1. The Health Status of American Indians/Native Americans in Massachusetts Massachusetts Department of Public Health Center for Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology

2. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation National American Indian Heritage Month During National American Indian Heritage Month, we honor the generations of American Indians and Alaska Natives who have added to the character of our Nation. This month is an opportunity to celebrate their many accomplishments and their rich ancestry and traditions. George W. Bush, 2006

3. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Native American Collaborators Mashpee Wampanoag Tribe Aquinnah Wampanoag Tribe North American Indian Center of Boston

4. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Indian Health Service Areas

5. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Making History One of the first comprehensive reports on Native American health by a state

6. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Making History in Massachusetts First health report on American Indians First statewide report to collaborate with Native Americans First report to integrate information from federal, state and tribal data collections First report to use Indian-driven data

7. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation American Indian Population by County Massachusetts: Census 2000 Source: U.S. Census 2000

8. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Outline of Today’s Presentation 1.Socio-demographics 2.Survey Results -Behavioral Risk Factor Surveillance System -Mashpee Wampanoag Community Health Survey -NAICOB Community Health Survey -Youth Risk Behavior Survey 3.Health Outcomes -Births -Deaths 4.Summary

9. Socio-Demographics

10. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Race According to Census 2000 United States Massachusetts Source: Census 2000 White Black Asian Other American Indian Two+

11. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation American Indians in Race Combinations Census 2000 United StatesMassachusetts Source: U.S. Census 2000

12. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Different Counts of the American Indian/Alaska Native Population in Massachusetts: 2000 19,390 38,050 20,760 15,015 Census 2000 MDPH 2000 MARS 2000 Census 2000

13. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Age Distribution of American Indians in Massachusetts: Census 2000 American Indian Massachusetts Overall 65+ Source: U.S. Census 2000 45-64 25-44 0-24

14. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation American Indian and Alaska Native Tribes Massachusetts: Census 2000 Tribe (Self-Identified)Number Tallied Percent of MA AIAN Population (Alone or in Combination) Cherokee4,03710.6% Canadian and Latin American2,7167.1% Wampanoag Aquinnah Wampanoag* Mashpee Wampanoag 2,546 303 178 6.7% Micmac1,5544.1% Blackfeet1,5214.0% Iroquois1,4643.8% Nipmuc 7101.9% Abenaki Nation of Missiquoi 6961.8% Other Tribes20,68954.4% Tribe Not Specified & Not Elsewhere Classified 2,1175.6% * Only federally recognized American Indian Tribe in Massachusetts Source: U.S. Census 2000

15. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation American Indian Population by City/Town Massachusetts: 2000 Source: U.S. Census 2000 > 1% MA population <= 1% MA population

16. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Cities with the Largest American Indian Populations Massachusetts: Census 2000 City / TownAmerican Indian (Alone) City / Town American Indian (Alone, or in Combination) Boston2,365Boston5,384 Worcester769Worcester1,700 Lawrence583Springfield1,473 New Bedford579New Bedford1,288 Springfield569Lawrence921 Mashpee377Brockton876 Brockton338Cambridge853 Lynn332Lynn796 Cambridge290Lowell676 Barnstable283Fall River587 Source: U.S. Census 2000

17. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation American Indian Population Massachusetts: Census 2000 City / TownAmerican Indian (Alone) City / Town American Indian (Alone, or in Combination) Mashpee377Mashpee502 Aquinnah126Aquinnah148 Source: U.S. Census 2000

18. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Economic Indicators: 1999 Source: U.S. Census 2000

19. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Socio-Demographic Indicators: 2000 Source: U.S. Census 2000

20. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Less Than High School Education Massachusetts: 2000 Source: U.S. Census 2000, SF-4

21. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Census 2000 Adjusted Count Massachusetts: 2000 Source: U.S. Census 2000

22. Survey Results

23. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Health Status Findings Behavioral Risk Factor Surveillance Survey Massachusetts: 2001-2005 Source: Behavioral Risk Factor Surveillance System (BRFSS) 2001-2005

24. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Access to Health Behavioral Risk Factor Surveillance Survey Massachusetts: 2001-2005 Source: Behavioral Risk Factor Surveillance System (BRFSS) 2001-2005

25. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Health Status Indicators North American Indian Center of Boston Community Health Survey: 2002 Source: North American Indian Center of Boston Community Health Survey, 2002.

26. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Health Status Indicators Mashpee Wampanoag Community Health Survey Massachusetts: 2002 Source: Wampanoag Community Health Survey, 2002.

27. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation The Health Status of High School Students Youth Risk Behavior Survey: 1993-2003 Source: Department of Education, YRBS: 1993-2003

28. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Source: Department of Education, YRBS: 1993-2003 The Health Status of High School Students Youth Risk Behavior Survey: 1993-2003

29. Health Outcomes

30. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Source: Massachusetts Births 1999-2004 Birth Indicators Massachusetts: 1999-2004

31. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Birth Indicators Massachusetts: 1999-2004 Source: Massachusetts Births 1999-2004

32. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Leading Causes of Death (NCHS Ranking) Massachusetts: 1994-2004 Massachusetts (N=611,825) 1.Heart Disease (28%) 2.Cancer (25%) 3.Stroke (6%) 4.CLRD 1 (5%) 5.Injuries & Poisonings (4%) American Indians (N=443) 1.Cancer (23%) 2.Heart Disease (22%) 3.Injuries & Poisonings (9%) 4.Stroke (5%) 5.Pneumonia & Influenza (4%) 1 Chronic Lower Respiratory Disease Source: Massachusetts Department of Public Health, Massachusetts Deaths 1994-2004

33. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Underestimation in Mortality Rates for American Indians Because it is more likely for race to be reported as Native American in the Census than it is in the death certificates, this results in a net underestimation of mortality The number of deaths (numerator) and the population count (denominator) are inconsistent. Race is self-reported on the Census; whereas, on death certificates, race may be reported by the family, the certifying physician, the funeral director, or other informant. More than one race can be reported on the Census, whereas, currently, only single races are allowed on the death certificate The American Indian population count (denominator) in mortality rates may be inaccurate because of the large number of mixed-race persons who are, in part, Native American.

34. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation All Cause Mortality Age-Adjusted Death Rates: 1994-2004 Age-adjusted to the 2000 US standard population. Source: Massachusetts Department of Public Health, Death certificates. Adjusted Estimate Underestimate

35. Summary

36. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation The Health Status of American Indians/Native Americans in Massachusetts Makes history in Massachusetts public health A baseline by which we can track improvements in American Indian health A much needed resource for American Indian groups to assess the health needs of their communities Highlights the need for better methods of collection of race and ethnicity data Starting point for research into the health of American Indians and the development of programs targeted to this population Summary

37. Prepared by the Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation How Can You Access this Report? Hard Copies: (617) 624-5640 (617) 624-5639 TDD/TTY: (617) 624-6001 DPH Website: http://www.mass.gov/dph/pubstats.htm

38. Thank You