Urban American Indian and Alaska Native Health Indicator Graphs September 2010 Urban Indian Health Institute Seattle Indian Health Board

Introduction This PowerPoint includes graphs from select Urban Indian Health Institute (UIHI) reports. These are intended to be used by urban Indian health organizations (UIHO) and other partners in grants or presentations of health status and disparities. More detailed information on data sources, study populations and limitations may be obtained by accessing individual reports online at: Seattle Indian Health Board’s Urban Indian Health Institute

Outline of included UIHI reports Community Health Profile (2009) Health and Health-Influencing Behaviors among Urban AI/AN (2008) Urban American Indian and Alaska Native Youth (2009) Reproductive Health of Urban American Indian and Alaska Native Women (2010) Visibility Through Data (2009) Seattle Indian Health Board’s Urban Indian Health Institute

Community Health Profile: Urban Indian Health Organizations (UIHO) Aggregate Urban Counties (2009) Seattle Indian Health Board’s Urban Indian Health Institute Enclosed Figures: Percentage of U.S. AI/AN Population Living in Urban Areas Highest Educational Attainment, 25 and Older Poverty Status AI/AN Top Cause Mortality, AI/AN Cancer Mortality, Select Mortality Disparities, Self-Reported Health Status, Current Smoker, Obesity (BMI≥30) REPORT:

Community Health Profile: Urban Indian Health Organizations (UIHO) Aggregate Urban Counties (2009) Seattle Indian Health Board’s Urban Indian Health Institute REPORT: Enclosed Figures (Cont.): y, Diagnosed with Diabetes, Could Not See a Doctor Because Of Cost, No Health Insurance, Smoking During Pregnancy, Births to Teen Mothers, Late or No Prenatal Care, All Cause Infant Mortality, Infant Mortality due to SIDS,

Data Sources Data include AI/AN living in counties served by the 34 UIHO compared to all races in the same counties Census Data –AI/AN includes people reporting AI/AN alone and AI/AN in combination with another race. Vital Records –Collection methods for prenatal care and maternal smoking on birth certificates have recently changed. Data is presented pre-birth certificate change ( ). –To protect confidentiality, select indicators (e.g., SIDS) are presented with more years ( ) so reporting on these indicators is possible. Behavioral Risk Factor Surveillance System (BRFSS) –AI/AN includes individuals who selected AI/AN when asked, “Which one of these groups would you say best represents your race?”. Seattle Indian Health Board’s Urban Indian Health Institute

Percentage of U.S. AI/AN Population Living in Urban Areas U.S. Census, Urban Areas, United States, 2000 Seattle Indian Health Board’s Urban Indian Health Institute

Highest Educational Attainment, Age 25 and older U.S. Census, UIHO Service Areas, United States, 2000

Seattle Indian Health Board’s Urban Indian Health Institute Poverty Status U.S. Census, UIHO Service Areas, United States, 2000

Seattle Indian Health Board’s Urban Indian Health Institute Could Not See Doctor Because of Cost BRFSS, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute No Health Insurance in Past 12 Months, BRFSS, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute AI/AN Top Cause Mortality U.S. Centers for Health Statistics, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute AI/AN Cancer Mortality U.S. Centers for Health Statistics, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Select Mortality Disparities U.S. Centers for Health Statistics, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Self-Reported Health Status BRFSS, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Current Smoker BRFSS, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Obesity (BMI ≥ 30) BRFSS, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Diagnosed with Diabetes BRFSS, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Smoking During Pregnancy U.S. Centers for Health Statistics, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Births to Teen Mothers U.S. Centers for Health Statistics, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Late or No Prenatal Care US Centers for Health Statistics, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute All Cause Infant Mortality US Centers for Health Statistics, UIHO Service Areas, United States,

Seattle Indian Health Board’s Urban Indian Health Institute Infant Mortality due to SIDS US Centers for Health Statistics, UIHO Service Areas, United States,

Reported Health and Health-influencing Behaviors Among Urban American Indians and Alaska Natives: An analysis of Data Collected by the Behavioral Risk Factor Surveillance System (2008) Seattle Indian Health Board’s Urban Indian Health Institute Enclosed Figures: Any Alcohol in the Last 30 Days Binge Drinking Among Those Who Drink Alcohol No Leisure-time Physical Activity in Past 30 Days One or More Days of Poor Mental Health in Past 30 Days One or More Days of Poor Physical Health in Past 30 Days REPORT:

Reported Health and Health-influencing Behaviors Among Urban American Indians and Alaska Natives: An analysis of Data Collected by the Behavioral Risk Factor Surveillance System (2008) Seattle Indian Health Board’s Urban Indian Health Institute REPORT: Enclosed Figures (cont): Eat Five Fruits/Vegetables in a Day Visit to Dentist for Any Reason in Past Year Dental Cleaning in Past Year Ever Told By a Doctor that You Have High Blood Pressure Ever Test for HIV (Excludes Blood Donation)

