Transcript Native Americans

Native Americans
Chapter 5
Native Americans
Largest number of ethnic groups
 American Indian
 Alaska Natives
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◦ American Indians
◦ Inuits (Eskimos)
◦ Aleuts (Alaska Natives)
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Most live west of the Mississippi River
History of Native Americans
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Came to North America across the
Bering Strait
No written records
Europeans introduced horses, firearms,
metal knives, diseases, massacres of
whole nations
By late 19th century most lived on
reservations
Bureau of India Affairs (BIA) took over
reservations in late 20th century
Have not fully assimilated
Current Demographics
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States with largest numbers
◦ California
◦ Oklahoma
◦ Arizona
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Largest ethnic groups in Alaska,
Montana, North Dakota, Oklahoma,
and South Dakota
◦ Alaska Natives
◦ NativeAmericans/American Indians
Native American Nations in
the United States.
Socioeconomic Status
Declined with forced migrations of the 19th
century
 Indian Self-Determination / Education Act of
1975
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◦ Promote Native American participation in
government and education
Unemployment lower than for total population
Median earnings 25% less than average
Overall poverty rate double the general
population
 24% have not finished high school or
equivalent
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Native American Organizations
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Have done much to maintain Indian
identity
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Clubs
Service Organizations
Organizations to promote ethnic identity
Athletic clubs
Dance groups
Numerous traditional celebrations
across the nation each year
Worldview
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Harmony
Strive to maintain balance
◦ Spiritual
◦ Social
◦ Physical
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Earth cared for and respected
Generosity valued, competitiveness
discouraged
Individual right highly regarded
Time without beginning or end
Present-oriented
Native American Religion
Permeates all aspects of life
 Holistic worldview
 Physical and emotional well-being
 Religion varies
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Traditional
Catholic
Mixed
Protestantism
Russian Eastern Orthodox in Alaska
Family
Extended family
 Children highly valued
 Great respect for
elders
 Blood kin of all
generation are equal
 Men are providers
 Women in charge of
domestic matters
 Men and women are
equal
 Children assist parents
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Traditional Health Beliefs and
Practices
Reflects relationship to nature
 Imbalance with supernatural, spiritual,
or social
 Treatment is holistic in approach
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◦ Focuses on restoring harmony
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Concerned with physical, mental, and
spiritual renewal
◦ Health maintenance
◦ Prevention of illness
◦ Restoration of health
Traditional Health Beliefs and
Practices
Causes of illness
 Witchcraft
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 Through agents such
as
 Animals
 Lightning
 Whirlwinds
 Improperly performed
ceremonies
 Evil spirits
 Intrusive objects
◦ Causes of illness
◦ Possession
◦ Soul loss
 Alcoholism
◦ Violation of a taboo
◦ Unfulfilled dreams or
desires
◦ Domination by white
society
Traditional Health Beliefs and
Practices
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May reject modern concepts
◦ Virus, bacteria, infection, etc.
