2006 SUMMER SCHOOL OF GERONTOLOGY The Invisible Population Native Americans in South Carolina August 23, 2006 Barbara MorningStar Paul Program Coordinator,

2006 SUMMER SCHOOL 2006 SUMMER SCHOOL OF OF

GERONTOLOGYGERONTOLOGY

The Invisible PopulationThe Invisible PopulationNative Americans in South CarolinaNative Americans in South Carolina

August 23, 2006August 23, 2006

Barbara MorningStar PaulBarbara MorningStar PaulProgram Coordinator, Native American AffairsProgram Coordinator, Native American Affairs

SC Commission for Minority AffairsSC Commission for Minority Affairs6904 N. Main St., Suite 1076904 N. Main St., Suite 107

Columbia, SC 29203Columbia, SC 29203803.333.9621 extension 23803.333.9621 extension 23

[email protected]@cfma.state.sc.us

WHAT ARE THE MAJOR ISSUES WHAT ARE THE MAJOR ISSUES TODAY?TODAY?

How to Relate to Native peopleHow to Relate to Native peopleCultural differencesCultural differencesAddiction issuesAddiction issuesPhysical Health/Mental Health Issues Physical Health/Mental Health Issues Criminal Justice issuesCriminal Justice issuesFamily structureFamily structureIndian Child Welfare Act Indian Child Welfare Act Spiritual beliefsSpiritual beliefsSERIOUS Lack of Accurate Statistics in South SERIOUS Lack of Accurate Statistics in South CarolinaCarolinaBarriers to TreatmentBarriers to Treatment

MORE ISSUES TO MORE ISSUES TO CONSIDERCONSIDER

Education/Literacy Education/Literacy HealthcareHealthcare Economic StatusEconomic Status Poverty RatesPoverty Rates Addiction to Alcohol and Other DrugsAddiction to Alcohol and Other Drugs Criminal Justice – Adult and Juvenile…Criminal Justice – Adult and Juvenile…

Crimes Against Women/Domestic ViolenceCrimes Against Women/Domestic Violence Family StructureFamily Structure Infant MortalityInfant Mortality

Overview of Native American Overview of Native American PopulationPopulation

Federal vs. State Recognition – What it means…..Federal vs. State Recognition – What it means…..

The Native American Population is growing at a rapid The Native American Population is growing at a rapid pacepace

Current Native American population in South Carolina:Current Native American population in South Carolina:

Claiming Native American race only – 13,718Claiming Native American race only – 13,718 Claiming Native American and another race – 27,623Claiming Native American and another race – 27,623 Of those: Of those:

1,441 claim Native American of Hispanic descent as one race 1,441 claim Native American of Hispanic descent as one race onlyonly

2,107 claim Native American of Hispanic descent as more than 2,107 claim Native American of Hispanic descent as more than once raceonce race

Comparison reportComparison report

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

1990 2000

Population Growth

Native Americans

A BRIEF HISTORY LESSONA BRIEF HISTORY LESSON

First contacts between Europeans and Indians in South Carolina.

Colonization

Treaties

The Trail of Tears (Indian Removal Act)The Trail of Tears (Indian Removal Act)

What did it do??What did it do??

""Even the seasons form a great circle in their changing, and Even the seasons form a great circle in their changing, and always come back again to where they were. The life of a always come back again to where they were. The life of a man is a circle from childhood to childhood and so it is man is a circle from childhood to childhood and so it is everything where power moveseverything where power moves." ." --Black Elk (Hehaka sapa), OGLALA --Black Elk (Hehaka sapa), OGLALA SIOUX SIOUX

MORE HISTORY…MORE HISTORY…

In all, Southeastern Indians (not In all, Southeastern Indians (not just Cherokee) gave up about just Cherokee) gave up about 100 million acres of land for 100 million acres of land for about 32 million acres in Westabout 32 million acres in West

Indian Appropriations Act of 1871

The General Allotment Act in The General Allotment Act in 18871887

How did all of this affect Indian How did all of this affect Indian health??health??

PERCEPTIONS BY PERCEPTIONS BY OTHERSOTHERSPan-IndianismPan-Indianism

HeathenismHeathenism

Presence or lack of presence in the State – “NATIVE Presence or lack of presence in the State – “NATIVE AMERICANS DO NOT REPORT THEIR RACE ACCURATELY”AMERICANS DO NOT REPORT THEIR RACE ACCURATELY”

REASONS FOR NOT REPORTING RACE AS NATIVE AMERICANREASONS FOR NOT REPORTING RACE AS NATIVE AMERICAN MISCEGENATION LAWSMISCEGENATION LAWS CENSUSCENSUS TRAIL OF TEARSTRAIL OF TEARS PREJUDICE/REPRISAL PRE AND POST CIVIL WAR/SEGREGATION SOUTHPREJUDICE/REPRISAL PRE AND POST CIVIL WAR/SEGREGATION SOUTH CIVIL RIGHTS??? FOR WHO???CIVIL RIGHTS??? FOR WHO??? RELIGIOUS FREEDOM ISSUESRELIGIOUS FREEDOM ISSUES FEAR, FEAR, FEARFEAR, FEAR, FEAR

How they look…..How they look…..

Stereotypes Stereotypes

INACCURACIES ARE DOCUMENTED AND OBVIOUSINACCURACIES ARE DOCUMENTED AND OBVIOUS

SO WHAT?? WHY ARE YOU SO WHAT?? WHY ARE YOU TELLING US ALL THIS?TELLING US ALL THIS?

IS THERE A CONNECTION BETWEEN SELF IS THERE A CONNECTION BETWEEN SELF IMAGE/SELF RESPECT AND:IMAGE/SELF RESPECT AND: MENTAL HEALTHMENTAL HEALTH PHYSICAL HEALTHPHYSICAL HEALTH BEHAVIORS – HEALTHY AND UNHEALTHYBEHAVIORS – HEALTHY AND UNHEALTHY

IS THERE A CONNECTION BETWEEN IS THERE A CONNECTION BETWEEN POVERTY/ILLITERACY AND:POVERTY/ILLITERACY AND: MENTAL HEALTHMENTAL HEALTH PHYSICAL HEALTHPHYSICAL HEALTH BEHAVIORS – HEALTHY AND UNHEALTHYBEHAVIORS – HEALTHY AND UNHEALTHY

NATIVE AMERICANS IN SOUTH NATIVE AMERICANS IN SOUTH CAROLINACAROLINA

How many tribes and groups are How many tribes and groups are in South Carolina?in South Carolina?

““First Contact”First Contact”

Archaeology Archaeology

““Invisible” Invisible”

Statistics.Statistics.

Are Are seriously seriously underserved.underserved.

The good, the bad and The good, the bad and the ugly…..the ugly…..

SmallpoxSmallpox Alcoholism/AddictionAlcoholism/Addiction Lack of educationLack of education High drop out ratesHigh drop out rates Low economic and income levelsLow economic and income levels MiscommunicationsMiscommunications FearsFears

So you think you can relate to Native So you think you can relate to Native People?People?

““My grandmother was a Cherokee princess……”My grandmother was a Cherokee princess……”

ExerciseExercise: : "What you see with your eyes shut is what counts." "What you see with your eyes shut is what counts." --Lame --Lame Deer, LAKOTA Deer, LAKOTA

““The Santee Indians came together and built their won school. It The Santee Indians came together and built their won school. It was called Crane Pond School and it was an all-Indian school. was called Crane Pond School and it was an all-Indian school. This was set up by the government. We also weren’t allowed to This was set up by the government. We also weren’t allowed to mix with the white people. This took place back in the early mix with the white people. This took place back in the early 1900’s. I was only allowed to go to the seventh grade and only 1900’s. I was only allowed to go to the seventh grade and only the whites and blacks could finish high school. We could not ride the whites and blacks could finish high school. We could not ride the bus or go into establishments. If we went to town for the bus or go into establishments. If we went to town for anything we had to go to the window and wait for whatever anything we had to go to the window and wait for whatever service was needed by the established. We were finally allowed service was needed by the established. We were finally allowed to ride the bus but could only sit in the very back, quietly.” to ride the bus but could only sit in the very back, quietly.” (Voncile Pratt-Platt Todd, August 25, 2005”).(Voncile Pratt-Platt Todd, August 25, 2005”).

Educational/Language BarriersEducational/Language Barriersi.e. medical-speaki.e. medical-speaki.e. government speaki.e. government speak

Literacy issue and sensitivityLiteracy issue and sensitivity

The Old Ones have always said that no matter who despises or ignores you, no The Old Ones have always said that no matter who despises or ignores you, no matter who keeps you from entering their circles, it is right to pray for them matter who keeps you from entering their circles, it is right to pray for them because the are like us, too." because the are like us, too." --Larry P. Aitken, CHIPPEWA --Larry P. Aitken, CHIPPEWA

Cultural IssuesCultural Issues

Resentments and Why:Resentments and Why: Euro-cultureEuro-culture African American CultureAfrican American Culture Hispanic/Latino CultureHispanic/Latino Culture

How to avoid triggering How to avoid triggering resentmentsresentments

Addiction IssuesAddiction Issues AI/ANs are the most impoverished of today’s minority

groups. Over one quarter live in poverty, compared to 8 percent of whites. A heterogeneous grouping of more than 500 Federally recognized tribes, the AI/AN population experiences a range of health and mental health outcomes.

While AI/ANs are, on average, five times more likely to die of alcohol-related causes than are whites, they are less likely to die from cancer and heart disease.

According to the S.C. Budget and Control Board Office of Research According to the S.C. Budget and Control Board Office of Research and Statistics (9/19/2005), DAODAS reported serving ONLY and Statistics (9/19/2005), DAODAS reported serving ONLY 127127 Native American people.Native American people.

WHAT IS WRONG WITH THIS PICTURE???WHAT IS WRONG WITH THIS PICTURE???

MENTAL HEALTH: A REPORT OF THE SURGEON GENERAL 1999

PHYSICAL HEALTH/PHYSICAL HEALTH/MENTAL HEALTHMENTAL HEALTH

“…… “…… more than half of the AI/AN population does not more than half of the AI/AN population does not permanently reside on a reservation,permanently reside on a reservation,33 and therefore have and therefore have limited or no access to IHS services.limited or no access to IHS services. Geographic isolation, Geographic isolation, economic factors, and suspicion toward traditional economic factors, and suspicion toward traditional spiritual beliefs are some of the reasons why health among spiritual beliefs are some of the reasons why health among AI/ANs is poorer than other groups. Other factors that AI/ANs is poorer than other groups. Other factors that contribute to poorer health outcomes for AI/ANs include contribute to poorer health outcomes for AI/ANs include cultural barriers, geographic isolation, inadequate sewage cultural barriers, geographic isolation, inadequate sewage disposal, and economic factors.disposal, and economic factors.44 “ “

American Indians born today have a life expectancy 5 years less than non-American Indians born today have a life expectancy 5 years less than non-IndiansIndians (NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH Release Date: August (NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH Release Date: August 21, 2000) 21, 2000)

HOW MANY FEDERALLY RECOGNIZED TRIBES ARE IN SOUTH HOW MANY FEDERALLY RECOGNIZED TRIBES ARE IN SOUTH CAROLINA?????CAROLINA?????

