Native Americans Chapter 5 Native Americans Largest number

Native Americans Chapter 5

Native Americans Largest number of ethnic groups American Indian Alaska Natives ◦ American Indians ◦ Inuits (Eskimos) ◦ Aleuts (Alaska Natives) Most live west of the Mississippi River

History of Native Americans Came to North America across the Bering Strait No written records Europeans introduced horses, firearms, metal knives, diseases, massacres of whole nations By late 19 th century most lived on reservations Bureau of India Affairs (BIA) took over reservations in late 20 th century Have not fully assimilated

Current Demographics States with largest numbers ◦ California ◦ Oklahoma ◦ Arizona Largest ethnic groups in Alaska, Montana, North Dakota, Oklahoma, and South Dakota ◦ Alaska Natives ◦ Native. Americans/American Indians

Native American Nations in the United States.

Socioeconomic Status Declined with forced migrations of the 19 th century Indian Self-Determination / Education Act of 1975 ◦ 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

Native American Organizations Have done much to maintain Indian identity ◦ Clubs ◦ Service Organizations ◦ Organizations to promote ethnic identity ◦ Athletic clubs ◦ Dance groups Numerous traditional celebrations across the nation each year

Worldview Harmony Strive to maintain ◦ Spiritual ◦ Social ◦ Physical balance 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 ◦ 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

Traditional Health Beliefs and Practices Reflects relationship to nature Imbalance with supernatural, spiritual, or social Treatment is holistic in approach ◦ Focuses on restoring harmony Concerned with physical, mental, and spiritual renewal ◦ Health maintenance ◦ Prevention of illness ◦ Restoration of health

Traditional Health Beliefs and Practices Causes of illness Witchcraft 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 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

Causes of Illness Utilize healers, medicine men & women Prevention through sweat baths Diagnose through ◦ ◦ ◦ 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 ◦ The 3 Sisters Corn Squash Beans

Food introduced from Europe Apples Turnips Apricots Livestock Carrots Alcohol Lentils Rye Peaches Wheat Purslane

Regional Variations Northeastern ◦ Maple-sweetened baked beans, clambakes, succotash Southern ◦ Brunswick Stew, hominy Plains (hunters ) ◦ Jerky, Bison, Pemmican Southwestern ◦ Piki, Nopales, Tortillas Northwestern Coast/Alaska Native ◦ Salmon, Berries, Muktuk

Regional Variations Others Indians” “Digger ◦ Roots, supplemented by small game and insects Central California ◦ Acorn based diet ◦ Must remove tannic acid Rugged northern mountains and plains ◦ Game ◦ Wild plants

Meal Composition and Cycle Daily patterns ◦ Varied patterns 1 – 2 meals per day Snacks ◦ Men served first ◦ Monotonous ◦ Silent ◦ Simply prepared ◦ Sweets limited to fruits, honey, maple syrup

Special Occasions Religious ceremonies Planting Harvest Hunt Green ◦ ◦ Corn Festival 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

Therapeutic Uses of Food Important in spiritual and physical health Corn derivatives used for a variety of ailments Indigenous plants used for medicinal purposes ◦ Agave, yucca, pumpkin paste, chile peppers 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 ◦ Meat among the Seminole ◦ Meat and blue cornmeal in the Navajo Pregnancy/childbirth restrictions common ◦ May avoid sweets cod, halibut, huckleberries, and spring salmon Psychotherapeutic use of plants

Contemporary Food Habits 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 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 Little reported on meal patterns ◦ 3 meals per day, at least 1 or 2 main meals 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 ◦ 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

Diet of other American Indians 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 Low in fruits and vegetables ◦ Cost, availability, quality Similar when compared to general population ◦ Except Alaska Natives

Nutritional Status Life expectancy has improved ◦ 2. 4 years less than the average American Die ◦ ◦ ◦ ◦ at higher rates from TB Alcoholism Motor vehicle accidents Diabetes Unintentional injuries Homicide Suicide

Nutritional Status Native American mothers more likely to be younger and not married No prenatal care for most during first trimester ◦ Pregnancy considered a healthy state Postnatal mortality rates 60% higher SIDS a major concern Breastfeeding is traditional Baby Bottle Tooth Decay a major concern

Nutritional Status: Obesity Overweight ◦ ◦ ◦ and obesity prevalent 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 Pima Indians have highest incidence in of diabetes in the world 2 – 4 times higher than general population ◦ Alaska Natives ◦ Plains ◦ Southwest Rates among children increasing Death rate 3 x as high Deaths from diabetes 50 years ago rare were

Cultural Controversy: Type 2 Diabetes, Thrifty Genes, and Changing Theories Why the increase in diabetes? Genetic predisposition? ◦ Increased insulin resistance? Less indigenous foods? Less protein? Change in type of carbs? Increased fats?

Nutritional Status 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

Nutritional Status: Alcoholism Numbers have decreased ◦ Rate for alcohol-related deaths 8 x higher than general population Still a significant medical and social problem Reasons for substance abuse ◦ ◦ High unemployment rates Loss of tribal integrity Loss of ethnic identity Loss of self-esteem

Counseling Open-minded Avoid ethnocentrism Use intercultural communication ◦ Listen carefully ◦ Respect silence Learn skills about Native American worldview ◦ Traditional health beliefs ◦ Differences between nations ◦ History of each group Recognize diversity Understand local culture

Counseling: Access to care Biomedical health care may be limited ◦ Low income or limited transportation ◦ May be limited to care through IHS Often limited technology and other resources Beliefs may cause them to avoid treatment ◦ ◦ ◦ Pregnancy is a healthy state Fear Impersonal care Dislike knowing of risks Anger and blame

Counseling 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

Counseling 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 ◦ Allow trust to be developed 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 ◦ Not vigorous Often sit at distance Averted eyes are common Quiet, unhurried, talking “with” not “to”

Counseling 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 Identify degree of acculturation through indepth interview

Native American SEE PRACTITIONER PERSPECTIVE