◦ Will have their own thoughts as to why
someone is not well
Utilize herbals, medicine bundles,
fetishes, feathers, or symbols for
protection
 Will seek home remedy first
 May seek traditional healers
 Often utilize concurrent with
Westernized care
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Causes of Illness
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Utilize healers, medicine men & women
Prevention through sweat baths
Diagnose through
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Stargazing or listening
Hand trembling
Painting
Singers
Chanters
Dreamers
May diagnose or treat
Traditional Food Habits
Influenced by geography/climate
 Maximized indigenous resources
 Agriculture or hunter/gatherer/fishing
 Staples for almost all
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◦ The 3 Sisters
 Corn
 Squash
 Beans
Food introduced from Europe
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Apples
Apricots
Carrots
Lentils
Peaches
Purslane
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Turnips
Livestock
Alcohol
Rye
Wheat
Regional Variations
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Northeastern
◦ Maple-sweetened baked beans, clambakes,
succotash
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Southern
◦ Brunswick Stew, hominy
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Plains (hunters )
◦ Jerky, Bison, Pemmican
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Southwestern
◦ Piki, Nopales, Tortillas
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Northwestern Coast/Alaska Native
◦ Salmon, Berries, Muktuk
Regional Variations
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Others
“Digger Indians”
◦ Roots, supplemented by small game and
insects
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Central California
◦ Acorn based diet
◦ Must remove tannic acid
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Rugged northern mountains and plains
◦ Game
◦ Wild plants
Meal Composition and Cycle
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Daily patterns
◦ Varied patterns
 1 – 2 meals per day
 Snacks
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Men served first
Monotonous
Silent
Simply prepared
Sweets limited to fruits, honey, maple
syrup
Special Occasions
Religious ceremonies
 Planting
 Harvest
 Hunt
 Green Corn Festival
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In the South
Thorough cleaning of homes and persons
Amnesty granted for all but murder
Beginning of a new year for marriages,
divorces, periods of mourning
Role of Food in Native American
Culture and Etiquette
Food is sacred
Gift of the natural realm
Ceremonies accompany cultivation of crops
Prayers offered for a successful hunt
Men responsible for hunting /care of livestock
Women gather, prepare and store food
Men and women cultivate crops
Sharing food important
Meals usually prepared and eaten
communally
 Idea of selling food not popular
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Therapeutic Uses of Food
Important in spiritual and physical
health
 Corn derivatives used for a variety of
ailments
 Indigenous plants used for medicinal
purposes
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◦ Agave, yucca, pumpkin paste, chile
peppers
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Bitter purges and emetics
◦ Distasteful and repugnant to evil spirits
Therapeutic Uses of Food, Cont..
Food restrictions common
 May eliminate cabbage, eggs, fish, meat,
milk, onions, or organ meats
 May eat certain foods to maintain strength
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◦ Meat among the Seminole
◦ Meat and blue cornmeal in the Navajo
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Pregnancy/childbirth restrictions common
◦ May avoid sweets cod, halibut, huckleberries,
and spring salmon
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Psychotherapeutic use of plants
Contemporary Food Habits
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Transitional adaptation of the Chippewa may
serve as a
Model for other Native Americans
Traditional: parents and grandparents speak
Chippewa at home, practice Midewiwin religion,
participate in feasts and powwows
More acculturated: English is primary language,
Catholic, involved in primary culture activates
Pan-traditional: Speak either English or Ojibwa
exclusively, practices a combined religion such
as the Native American Church, and is involved
in both traditional and white societies
Adaptation of Food Habits
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Diet today includes
few traditional foods
Gardening, hunting,
fishing, gathering
Dependent on foods
provided by the
reservations
Limited access to
supermarkets
Traditional foods have
been lost and
substitutions made
◦ Beef
◦ Fry bread
Adaptation of Food Habits
Typical Commodity Foods
Poultry
Fruit juices
Canned and
chopped meats
Peas and string
beans
Evaporated
and powdered
milk
Dried beans
Instant potatoes
Eggs
Peanut Butter
May very well be discarded due to dislike or
beliefs
Meal Composition and Cycle
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Little reported on meal patterns
◦ 3 meals per day, at least 1 or 2 main meals
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Meat and starch
Lots of fried food
Little variety
Few fruits & vegetables
Impacted by availability of commodities
Traditional foods consumed at
celebrations, birthdays
Nutritional Status
Research is limited
 Low socioeconomic status, lack of
transportation, fuel, refrigeration,
running water contribute to inadequate
diet
 Lactose intolerance is common
 Diseases today associated with
overconsumption
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◦ Obesity, Type 2 diabetes, cardiovascular
disease
Alaska Native
Diet high in refined carbohydrates and
fat
 Low in fruits and vegetables
 Calorie and protein intake declined
 Traditional diet replaced by
processed, canned and packaged
food low in nutrients
 Low intake of numerous nutrients