WHAT HAPPENS TO THE REST OF THEM???WHAT HAPPENS TO THE REST OF THEM???

33 Statistical Handbook on Racial Groups in the United StatesStatistical Handbook on Racial Groups in the United States by T.B. Heaton, B.A. Chadwick, and C.K. Jacobson; by T.B. Heaton, B.A. Chadwick, and C.K. Jacobson; Phoenix: Oryx Press, 2000; Table A3.5. Phoenix: Oryx Press, 2000; Table A3.5.

44 T The Health Care Challenge: Acknowledging Disparity, Confronting Discrimination, and Ensuring Equality. he Health Care Challenge: Acknowledging Disparity, Confronting Discrimination, and Ensuring Equality. United States Commission on Civil RightsUnited States Commission on Civil Rights, Sept. 1999., Sept. 1999.

55 American Indian & Alaska Native (AI/AN) Populations;American Indian & Alaska Native (AI/AN) Populations;CDC; Office of Minority HealthCDC; Office of Minority Health

PHYSICAL HEALTH/MENTAL HEALTH – ContinuedPHYSICAL HEALTH/MENTAL HEALTH – Continued

According to a 2001 study by the U.S. Department of Health and Human According to a 2001 study by the U.S. Department of Health and Human Services , among AI/AN youth aged 12 to 17 years in 1999-2000:Services , among AI/AN youth aged 12 to 17 years in 1999-2000:

Illicit drug use was more than twice as high (22.2%) as the national Illicit drug use was more than twice as high (22.2%) as the national average (9.7%). average (9.7%).

Binge alcohol use was higher (13.8%) than the national average Binge alcohol use was higher (13.8%) than the national average (10.3%). (10.3%).

Heavy alcohol use was higher (3.8%) than the national average Heavy alcohol use was higher (3.8%) than the national average (2.5%). (2.5%).

Driving under the influence of illicit drugs or alcohol in the past year Driving under the influence of illicit drugs or alcohol in the past year was slightly lower (10%) than the national average (11.2%). was slightly lower (10%) than the national average (11.2%).

Use of cigarettes was more than twice as high (27.2%) as the national Use of cigarettes was more than twice as high (27.2%) as the national average (13.4%). average (13.4%).

Getting into at least one serious fight at school or work in the past Getting into at least one serious fight at school or work in the past year was higher (22.1%) than the national average (19.9%). year was higher (22.1%) than the national average (19.9%).

Source: Fact Sheet, Surgeon General’s Report; U.S. Department of Health and Human Services, Office of the Surgeon General, SAMHSA, 1999Source: Fact Sheet, Surgeon General’s Report; U.S. Department of Health and Human Services, Office of the Surgeon General, SAMHSA, 1999

PHYSICAL HEALTH/MENTAL HEALTH – ContinuedPHYSICAL HEALTH/MENTAL HEALTH – Continued Taking part in at least one group-against-Taking part in at least one group-against-

group fight in the past year was higher group fight in the past year was higher (22.4%) than the national average (16.1%). (22.4%) than the national average (16.1%).

Carrying a handgun at least once in the past Carrying a handgun at least once in the past year was about the same (3.3%) as the year was about the same (3.3%) as the national average (3.2%). national average (3.2%).

Data also indicate the presence of despair. Data also indicate the presence of despair.

Suicide is the second leading cause of death Suicide is the second leading cause of death for AI/AN youth in the 15-24 age groupfor AI/AN youth in the 15-24 age group

The suicide rate is 2.5 times higher for The suicide rate is 2.5 times higher for AI/AN people than the combined rate for all AI/AN people than the combined rate for all races in the United States (USDHHS, 1999). races in the United States (USDHHS, 1999).

PHYSICAL HEALTH/MENTAL HEALTH – ContinuedPHYSICAL HEALTH/MENTAL HEALTH – Continued In the BIA study, 19% of AI/AN high school youth had In the BIA study, 19% of AI/AN high school youth had

seriously considered suicide during the preceding year. seriously considered suicide during the preceding year. Although still a strong cause for concern, this statistic Although still a strong cause for concern, this statistic does represent an improvement over the 29% reported in does represent an improvement over the 29% reported in the 1994 survey (Shaughnessy, Branum, & Everett-Jones, the 1994 survey (Shaughnessy, Branum, & Everett-Jones, 2001). 2001).

Native males ages 15 to 24 account for two-thirds of all Native males ages 15 to 24 account for two-thirds of all Native suicides.Native suicides.

Violent deaths – unintentional injuries, homicide, and Violent deaths – unintentional injuries, homicide, and suicide – account for 75% of all mortality in the second suicide – account for 75% of all mortality in the second decade of life for AIANs. (Source: Fact Sheet, Surgeon decade of life for AIANs. (Source: Fact Sheet, Surgeon General’s Report; U.S. Department of Health and Human General’s Report; U.S. Department of Health and Human Services, Office of the Surgeon General, SAMHSA, 1999.)Services, Office of the Surgeon General, SAMHSA, 1999.)