Data Source: Behavioral Risk Factor Surveillance System (BRFSS) National phone-based survey administered annually This analysis includes BRFSS years ,273 urban AI/AN; 245,960 urban non-AI/AN Each year, AI/AN were 1.4%-1.6% of the total sample. Women made up approximately 60% of the sample among both groups (AI/AN and non-AI/AN). AI/AN respondents were younger as a group than other respondents (mean age 46 years vs. 52 years). Lines show the 95% confidence intervals; all graphs show statistically significant disparities between groups. Seattle Indian Health Board’s Urban Indian Health Institute

Any Alcohol in the Past 30 Days BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Binge Drinking Among Those Who Drink Alcohol BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

No Leisure-Time Physical Activity in Past 30 Days BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

One or More Days of Poor Mental Health in Past 30 Days BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

One or More Days of Poor Physical Health in Past 30 Days BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Eat Five Fruits/Vegetables Each Day BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Visit to Dentist for Any Reason in Past Year BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Dental Cleaning in Past Year BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Ever Tested for HIV (Excludes Blood Donation) BRFSS, UIHO Service Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Urban American Indian and Alaska Native Youth: An Analysis of Select National Data Sources (2009) Seattle Indian Health Board’s Urban Indian Health Institute Enclosed Figures: Leading Causes of Death among AI/AN Youth Aged ( ) Safety and Violence at School ( ) Reports of Suicidal Behavior ( ) Reports of Lifetime Illegal Drug Use ( ) Reports of Sexual Behavior ( ) REPORT:

Data Source: Youth Risk Behavior Survey (YRBS) Surveys completed by students in public and private schools Data from four survey years were added together and averaged: 1997, 1999, 2001 and 2003 Urban is inside a Census-defined Metropolitan Statistical Area 59,839 students total in all four survey years 513 urban AI/AN; 19,189 urban whites Mixed race AI/AN and whites are not included in data Participant demographic profiles are not statistically significantly different. All data presented are statistically significant disparities. Seattle Indian Health Board’s Urban Indian Health Institute

Safety and Violence at School Youth Risk Behavior Survey, Urban Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Reports of Suicidal Behavior Youth Risk Behavior Survey, Urban Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Reports of Lifetime Illegal Drug Use Youth Risk Behavior Survey, Urban Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Reports of Sexual Behavior Youth Risk Behavior Survey, Urban Areas, United States, Seattle Indian Health Board’s Urban Indian Health Institute

Reproductive Health of Urban American Indian and Alaska Native Women: Examining Unintended Pregnancy, Contraception, Sexual History and Behavior, and Non-Voluntary Sexual Intercourse (2010) Seattle Indian Health Board’s Urban Indian Health Institute Enclosed Figures: Current Contraceptive Status Contraception: Current Use Depo-Provera Use by Age Contraceptive Use at First Sex Using Any Contraception: yrs Non-Voluntary First Sex Unintended Pregnancy REPORT:

Seattle Indian Health Board’s Urban Indian Health Institute Data Source: National Survey of Family Growth (NSFG) Represents U.S. household population, years old In-person interviews and self-completed surveys are used Data are from 2002; NSFG survey cycle 6 Urban is inside a Census-defined Metropolitan Statistical Area 7,643 total females included in urban AI/AN; 3,173 non-Hispanic whites (NH-white) AI/AN reported AI/AN only or AI/AN as the race that best describes them Lines are 95% confidence intervals. Non-overlapping lines are statistically significant disparities between groups.

Current Contraceptive Status: AI/AN NSFG, Urban Areas, United States, 2002 Seattle Indian Health Board’s Urban Indian Health Institute

Contraception: Current Use Most Common Methods NSFG, Urban Areas, United States, 2002

Seattle Indian Health Board’s Urban Indian Health Institute Depo-Provera Use By Age Groups NSFG, Urban Areas, United States, 2002

Use of Any Method of Contraception at first sexual intercourse NSFG, Urban Areas, United States, 2002 Seattle Indian Health Board’s Urban Indian Health Institute

Current Use of Any Contraception years NSFG, Urban Areas, United States, 2002 Seattle Indian Health Board’s Urban Indian Health Institute

Non-Voluntary First Sex NSFG, Urban Areas, United States, 2002

Unintended Pregnancy NSFG, Urban Areas, United States, 2002 Seattle Indian Health Board’s Urban Indian Health Institute

Urban Indian Health Institute Seattle Indian Health Board P.O. Box 3364 Seattle, WA Phone: (206) Fax: (206) Website: