults are consistent with preexisting data showing higher rates of medicinal plant use among college students compared to the larger US population of adults and demonstrate previously documented health disparities in Native American populations compared to non-Native Americans.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-015-0725-1) contains supplementary material, which is available to authorized users.

Comparison of fruit and vegetable consumption among Native and non-Native American populations in rural communities

Fruit and vegetable consumption of Native Americans was compared with that of non-Native Americans and determinants of fruit and vegetable intake for both populations were found based upon the Theory of Planned Behavior. A one-time survey was conducted as part of a larger research project funded by the South Dakota Department of Health. The survey was administered in local grocery stores and supermarkets in six South Dakota communities, including two located on Native American reservations. Of the 1000 distributed surveys, 499 were returned with 230 being usable, resulting in a response rate of 49.9%. Wilcoxon signed-rank test and two regression models were tested using SAS 9.2 software. Dependent variables were fruit and vegetable intake. Attitudes towards health, fruit and vegetable consumption, perceived difficulty, subjective norm and intention were also measured. Community size, family income, employment status and participation in food assistance programmes [Supplemental Nutrition Assistance Program or Women, Infants, and Children (SNAP or WIC)] were socio-demographic control variables. Overall, Native American participants consumed more fruit and vegetables at home and had a more positive attitude towards healthy diets than non-Native American participants. SNAP or WIC participation, family health, exercise, intention to live healthier than parents, buying healthy food, and fruit and vegetable consumption when eating out were positively associated with fruit and vegetable consumption among Native Americans, while participation in the SNAP or WIC programme had a negative influence on consumption among non-Native American participants. Family health, exercise, buying healthy food, fruit and vegetable when eating out, and intention to buy healthy food were positively associated with fruit and vegetable consumption among the non-Native American population. Theory of Planned Behavior variables (e.g. attitude towards healthy food) significantly contributed to the model explaining fruit and vegetable consumption. The fact that SNAP and WIC participation had an opposite influence on the two populations warrants further research.

Sociocultural Influences on Gambling and Alcohol Use Among Native Americans in the United States.

Gambling opportunities on and near Native American lands have increased in recent decades; yet there is a lack of research examining the patterns of problem gambling and alcohol abuse among Native Americans in the US. Traditional Native American cultural identity may be a protective factor for problem gambling and alcohol abuse among Native Americans. Telephone interviews were conducted with 415 Native American adults aged 18 years and older across the US. The past-year prevalence of gambling among Native Americans is similar to the rate for non-Native Americans in the US (80 vs. 77%). However, Native Americans have over twice the rate of problem gambling as the US sample (18 vs. 8%). Although Native Americans have a lower rate of past-year alcohol use than the US population (47 vs. 68%), they have a somewhat higher rate of alcohol abuse than their US counterparts (5.5 vs. 4.3%). Logistic regression analysis, with problem gambling as the dependent variable, revealed that lower socioeconomic status is significantly associated with an increased odds of problem gambling for Native Americans. Counter to the hypothesis, the higher the score on the Native American orientation, the higher the odds of being a problem gambler. Further, living by the "White way of life" was associated with a decreased odds of being a problem gambler; and perceived gambling convenience was associated with an increased odds of being a problem gambler. None of the Native American factors was significant in predicting alcohol abuse. These findings highlight the need for further investigation into the influence of cultural factors on Native American gambling.

The Disappearing Turnout Gap between Native Americans and Non-Native Americans

Past research has consistently found that American Indians have traditionally turned out to vote at lower rates than do other citizens. Using two separate data sets, we examine this "turnout gap" over the past several decades. We find that not only has Native American turnout increased generally, but that the "gap" between Native Americans and non-Native Americans has declined substantially, and that in recent elections this "gap" has largely disappeared. We then provide a preliminary and tentative examination of possible causes for the decline, including the role of Indian gaming, mobilization by political parties and candidates, and shifting political values among Native Americans.

Prevalence of asthma and chronic obstructive pulmonary disease in Aboriginal and non-Aboriginal populations: a systematic review and meta-analysis of epidemiological studies.

Asthma and chronic obstructive pulmonary disease (COPD) have considerable potential for inequities in diagnosis and treatment, thereby affecting vulnerable groups. To evaluate differences in asthma and COPD prevalence between adult Aboriginal and non-Aboriginal populations. MEDLINE, Embase, specialized databases and the grey literature up to October 2011 were searched to identify epidemiological studies comparing asthma and COPD prevalence between Aboriginal and non-Aboriginal adult populations. Prevalence ORs (PORs) and 95% CIs were calculated in a random-effects meta-analysis. Of 132 studies, eight contained relevant data. Aboriginal populations included Native Americans, Canadian Aboriginals, Australian Aboriginals and New Zealand Maori. Overall, Aboriginals were more likely to report having asthma than non-Aboriginals (POR 1.41 [95% CI 1.23 to 1.60]), particularly among Canadian Aboriginals (POR 1.80 [95% CI 1.68 to 1.93]), Native Americans (POR 1.41 [95% CI 1.13 to 1.76]) and Maori (POR 1.64 [95% CI 1.40 to 1.91]). Australian Aboriginals were less likely to report asthma (POR 0.49 [95% CI 0.28 to 0.86]). Sex differences in asthma prevalence between Aboriginals and their non-Aboriginal counterparts were not identified. One study compared COPD prevalence between Native and non-Native Americans, with similar rates in both groups (POR 1.08 [95% CI 0.81 to 1.44]). Differences in asthma prevalence between Aboriginal and non-Aboriginal populations exist in a variety of countries. Studies comparing COPD prevalence between Aboriginal and non-Aboriginal populations are scarce. Further investigation is needed to identify and account for factors associated with respiratory health inequalities among Aboriginal peoples.

Native American breast cancer survivors' physical conditions and quality of life.

Based on Survivors' Guidance, an interactive, Web-based, culturally relevant Native American cancer survivorship program, Native American Cancer Education for Survivors (NACES), was developed. The focus of the program is to improve quality of life (QOL) for Native American breast cancer survivors. NACES is a community-driven research and education project, based on the Social Cognitive Theoretical Model. Participants complete a QOL survey that includes physical, psychosocial, spiritual, and social components. This publication focuses on the physical component of the survey collected by trained Native American patient advocates, and compares physical conditions among Native American breast cancer survivors who were diagnosed within 1 year, those diagnosed between 1 and 4 years, and those who are long-term survivors (diagnosed > or = 5 years ago). For the first time, survivorship issues are reported specifically for Native American breast cancer patients (n = 266). Selected access issues document situations that contribute to disparities. Comorbidities such as high blood pressure and arthritis are common in the survivors, with more than a third having diabetes, in addition to breast cancer. Numerous side effects from cancer treatments are experienced by these survivors. These data describe what Native American breast cancer patients are experiencing based on self-reported information. Clearly there is need for much more work and long-term tracking of Native American patients to begin to document if or how the severity of physical symptoms lessens over time and if their experiences are significantly different from non-Native Americans.