Homicide and legal intervention are the third leading Homicide and legal intervention are the third leading cause of death for Indian youth (ages 15-24); the homicide cause of death for Indian youth (ages 15-24); the homicide rate among American Indians is 1.2 times that of the rate among American Indians is 1.2 times that of the general U.S. population (USDHHS, 1999). general U.S. population (USDHHS, 1999).

Social and Emotional Distress Among American Indian and Alaska Native students: Research Findings Social and Emotional Distress Among American Indian and Alaska Native students: Research Findings by Ardy SixKiller Clarke; EDO-RC-01-11 (January 2002)by Ardy SixKiller Clarke; EDO-RC-01-11 (January 2002)

PHYSICAL HEALTH/MENTAL HEALTH – ContinuedPHYSICAL HEALTH/MENTAL HEALTH – ContinuedAI/ANs are over-represented among high need populations:AI/ANs are over-represented among high need populations:

People who are homeless. People who are homeless.

People who are homeless. While representing less than 2% of People who are homeless. While representing less than 2% of the U.S. population, it is estimated that AI/ANs constitute 8% the U.S. population, it is estimated that AI/ANs constitute 8% of Americans who are homeless. of Americans who are homeless.

People with alcohol and drug problems. People with alcohol and drug problems.

People who are incarcerated – see “Criminal Justice” slide

People who are victims of trauma – see “Criminal Justice” slide

“Need for Services: Research on AI/ANs is limited by the small size of this population and by its heterogeneity. “


*****""Silence is the absolute poise or balance of body, mind and Silence is the absolute poise or balance of body, mind and spirit." spirit." --Charles A. Eastman (Ohiyesa), SANTEE SIOUX --Charles A. Eastman (Ohiyesa), SANTEE SIOUX

AND MORE INFO……AND MORE INFO…… Access to Services: About 20 percent

of AI/ANs do not have health insurance, compared to 14 percent of whites.

Traditional healing is used by a

majority of AI/ANs.

Appropriateness and Outcomes of Services: The appropriateness and outcomes of mental health care for AI/ANs have yet to be examined, but are critical for planning treatment and prevention programs.


SO DO INDIAN PEOPLE TRUST YOU??SO DO INDIAN PEOPLE TRUST YOU??

A government A government prohibition on participation in traditional prohibition on participation in traditional spiritual ceremonies continued until the American Indian spiritual ceremonies continued until the American Indian Religious Freedom Act of (1978).Religious Freedom Act of (1978).

………….traditional cultural views still heavily influence the .traditional cultural views still heavily influence the way in which Native people understand life, health, illness, way in which Native people understand life, health, illness, and healingand healing (Todd-Bazemore, 1999). (Todd-Bazemore, 1999).

American Indian adolescents were much more likely to be American Indian adolescents were much more likely to be diagnosed with AD/HD and substance abuse or substance diagnosed with AD/HD and substance abuse or substance dependence disorders.dependence disorders. The rates of conduct disorder and The rates of conduct disorder and oppositional defiant disorder were also elevated in the oppositional defiant disorder were also elevated in the American Indian sample.American Indian sample.


Everything's so simple, and we make everything so Everything's so simple, and we make everything so complicated. That's why we're confused." complicated. That's why we're confused." --Vickie Downey, --Vickie Downey, TEWA/Tesuque Pueblo TEWA/Tesuque Pueblo

Criminal Justice – Victimization;Crimes Criminal Justice – Victimization;Crimes Against Women/Domestic ViolenceAgainst Women/Domestic Violence

People who are incarcerated. People who are incarcerated.

People exposed to trauma. The rate of violent People exposed to trauma. The rate of violent victimization of AI/ANs is more than twice the victimization of AI/ANs is more than twice the national average. national average.

The higher rate of traumatic exposure results The higher rate of traumatic exposure results in a 22% rate of PTSD for AI/ANs, compared to in a 22% rate of PTSD for AI/ANs, compared to 8% in the general U.S. population. 8% in the general U.S. population.

The American Indian Vietnam Veterans Project The American Indian Vietnam Veterans Project found lifetime prevalence of PTSD to be 45 to found lifetime prevalence of PTSD to be 45 to 57% among AI veterans, rates significantly 57% among AI veterans, rates significantly higher than among other Vietnam veterans.higher than among other Vietnam veterans.

Source: Fact Sheet, Surgeon General’s Report; U.S. Department of Health and Human Services, Office of the Surgeon General, SAMHSA, 1999Source: Fact Sheet, Surgeon General’s Report; U.S. Department of Health and Human Services, Office of the Surgeon General, SAMHSA, 1999 Catawba Indians 1910Catawba Indians 1910

Criminal Justice and IncarcerationCriminal Justice and Incarceration THE FASTEST GROWING INDIAN RESERVATIONS?? THE FASTEST GROWING INDIAN RESERVATIONS??

Family StructureFamily StructureAmerican Indian families maintained by a single female American Indian families maintained by a single female increased between 1980 and 1990. However, the Native increased between 1980 and 1990. However, the Native AmericanAmerican increase ofincrease of 27 27 percent was considerably larger percent was considerably larger than the national figure of 17 percent. *than the national figure of 17 percent. *

High incidence of Indian households headed by women High incidence of Indian households headed by women (45%), 42% of whom were younger than 20 when they had (45%), 42% of whom were younger than 20 when they had their first child (LaFromboise, Choney, James, & Running their first child (LaFromboise, Choney, James, & Running Wolf, 1995). Wolf, 1995).