including calcium, iron and Vit C
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Diet of other American Indians
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Refined carbohydrates prominent
◦ White breads, tortillas, potato chips, French
fries and candy are top contributors of energy
◦ High consumption of soda and fruit-flavored
drinks
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Low in fruits and vegetables
◦ Cost, availability, quality
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Similar when compared to general
population
◦ Except Alaska Natives
Nutritional Status
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Life expectancy has improved
◦ 2.4 years less than the average American
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Die at higher rates from
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TB
Alcoholism
Motor vehicle accidents
Diabetes
Unintentional injuries
Homicide
Suicide
Nutritional Status
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Native American mothers more likely to
be younger and not married
No prenatal care for most during first
trimester
◦ Pregnancy considered a healthy state
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Postnatal mortality rates 60% higher
SIDS a major concern
Breastfeeding is traditional
Baby Bottle Tooth Decay a major
concern
Nutritional Status: Obesity
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Overweight and obesity prevalent
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20% above national average
Heavier body weight preferred
May be metabolic differences
Report very low leisure-time physical activity
Some studies indicate:
 Sweetened and alcoholic beverages may contribute
to obesity in women
 Dieting behaviors among adult women include
healthy approaches
 Some do skip meals, fast, induce vomiting, bingeeat
Nutritional Status: Diabetes
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Pima Indians have highest incidence in
of diabetes in the world
2 – 4 times higher than general
population
◦ Alaska Natives
◦ Plains
◦ Southwest
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Rates among children increasing
Death rate 3x as high
Deaths from diabetes 50 years ago were
rare
Cultural Controversy: Type 2 Diabetes,
Thrifty Genes, and Changing Theories
Why the increase in diabetes?
 Genetic predisposition?
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◦ Increased insulin resistance?
Less indigenous foods?
 Less protein?
 Change in type of carbs?
 Increased fats?
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Nutritional Status
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Heart disease now leading cause of
death
◦ Often more fatal
◦ High rates of smoking, high cholesterol
and hypertension
Chronic kidney disease associated
with Type 2 Diabetes
 Tuberculosis
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Nutritional Status: Alcoholism
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Numbers have decreased
◦ Rate for alcohol-related deaths 8x higher
than general population
Still a significant medical and social
problem
 Reasons for substance abuse
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High unemployment rates
Loss of tribal integrity
Loss of ethnic identity
Loss of self-esteem
Counseling
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Open-minded
Avoid ethnocentrism
Use intercultural communication skills
◦ Listen carefully
◦ Respect silence
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Learn about Native American worldview
◦ Traditional health beliefs
◦ Differences between nations
◦ History of each group
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Recognize diversity
Understand local culture
Counseling: Access to care
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Biomedical health care may be limited
◦ Low income or limited transportation
◦ May be limited to care through IHS
 Often limited technology and other resources
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Beliefs may cause them to avoid
treatment
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Pregnancy is a healthy state
Fear
Impersonal care
Dislike knowing of risks
Anger and blame
Counseling
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Belief in inevitable consequences to
diabetes
◦ Renal failure
◦ Amputations
◦ Blindness
Traditional attitudes about time may
cause delay in seeking care
 Do not question family members
 Use open ended questions
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Counseling
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Verbal is best
Watch terminology, even basic words
◦ Ex: vegetables = weeds
◦ Ex: germ – word does not exist
Allow silence, avoid yes or no questions
 May state “I don’t know” if they don’t want to
discuss topic
 May use stories or metaphors to make a point
 Direct questioning not best
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◦ Allow trust to be developed
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Emphasize how personal health promotes the
welfare of the client’s family and community
Counseling: Nonverbal
Communication
Very sophisticated
 May expect practitioner to use intuition
rather than a direct interview
 Smile and handshake are customary
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◦ Not vigorous
Often sit at distance
 Averted eyes are common
 Quiet, unhurried, talking “with” not
“to”
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Counseling
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May have misconceptions about biomedicine
Navajo health system classifies illness by
cause rather than symptoms
Believe medication or an injection can cure
anything
Weight loss associated with disease or
witchcraft
Often will combine biomedical with traditional
◦ Most effective for compliance
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Identify degree of acculturation through indepth interview
Native American
SEE PRACTITIONER
PERSPECTIVE