Surveillance for health behaviors of American Indians and Alaska Natives-findings from the behavioral risk factor surveillance system, 2000-2006

Abstract

Background: The authors compared estimates for cancer risk factors, use of cancer screening tests, health status indicators, and access to care for American Indians and Alaska Natives (AI/ANs) and non-Hispanic whites (NHWs) in the US and for AI/ANs in 6 Indian Health Service regions.

Methods: Behavioral Risk Factor Surveillance System data were aggregated from the years 2000 through 2006 and were used to calculate weighted prevalence estimates by gender for key variables except demographic variables.

Results: Compared with NHWs, AI/ANs had lower prevalence estimates for income, educational attainment, insurance coverage, and access to personal healthcare providers. AI/ANs in Alaska and NHWs had similar estimates for diabetes (approximately 6%); however, the prevalence was nearly twice as high among AI/ANs in the other regions. The prevalence of obesity was higher for AI/ANs (29.6%) than for NHWs (20.9%). The prevalence of binge drinking was higher among AI/AN males (24.9%) than among AI/AN females (8.5%). Heavy drinking was more prevalent among NHW females (5.3%) than among AI/AN females (3.5%). AI/ANs were more likely to be current smokers (31.1%) than NHWs (22.8%). The prevalence of AI/ANs who never smoked ranged from 31.5% in Alaska to 56.9% in the Southwest. In 5 of the 6 regions, AI/AN females had lower prevalence estimates of both Papanicolaou and mammography testing than NHW females. The use of colorectal cancer screening tests was more common among NHWs (53.8%) than among AI/ANs (44%).

Conclusions: Although cancer health disparities persist among AI/ANs, the current analysis indicated that variation in the prevalence of their chronic disease risk factors may be obscured when national data are not examined by smaller geographic areas such as regions.