American Indian families were slightly larger than the average size American Indian families were slightly larger than the average size of all U.S. families (3.6 versus 3.2 persons per family) (U.S. Census of all U.S. families (3.6 versus 3.2 persons per family) (U.S. Census Bureau, 1993). *Bureau, 1993). *

…………....households in many American Indian communities households in many American Indian communities exhibit much higher dependency indices than other exhibit much higher dependency indices than other segments of the U.S. population and are more comparable segments of the U.S. population and are more comparable to impoverished Third World countries (Manson & Callaway, to impoverished Third World countries (Manson & Callaway, 1988). 1988).

Families continue to feel alienated from mainstream Families continue to feel alienated from mainstream educational purposes and institutions, which reduces their educational purposes and institutions, which reduces their involvement in their children's educations (Cummins, 1989). involvement in their children's educations (Cummins, 1989).

* MENTAL HEALTH: A REPORT OF THE SURGEON GENERAL 1999

"Even the seasons form a great circle in their changing, and always come back again to where they were. The life of a man is a circle from childhood to "Even the seasons form a great circle in their changing, and always come back again to where they were. The life of a man is a circle from childhood to childhood and so it is everything where power moves." childhood and so it is everything where power moves." --Black Elk (Hehaka sapa), OGLALA SIOUX --Black Elk (Hehaka sapa), OGLALA SIOUX

SPIRITUAL BELIEFSSPIRITUAL BELIEFS

Many Christian Native Americans, but Many Christian Native Americans, but with remnants of their own cultures with remnants of their own cultures infiltratedinfiltrated

Some Native Americans maintain Some Native Americans maintain spiritual practices from their ancestorsspiritual practices from their ancestors Smudging Smudging Sweat lodgesSweat lodges Feathers….Feathers…. Pow wows and blessing of the circlePow wows and blessing of the circle

WHAT IS HAPPENING TO OUR CHILDREN?WHAT IS HAPPENING TO OUR CHILDREN?

"We know that in all creation/Only the human family/Has "We know that in all creation/Only the human family/Has strayed from the Sacred Way." strayed from the Sacred Way." --OJIBWA Prayer--OJIBWA Prayer

•Multiple studies have shown the adverse effects of chronic exposure to violence on a child's ability to learn

• Many AI/AN youth live in communities that continue to experience long-term economic and social distress. High rates of alcoholism, drug abuse, domestic abuse, child neglect, substandard housing, and lack of job opportunities are common conditions in Indian communities.

INDIAN CHILD WELFARE ACTINDIAN CHILD WELFARE ACTAND WHAT DOES THAT HAVE TO DO WITH AND WHAT DOES THAT HAVE TO DO WITH

YOU?YOU?

MULTI-PURPOSE ACTMULTI-PURPOSE ACT US Government recognizes that a disproportionate US Government recognizes that a disproportionate

number of Native children have been removed from number of Native children have been removed from their homes and placed in white homestheir homes and placed in white homes

Protects children from losing their cultureProtects children from losing their culture Prevents breakup of Native American families while Prevents breakup of Native American families while

protecting children from protecting children from

“In any adoptive placement of an Indian child under State law, a preference shall be given, in the absence of good

cause to the contrary, to a placement with (1) a member of the child's extended family; (2) other members of the

Indian child's tribe; or (3) other Indian families.”

SC American Indian Birth DataSC American Indian Birth Data In 2004, there were 328 births to Native American mothers in SC. This represents less than 1% of total live births.

• There were 5 infant deaths from 1999-2004.

• The US infant mortality rate for 2002 was 8.6 deaths per 1,000 live births.

Data Source: SC DHEC Vital Records Terri WhirrettTerri Whirrett

Lt. Governor’s Office on AgingLt. Governor’s Office on AgingPresented at the Native American ConferencePresented at the Native American ConferenceNovember 18, 2005November 18, 2005

CURRENT SITUATION

Most current statistics from IHS demonstrate: SIDS death rate declines 58% in IHS areas.

Infant mortality rate in IHS areas 94-96 was 9.3 vs. US all races rate of 7.6 (22% higher)Aberdeen, Tucson, and Nashville areas exceeded US rate by over

50%

Indian Healthcare Reauthorization ActR. Mona RosenmanDIRECTOR STRATEGIC COMMUNICATIONS & POLICYCJ Foundation For SIDS

LACK OF STATISTICS IN SOUTH LACK OF STATISTICS IN SOUTH CAROLINACAROLINA

What What DODO we know? we know? According to SC Department of Education, in According to SC Department of Education, in

their 2004 “Quick Facts” publication, the drop their 2004 “Quick Facts” publication, the drop out rate for American Indian/Alaskan children out rate for American Indian/Alaskan children grades 9-12 was a staggering grades 9-12 was a staggering 6.36.3 – the HIGHEST – the HIGHEST in the State, followed by in the State, followed by 3.83.8 for African for African American children.American children.

Does lack of education help/hurt this population?Does lack of education help/hurt this population?

Older American Act (Aging Services) have been Older American Act (Aging Services) have been provided to only 31 Native Americans in the last provided to only 31 Native Americans in the last year!year!

