Vulnerable Population and Self-Awareness

Vulnerable Population and Self-Awareness

The Neighborhood provided many interesting and diverse households with numerous examples of vulnerable populations. Jimmy and Cecelia from The Bley household are an older Native American couple that has been married for over 50 years. The Neighborhood has a total population of 64,200 residents and only 3% of that population is Native American, making them such a minority that they are considered a vulnerable population. In the United States those that identified themselves as only Native Americans constituted 0.9% of the population, which is roughly 2.5 million individuals, and 1.5% or 4.4 million in combination with other races. The largest populations can be found in the West, Southwest, and Midwest, specifically Alaska, Arizona, Montana, New Mexico, Oklahoma, and South Dakota. There are 562 tribes that are recognized by the federal government but there are an unknown number of tribes that are not and each tribe has its own practices and beliefs. (Ogunwole, 2002)

The ten leading causes of death for Native Americans include heart disease, cancer, unintentional injuries, diabetes, chronic liver disease and cirrhosis, chronic lower respiratory diseases, stroke, suicide, nephritis, influenza/pneumonia. (Ogunwole, 2002) Native Americans also have an alarmingly high prevalence of obesity, SIDS/infant mortality, mental health, and substance abuse. Factors that contribute to this poor health include "geographic isolation, economic factors, suspicion toward spiritual beliefs, cultural barriers, and inadequate sewage disposal" (Tann, Yabiku, Okamoto, Yanow, 2007). More than half of the population does not reside on a reservation so many Native Americans have limited or no access to the Indian Health Services, which they are entitled to through the federal government.

Personally, I have only had limited contact with Native Americans. I have heard some of the stereotypes associated with Native Americans such as they are alcoholics and don't care for "white" people. As far as health care some biases I have heard is that many Native Americans do not agree or comply with western medicine and many are not open to communicate their feelings and symptoms. They present themselves as strong and firm even in the time of pain and despair.

After researching more about the population and demographics it makes sense why they are considered a vulnerable population and why some of these stereotypes and biases are true to a certain degree. For example, according to De Chasnay & Anderson (2008) "historically, fur traders and trappers often used alcohol as part of the barter process with Native Americans which can help explain why there are higher rates of drugs and alcohol use" which affects the lives of many Native Americans. Also, historically, their diet consisted of wild rice, game, berries and nuts which are low in fat, but with government assistance programs that came into effect the food that was subsidized was high in fat and carbohydrates. The introduction of western food and high fat food choices for family feasts and gatherings have led to many of the comorbidities seen in this community. (De Chesnay & Anderson, 2008)

As nurses it is important to be aware of the history of Native Americans and their