The Health of Native Americans: Toward a Biocultural Epidemiology

The Health of Native Americans: Toward a Biocultural Epidemiology

The Health of Native Americans: Toward a Biocultural Epidemiology

The Health of Native Americans: Toward a Biocultural Epidemiology

Synopsis

This book provides a comprehensive review of the health of Native Americans in Canada and the United States. Historical trends in population and health status from pre-European contact to the present are examined in three groups of diseases: infectious diseases, chronic diseases, and injuries. The author discusses the etiology and pathogenesis of different diseases in each group, and weighs genetic and environmental risk factors. He also compares the incidence of disease among Native Americans and non-Native Americans, examines variations among Native Americans belonging to different geographical, cultural and linguistic groups, and reviews control and prevention strategies. On a broader level, the author's purpose is to integrate the approaches of anthropology and epidemiology in order to show the interaction of biology and culture on disease causation, distribution, and control. Attention to both perspectives offers a promising approach to understanding and improving the health status of Native Americans.

Excerpt

This book was written during 1992, a year that marked the 500th anniversary of the arrival of Christopher Columbus in the New World. That this symbolic event has aroused passionate debates highlights the continuing need for, and contentious nature of, "taking stock" of the current state of the indigenous peoples in the Americas.

It is customary to declare one's motives at the outset in writing a book. I write from the perspective of an academic researcher who has felt the need to take a critical and comprehensive look at what is known about the state of health of Native Americans, why certain diseases are common, and how best to prevent and control them. Unlike most academic researchers, I have spent a good part of my professional life practicing, first clinical medicine, and later public health, in Native communities in northern Canada. While I have also visited Alaska and Greenland, the extent of my personal knowledge and experience is still geographically limited. I have relied on the published literature in both the social and biomedical sciences and on assistance from a network of researchers, practitioners, and administrators in Canada and the United States. This is an academic book, for which I make no apologies. There is a time and place for advocacy and activism; there is an equally important time and place for analysis and appraisal. By sifting through the massive amount of data on Native American health, I hope to have something to offer, not just to fellow researchers, but also to those engaged in the delivery of health services in Native communities, from the harassed and burdened front-line workers to the desk-bound bureaucrats.

By invoking the phrase "biocultural epidemiology" in the subtitle, I deliberately hope to forge closer links between the disciplines of epidemiology and . . .

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