MORE THAT WE MORE THAT WE DODO KNOW… KNOW…“Diabetes has risen to epidemic proportions in some populations, and many others are fighting the

battle against obesity and high blood pressure. Because native people generally earn less than the average American and tend to live in remote, rural locations, some may have limited access to

clinical preventive services, health education, and prevention efforts. All these factors act synergistically to place native people at very high risk for chronic diseases.” (NIH Study 1998.)

heraldonline.comBy Denyse C. Middleton · The Herald - Updated 08/21/06 - 12:40 AM

Catawba master potter Evelyn George, 92, polishes a piece of pottery with a smooth stone to prepare it for firing Thursday at the Catawba Senior Center on the reservation.

Andy Burriss · The Herald

“…But the elimination of federal grants for health care to the only federally recognized American Indian tribe in the state has resulted in transportation and medication problems at the reservation's health clinic. The clinic is operated by Indian Health Services and offers free health checks and generic medications to the elders, said tribal executive committee member Claude Ayers…..”

"Just about everyone down here on the reservation has heart trouble and diabetes," Plyler said. "We need someone to go out and check on the seniors at home. We need a home health service."

http://www.heraldonline.com/109/v-print/story/5925-a5924-t3.html

Interesting information…Interesting information…

STATISTICS (OR LACK OF) IN SOUTH STATISTICS (OR LACK OF) IN SOUTH CAROLINACAROLINA

According to the 2000 According to the 2000 Census, there were only Census, there were only 1,180 Native American 1,180 Native American Indians age 65+ in the Indians age 65+ in the entire state!entire state!

Terri WhirrettTerri WhirrettLt. Governor’s Office on AgingLt. Governor’s Office on AgingPresented at the Native American ConferencePresented at the Native American ConferenceNovember 18, 2005November 18, 2005

Census 2000Census 2000

““According to the 2000 census, the According to the 2000 census, the median age of 29 years for American median age of 29 years for American Indians and Alaska Natives was about 6 Indians and Alaska Natives was about 6 years younger than the national median of years younger than the national median of 35 years”.35 years”.

““Less than 10 per cent of all American Less than 10 per cent of all American Indian tribal groupings were 65 years of Indian tribal groupings were 65 years of age and older”age and older”

American Indian Leading Causes American Indian Leading Causes of Death for of Death for USUS

Cause of DeathCause of Death US US 20022002

NumberNumber

All CausesAll Causes 12,41512,415

1. Disease of Heart1. Disease of Heart 2,4672,467

2. Malignant Neoplasms (Cancer)2. Malignant Neoplasms (Cancer) 2,1752,175

3. Accidents3. Accidents 1,4881,488

4. Diabetes4. Diabetes 744744

5. Cerebrovascular Disease (Stroke)5. Cerebrovascular Disease (Stroke) 567567

6. Chronic Liver Disease and 6. Chronic Liver Disease and CirrhosisCirrhosis

547547

*Age adjusted to 2000 population

American Indian Leading Causes of Death American Indian Leading Causes of Death for SCfor SC

Cause of DeathCause of Death SC SC 1999-20041999-2004

NumberNumber

All CausesAll Causes 204204

1. Disease of Heart1. Disease of Heart 5555

2. Malignant Neoplasms (Cancer)2. Malignant Neoplasms (Cancer) 4141

3. Accidents3. Accidents 1212

4. Chronic Lower Respiratory Disease 4. Chronic Lower Respiratory Disease (Asthma, COPD, etc)(Asthma, COPD, etc)

1111

5. Cerebrovascular Disease (Stroke)5. Cerebrovascular Disease (Stroke) 1010

5. Diabetes5. Diabetes 1010

Data Source: SC DHEC Vital Records Rate not available for SCTerri WhirrettTerri WhirrettLt. Governor’s Office on AgingLt. Governor’s Office on AgingPresented at the Native American ConferencePresented at the Native American ConferenceNovember 18, 2005November 18, 2005

Aging PopulationAging PopulationPROGRAMS AND SERVICES AVAILABLE TO SENIORS IN PROGRAMS AND SERVICES AVAILABLE TO SENIORS IN

S.C.S.C.

Information, Assistance, and ReferralInformation, Assistance, and Referral Insurance Counseling Insurance Counseling Legal Assistance ServicesLegal Assistance Services Living Will Witness ProgramLiving Will Witness Program Long Term Care Ombudsman ProgramLong Term Care Ombudsman Program Adult Day ServicesAdult Day Services Group DiningGroup Dining Disease Prevention and Health PromotionDisease Prevention and Health Promotion Elder Abuse PreventionElder Abuse Prevention Employment ServicesEmployment Services Homebound SupportHomebound Support Home Care ServicesHome Care Services Home-Delivered MealsHome-Delivered Meals Respite and Caregiver helpRespite and Caregiver help


availability of limited state and federal resources; availability of limited state and federal resources; therefore, the percentage of persons served therefore, the percentage of persons served

declineddeclined

Figure III.7.2.5Source: US Census current population and National Aging Program Information System Federal ReportTerri WhirrettTerri WhirrettLt. Governor’s Office on AgingLt. Governor’s Office on AgingPresented at the Native American ConferencePresented at the Native American ConferenceNovember 18, 2005November 18, 2005

