A Report on the Health and Cultural Status of Alaska Native Elders

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1 A Report on the Health and Cultural Status of Alaska Native Elders Rosellen M. Rosich, Ph.D. Director Summer Institute

2 Specific Aims of Presentation Enhance and strengthen medical students understanding regarding Alaska Native Elders Health Status Disseminate and discuss newly acquired qualitative data about the cultural values, preferences and customary practices of Alaska Native Elders Summer Institute

3 How Big is Alaska? Summer Institute

4 Alaska Geriatric Education Center (AKGEC) Advance access to quality health care for all older Alaskans by promoting multicultural, interdisciplinary and discipline specific geriatric education for current and aspiring health care professionals, health care providers and health professions faculty. A special focus is placed upon development of geriatric training materials that incorporate best promising and emerging practices that maintain the social, cultural and biological well being of Alaskan residents. Summer Institute

5 National Resource Center for American Indians Alaska Natives and Native Hawaiian Elders Incorporate Native communities and voices of Elders regarding traditional community heritages, tribal values, and customs into health care services Promotes culturally sensitive and functionally appropriate services to maintain the social well being of Alaska Natives Summer Institute

6 Alaska Native People Summer Institute

7 Alaska Native Elder Demographics Alaska Natives and American Indians have higher proportion of younger age groups and lower proportion of senior citizens Life expectancy increased from 64.4 years in 1980 to 68.8 in 1990 and 69.5 by 1997 From 1990 to 1999 however Alaska Natives who were increased 30.1% increased 42.4% increased 21.7% 85+ increased 43.1% Similar to National statistics, fastest growing cohort is Alaska Elders 85+ Summer Institute

8 Health Status Death Rates Proportion of death rates for seniors higher among AK Natives and AI than other national population groups AK Native Elders have far lower death rates than their non native counter parts in Alaska AK Native Elder males higher than AK Native females but still lower over time ( ) than their white counterparts for both genders. Death rates for younger Alaska Native cohorts are far higher than non native Alaskans and for AK Native Elders (cause unintentional injuries) Summer Institute

9 Leading Causes of Death Malignant Neoplasms (cancer) Disease of the Heart (high cholestorol, narrowing of the arteries, related to heart attack) Chronic Lower Respiratory Disease (pneumonia, exposure to toxins, 0 Unintentional Injuries (falls, accidents, car wreaks, Cerebrovascular Disease (Stroke) Diabetes (special case, obseity type II) Summer Institute

10 Perceived Health Status In comparison to national data a higher proportion of AK Native Elders perceive their health status as Fair or poor 45.5 AK Natives compared to 26.7 for US Good 38.2% vs. 35.0% Excellent/very good were 1.3% to 38.1% Summer Institute

11 Chronic Diseases High Blood Pressure (43% AK Native vs 54% Nationally) Arthritis (40% vs 52%) Cataracts (27 % vs 29%) Diabetes (14% vs 15%) Congestive H. F. (8% vs 13%) Stroke (8% vs 10%) Summer Institute

12 Alaska Native Cultural Values Alaska native elders are primarily concerned about the welfare of the entire group not themselves Elders welcome the privilege of teaching cultural knowledge to the youth, family, community and tribe Elders have acquired cultural knowledge and maintain their ancestral worldview They act as a source of wisdom for future generations There has been a cultural holocaust related to colonialism that has impacted the elder s ability to acquire and transmit knowledge Summer Institute

13 Historical Trauma The cultural holocaust has impacted the elder s ability to acquire and transmit cultural knowledge Due to the boarding school and missionary era, there have been disruptions in parenting, acquisition of language, and dissemination of cultural knowledge Elders are concerned about the loss of interest they observe in the youth with regards to learning the traditional ways Many rural communities are beginning to initiative healing programs that have engaged elders in teaching traditions to the adults and youth Summer Institute

14 Health Services Elders want services that are reflective of their cultural values In the past, care for the elderly was the responsibility of the entire community and their family Elders want to live with their family members or independently The process of removing elders from their villages had had negative consequences on the elders, families and the community Native food is essential for the elder s health and well being Elders want health care workers who understand their culture, language and customs Summer Institute

15 Summary Demographics & Health Status Population of AK Native Elders is growing There are fewer differences in the death rates between elderly Alaska Natives and Whites than in younger age groups AK Native Elders have higher death rates from unintentional injury and chronic lower respirator disease Diabetes has doubled in 15 years among AK Natives and is expected to become more problematic Self perceived health status is lower among AK Native Elders in comparison to the US general population Summer Institute

16 Summary Cultural Values & Beliefs Wellness of the community, families and Elders will be enhanced through utilization of the contributions and worldview of the Elders Need to clearly delineate between Elder and elderly Elders are living longer lives but not necessarily healthier lives/ increased the need for senior services When Elders disengage from their role and function in their communities, there can be a negative impact on the elders, communities, and families. Summer Institute

17 Summary Cultural Values & Beliefs (continued) Elders living in institutions may experience increased levels of mental, social, and physical wellness if they maintain their traditional role and activities. Health care workers need to become aware and sensitive to non verbal communication patterns, English as a second language, and silence. Tribal, community and family healing will be enhanced when Elders are returned to a position of respect and authority. Summer Institute

18 Resources University of Alaska Anchorage NRC Report Health Status of Alaska Native Elders (Jan, 2005) NRC Qualitative Report Conferences of Alaska Native Elders: Our View of Dignified Aging (Jan, 2005) Institute of Social and Economic Research Executive Summary Status of Alaska Natives 2004 Summer Institute

19 Web Sites Alaska Geriatric Education Center (AGKEC) Alaska Native Language Center, Language map. University of Alaska, Fairbanks National Resource Center for America Indian Alaska Native and Native Hawaiian Elders elders.uaa.alaska Institute for Social and Economic Research Institute for Circumpolar Health Summer Institute

Adolescent Mortality. Alaska s adolescent mortality rate is 29% higher than the national rate and almost 1.6 times the Healthy People 2010 target.

Adolescent Mortality. Alaska s adolescent mortality rate is 29% higher than the national rate and almost 1.6 times the Healthy People 2010 target. Alaska Maternal and Child Health Data Book 23 15 Adolescent Mortality Nationally, unintentional injury, assault and suicide account for 51% of deaths among adolescents ages 1-14 years in 2. Over the last