1. NATIVE ELDER CAREGIVER CURRICULUM NECC Caring for Our Elders: Health Disparities Among Native Elders 2.2 Caring for our Elders: Health Disparities Among Native Elders 2.2 1

2. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 2  Average Life expectancy for American Indians  varies by geographic location  low average age of 64.3 years in Aberdeen Area  high average age of 76.3 years in California  Average life expectancy age in general population is 76.9 years* * cited in McDonald, Ludtke, & Allery (July 10, 2002) Testimony to Senate Committee on Indian Affairs

3. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 3  “Health Disparity” Definition:  “gaps in the quality of health & health care across racial, ethnic, and socioeconomic groups”*  * cited in Wikipedia from the U.S. Department of Health & Human Services, Healthy People 2010: National Health Promotion & Disease Prevention Objectives, conference ed. (Washington, D.C., January 2000)

4. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 4  Two Ways to think about the term “health disparities”  1.Disease rates are high  Can think that “more Indian people do get sick” … OR  2.Health risk factors can be controlled  Can think that “it is possible to reduce risk for disease” by reducing risk factors

5. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 5  Disparities in Chronic Diseases among Native Elders  Native elders are more likely to experience certain health conditions compared to the general population:

6. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 6  Examples* of Disparities in Chronic Diseases among Native Elders as compared to general population  Arthritis 19.5 % more likely  CHF48.7 % more likely  Hypertension 17.7 % more likely

7. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 7  Examples* of Health Disparities (Continued)  Stroke: 17.5 % more likely  Asthma: 4.3 % more likely  Diabetes: 173.0 % more likely  *Cited in McDonald, Ludtke, & Allery (July 10, 2002) Testimony to Senate Committee on Indian Affairs

8. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 8  Rates of some diseases appear “lower” in different regional areas  However… this may mean that people who have certain health conditions do not survive the condition, and are not “counted” in the rates  This may mean that people have lower survival rates of these diseases than the general population, not that the prevalence is lower

9. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 9  Other disparities occur also…  The following is just one example that really demonstrates the seriousness of the situation: From 1994-1996, I.H.S. estimated that the death rate from pneumonia & flu for American Indian people was 71 % higher than the entire general U.S. population* * Office of the General Counsel, U.S. Commission on Civil Rights, (February, 2004)

10. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 10  A number of causes for Health Disparities*  Discrimination related to generations of injustices  Limited access to appropriate health facilities  Poor access to health insurance programs  Insufficient federal funding  Quality of care issues  Disproportionate poverty  Poor education * Office of the General Counsel, U.S. Commission on Civil Rights (2004)

11. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 11  Social Determinants of Health*: contribute to Health Disparities among Native Elders  Socioeconomic status  transportation issues  Housing issues  Access to services  Discrimination  Social or environmental stressors *CDC Social Determinants of Health Working Group www.cdc.gov/sdohwww.cdc.gov/sdoh

12. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 12  The Causes of Health Disparities are real  But… going back to the earlier slide above…  TWO WAYS TO THINK ABOUT DISPARITIES  1.“People are just going to get sick more often if they are Native American…”(fatalistic perspective) OR  2.“ It is possible to reduce risk for diseases among Native American elders…”(health promotion perspective)

13. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 13  Communities, Elders & Caregivers have definite challenges in providing care for their elders! BUT…  Communities, Elders & Caregivers can decide which perspective to take in the care of their elders!

14. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 14  Community People can make a big difference working together !

15. Health Disparities: Native Elders HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 15  Communities can create healthier communities

16. HEALTH DISPARITIES AMONG NATIVE ELDERS Session 2.2 16 *