Native American Information Native American Information Across Agencies and Systems Across Agencies and Systems

for 2004for 2004 Service EntityService Entity Number of Native Americans Number of Native Americans HospitalHospital 2,551 2,551 InpatientInpatient 575 575 Outpatient 1, 351Outpatient 1, 351 MedicaidMedicaid InpatientInpatient 540 540 OutpatientOutpatient 416 416


""It is well to be good to women in the strength of our manhood because It is well to be good to women in the strength of our manhood because we must sit under their hands at both ends of our lives." we must sit under their hands at both ends of our lives." --He Dog, --He Dog, OGLALA LAKOTA OGLALA LAKOTA

Office of Research and Office of Research and Statistics, State Budget and Statistics, State Budget and

Control BoardControl Board

DemographicNumberDemographicNumberNative Indian/Alaska Native Indian/Alaska NativeNative

Age:Age: 60-64 390 60-64 390 64-69 360 64-69 360 70-74 190 70-74 190 75-84 180 75-84 180 85+ 60 85+ 60 Total 1,180Total 1,180 Median Income: Median Income: $30,568$30,568


“Indian Health Service figures for 1990 show average life expectancy at birth for Native Americans to be only 67 years, eight years less than 67 years, eight years less than

that of whites. that of whites. American Indians and Alaskan Natives are 10 times more likely to

develop diabetes than whites. In addition, alcohol abuse is a leading cause of health problems including accidents, cirrhosis of the liver,

suicide, and homicide. The other major health problems of older Native Americans are

tuberculosis, liver and kidney disease, high blood pressure, pneumonia, and malnutrition.

The majority of older Native Americans rarely see a physician, primarily because those needing medical assistance often live in isolated often live in isolated

areas and lack transportationareas and lack transportation. Native American traditions of ritual folk healing and the spiritual aspect of disease have also deterred

reliance on a strictly scientific medical community. These factors are often neglected or overlooked by health care professionals and

planners.

A Portrait of Older MinoritiesA Portrait of Older MinoritiesResearch ReportResearch Report

AARP Minority Affairs AARP Minority Affairs November 1995November 1995

A Portrait of Older MinoritiesA Portrait of Older MinoritiesResearch ReportResearch Report

AARP Minority Affairs AARP Minority Affairs November 1995November 1995

(CONTINUED)(CONTINUED)

““The status of the older minority The status of the older minority members is not likely to improve members is not likely to improve greatly in the immediate future. The greatly in the immediate future. The factors which largely determine their factors which largely determine their quality of life (education, employment, quality of life (education, employment, income, and health) will not vary much income, and health) will not vary much among the minority populations now among the minority populations now approaching retirement age. “approaching retirement age. “

Native American Information Native American Information Across Agencies and Systems Across Agencies and Systems

for 2004for 2004 Service EntityService Entity Number of Native AmericansNumber of Native Americans HospitalHospital 2,5512,551 InpatientInpatient 575 575 OutpatientOutpatient 1, 3511, 351 MedicaidMedicaid InpatientInpatient 540540 OutpatientOutpatient 416416


Native American and Native American and Alaskan Native alone or in Alaskan Native alone or in combination with one or combination with one or

more other racesmore other races Age:Age: 60+ 2,834 60+ 2,834 65+ 1,983 65+ 1,983 75+ 78375+ 783 Median Income: Median Income: $33,750$33,750Terri WhirrettTerri Whirrett

Lt. Governor’s Office on AgingLt. Governor’s Office on AgingPresented at the Native American ConferencePresented at the Native American ConferenceNovember 18, 2005November 18, 2005

AND MORE NUMBERS…….AND MORE NUMBERS…….

Service EntityService Entity Number of Native Am.Number of Native Am. DSSDSS TANFTANF 349 349 FoodstampsFoodstamps 2,4382,438 Foster CareFoster Care 15 15 Child Prot. Serv.Child Prot. Serv. 19 19 Dept. of Ed.Dept. of Ed. 2,869 2,869 DAODASDAODAS 127 127 DMH DMH 281 281

Total Undup.Total Undup. 8,113 8,113


SO WHAT’S UP WITH THESE SO WHAT’S UP WITH THESE NUMBERS???NUMBERS???

Native American population demographic Native American population demographic information is sketchy at best!information is sketchy at best!

Aging service providers need to find better Aging service providers need to find better ways to reach out to older Native ways to reach out to older Native Americans.Americans.

There is a need for Native Americans to There is a need for Native Americans to claim their heritage so that services can be claim their heritage so that services can be made available to them.made available to them.


Alternative Views within the Alternative Views within the Native American PopulationNative American Population

MedicinesMedicines Use ancient remedies and spiritual methodsUse ancient remedies and spiritual methods

DiseaseDisease DiabetesDiabetes Heart Disease/Cardiovascular DiseaseHeart Disease/Cardiovascular Disease CancerCancer Alcoholism/AddictionAlcoholism/Addiction

DNA Typing DNA Typing ““Proof” of Indianness pro’s and con’sProof” of Indianness pro’s and con’s

History, genealogyHistory, genealogy Understanding of cultureUnderstanding of culture

ReproductionReproduction Spiritual/Religious beliefs Spiritual/Religious beliefs

BARRIERS TO TREATMENT OFBARRIERS TO TREATMENT OFNATIVE AMERICANS IN S.C.NATIVE AMERICANS IN S.C.

