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Urban American Indian and Alaska Native Youth: Youth Risk Behavior Survey 1997-2003

Urban American Indian and Alaska Native Youth: Youth Risk Behavior Survey 1997-2003. Presenter: Shira P. Rutman, MPH (shirar@uihi.org). Urban Indian Health Institute Mission Statement.

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Urban American Indian and Alaska Native Youth: Youth Risk Behavior Survey 1997-2003

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  1. Urban American Indian and Alaska Native Youth: Youth Risk Behavior Survey 1997-2003 Presenter: Shira P. Rutman, MPH (shirar@uihi.org)

  2. Urban Indian Health Institute Mission Statement To provide centralized nationwide management of health surveillance, research, and policy considerations regarding the health status deficiencies affecting urban American Indians and Alaska Natives.

  3. Urban American Indian/Alaska Native Population • 2.5 million persons reporting AI/AN single-race • 61% (1.5 million) reside in urban areas Source: U.S. Census Bureau, 2000

  4. Background & Significance • Approx. 20 million youth ages 15-19 in the U.S.1 • Approx. 225,000 (1%) report AI/AN single-race1 • AI youth at highest risk for most adverse health outcome indicators 2 • AI youth from non-urban schools report high rates of risk factors related to: • unintentional injury, substance use, poor self-assessed health, emotional distress and suicide3 (1) U.S. Census Bureau, 2000 (2) 2006 Harris KM, Gordon-Larsen P, Chantala K, Udry JR (3) 1992 Blum RW, Harmon B, Harris L, Bergeisen L, Resnick MD

  5. Study Objectives • To describe the prevalence of health risk behaviors in urban AI/AN youth by examining Youth Risk Behavior Survey (YRBS) data • To identify disparities in health risk behaviors between AI/AN and white youth living in urban settings

  6. Methods: YRBS • Self-report questionnaire conducted biennially by CDC • Nationally representative sample of public high school students grades 9-12 • YRBS behaviors categorized into 6 risk areas: 1) Unintentional injury & violence 2) Tobacco use 3) Alcohol and drug use 4) Unintended pregnancy & sexually transmitted infections 5) Physical inactivity 6) Dietary behavior –plus weight status

  7. Methods: Data Analysis • Data aggregated and averaged for: 1997, 1999, 2001, and 2003 • Weighting factor used to adjust for sampling design (See CDC website for details) • Weighted estimates and percentages are presented • “Urban” defined as inside a MSA* • All findings presented are statistically significant (95% confidence intervals used) *Census defined Metropolitan Statistical Area

  8. Study Results

  9. YRBS Results: Participant Characteristics • A total of 59,839 students completed the national YRBS from 1997-2003 • 609 (1%) reported AI/AN race and 23,882 reported white race (40%) • 84% of AI/AN (N=513) and 80% of whites (N=19,189) were defined as urban • Demographic profiles of participants were similar between the AI/AN and white student populations overall and among urban groups

  10. YRBS Results: Safety & Violence More than 3-fold higher in AI/AN More than 2-fold higher in AI/AN * During the past 12 months † One or more of the past 30 days

  11. YRBS Results: Reports of Suicidal Behavior More than 3-fold higher in AI/AN Nearly 5-fold higher in AI/AN

  12. YRBS Results: Tobacco & Alcohol Use The prevalence of two behaviors related to tobacco and alcohol use were higher among AI/AN compared to white youth: • Smoking a cigarette/drinking alcohol for the first time before age 13 • Smoking cigarettes/drinking alcohol on school property during the last 30 days

  13. YRBS Results: Reports of Lifetime Illegal Drug Use More than 2-fold higher in AI/AN *Methamphetamines

  14. YRBS Results: Reports of Sexual Behavior Nearly 3-fold higher in AI/AN † Past 3 months; ‡During their life

  15. YRBS Results: Physical Inactivity & Dietary Behaviors • AI/AN youth were more likely than white youth to watch three or more hours of television on an average school day (45.1% and 31.7%, respectively) • AI/AN youth showed a higher percent of overweight students (based on BMI) compared to white youth (18.9% and 10.0%, respectively) • AI/AN youth less likely to have had green salad in the past week compared to white youth (60.2% and 70.1%, respectively)

  16. Conclusions • Urban AI/AN students significantly more likely than urban white students to engage in behaviors resulting in: • unintentional injuries and violence, drug use, and risky sexual behavior • Interventions such as education and services may reduce health problems later in life • Further research critical to understand reasons for disparities and for designing appropriate responses

  17. Urban Indian Health Organizations (UIHO) • 34 UIHO in 19 states serving 94 counties • Private, not for profit • Funding from Title V of Indian Health Care Improvement Act • 1/3 are Federally Qualified Health Centers • Sliding scale payment systems • Additional funding sources • Serve approximately 159,000 clients • Vary in size and service options

  18. IHS Funding Appropriations Urban Indian Health Organizations 1% Tribally-run Health Services 53% Indian Health Service Facilities 46% Total Budget = 2.6 billion Source: DHHS Budget, 2001

  19. Contact Information Urban Indian Health Institute Seattle Indian Health BoardP.O. Box 3364Seattle, WA 98114Phone: (206) 812-3030Fax: (206) 812-3044 Email: info@uihi.org Website: www.uihi.org

  20. Thank You

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