Geographic isolationGeographic isolation Economic factorsEconomic factors Suspicion towards government Suspicion towards government

agenciesagencies Fear of reprisalFear of reprisal Serious cultural barriers; lack of Serious cultural barriers; lack of

understanding by care providersunderstanding by care providers Reliance on traditional healingReliance on traditional healing Lack of respect from care providers to Lack of respect from care providers to

Native American peopleNative American people Honor is extremely importantHonor is extremely important

How do we How do we REACH REACH this this population?population?

Children:Children: Seniors/Elders:Seniors/Elders: How will this affect their self-image?How will this affect their self-image? How will this affect their health?How will this affect their health? How does this affect their personal How does this affect their personal

beliefs?beliefs? What will they gain?What will they gain? What can they lose?What can they lose? How will it affect their spirituality?How will it affect their spirituality?

How do we do How do we do OUTREACH OUTREACH to this population?to this population?

Meet with Native American Leaders to “demystify” Meet with Native American Leaders to “demystify” community servicescommunity services

Do not practice “pan-Indianism”Do not practice “pan-Indianism” Go into communities to gain understanding of Go into communities to gain understanding of

culturescultures Develop an education component that is culturally Develop an education component that is culturally

sensitive to Native American historysensitive to Native American history Incorporate Native People and ask them to give Incorporate Native People and ask them to give

input into their needsinput into their needs What will they gain?What will they gain? What can they lose?What can they lose? How will it affect their spiritualityHow will it affect their spirituality

So WHAT DOES THIS ALL So WHAT DOES THIS ALL MEAN?MEAN? How many other racial/ethnic groups have to PROVE How many other racial/ethnic groups have to PROVE

their heritage to receive services?their heritage to receive services?

Disproportionate levels in many problem areasDisproportionate levels in many problem areas

Native people do not trust government agenciesNative people do not trust government agencies

NO special programs have been initiated to met the NO special programs have been initiated to met the needs of Native Americans. WHY?needs of Native Americans. WHY?

Cultural awareness is essential in order to provide Cultural awareness is essential in order to provide effective services to this populationeffective services to this population

This population is in desperate need of early This population is in desperate need of early interventionsinterventions

WHAT CAN YOU DO???WHAT CAN YOU DO???

Research on resiliency has shown the importance of individuals and organizations in providing protection Research on resiliency has shown the importance of individuals and organizations in providing protection and hope to young people, while helping them to "find the good path" and lead fulfilling lives (Benard, and hope to young people, while helping them to "find the good path" and lead fulfilling lives (Benard, 1997; Bergstrom, Cleary, & Peacock, 2002).1997; Bergstrom, Cleary, & Peacock, 2002).

HONORHONOR RESPECTRESPECT DIGNITYDIGNITY KINDNESS………………………………KINDNESS……………………………… COMPASSIONCOMPASSION EMPATHYEMPATHY

"If I destroy you, I destroy myself. If I honor you, I honor myself." "If I destroy you, I destroy myself. If I honor you, I honor myself." ----Hunbatz Men, MAYAN Hunbatz Men, MAYAN

HOW CAN YOU HELP?HOW CAN YOU HELP?WATCH WHAT YOU SAY!!!!!!!!!!!!!!!!!!WATCH WHAT YOU SAY!!!!!!!!!!!!!!!!!!

Do not demeanDo not demean Do not compareDo not compare Do not question why they haven’t done something Do not question why they haven’t done something

(i.e. education, work.)(i.e. education, work.) Don’t talk about Indians as though they belong to Don’t talk about Indians as though they belong to

the past. There are about 800,000 Native the past. There are about 800,000 Native Americans living in the United States on Americans living in the United States on reservations, in cities and in rural areas. - many in reservations, in cities and in rural areas. - many in conditions of poverty and powerlessness, but they conditions of poverty and powerlessness, but they are very much alive today. are very much alive today.

Don’t lump all Native Americans together. There Don’t lump all Native Americans together. There were no “Indians” before the Europeans came to were no “Indians” before the Europeans came to America--that is, no peoples called themselves, America--that is, no peoples called themselves, “Indians.” We were Tsalagi, or Dine, or “Indians.” We were Tsalagi, or Dine, or Lakota…….Lakota…….

DON’T ASSUME!!!!!!!!!!!!!!!!!!!! Ask questions DON’T ASSUME!!!!!!!!!!!!!!!!!!!! Ask questions with respect.with respect.

ResourcesResources

Indian Health Service Indian Health Service http://www.ihs.gov/nonmedicalprograms/research/irb.htmhttp://www.ihs.gov/nonmedicalprograms/research/irb.htm

Native American Cancer Research Native American Cancer Research http://natamcancer.org/page3.htmlhttp://natamcancer.org/page3.html

The Pew Forum on Religion & Public LifeThe Pew Forum on Religion & Public Life http://pewforum.org/news/display.php?NewsID=2913http://pewforum.org/news/display.php?NewsID=2913

U.S. Census BureauU.S. Census Bureau http://www.census.gov/population/www/pop-profile/amerindhttp://www.census.gov/population/www/pop-profile/amerind.html.html

http://www.ihs.gov/nonmedicalprograms/research/irb.htm

http://natamcancer.org/page3.html

http://pewforum.org/news/display.php?NewsID=2913

http://www.census.gov/population/www/pop-profile/amerind.html

http://www.census.gov/population/www/pop-profile/amerind.html

Documents

2006 SUMMER SCHOOL OF GERONTOLOGY The Invisible Population Native Americans in South Carolina August 23, 2006 Barbara MorningStar Paul Program Coordinator,