Health Needs Assessment of Navajo Indians

Navajo Indians are Native American tribes that occupy Southwestern parts of the United States of America. Arizona and Utah are their concentration points. Federal government identifies Navajos as the natives of the USA and, therefore, it allocated a reservation to them. Most of the Navajo Indians live in the reservation. This ethnic group shares common land that they use for farming purposes to produce agricultural products. They get married and identify themselves through paternalistic lineages. For decades, this ethnic group has been concerned with monogamous marriages, with only a few individuals involving in polygamy. However, in the contemporary Navajo Indians, men are only allowed to have a single wife. Health analysis into this community, using the Purnell Model for cultural competence show that the leading cause of deaths is accidents; however, cancer and diabetes are the current health issues facing the Navajo Indians because they smoke, lack adequate physical exercise, and have genetics that leads to prolonging of diabetic and cancer conditions to the new generations.

Overview of the Navajo Indians’ Demographics

Total Number of the Population in the U.S

The population of Navajo Indians is little in the US. There were a total of 286,731 members of this community according to the census conducted in the US in the year 2010. The Navajo comprises of 500 tribes of native Indians and 318 reservations in the USA. Most of these ethnic groups are found in Utah, Arizona and New Mexico . They are collectively found in the Southwest regions of the greater USA. The number is part of the total Indians’ population of 5.2 American Indians recorded in the year 2010. The Natives have progressively higher populations of indigenous persons in the reservations in the U.S.A.

Age Distributions

Majority of the Navajo population are still relatively young compared to the general American population.  In the 2010 census, it was recorded that 51 percent of the population was of the age group 0-29 years. This comprised a total of 173,667 persons under the age bracket named above. The Young population implies that Navajos Indians have the potential of robust growth in the future. Age group of 29 years and above represents 49% of the total population of 286,731 persons. However, those aged 10-19 are the most at 51,732 persons according to the 2010’s census. This number has increased five times over the past seven decades. Thus, as a result of such high growth rate, it is expected that young people will dominate this community for several decades.

Sex Distributions

There are more women as compared to men Navajos according to the current population establishments of the Navajos Indians. The total number of women was 172,885 female, while as that of men was 159,244 based on 2016 estimations. Females at the age bracket 0-9, 10-19 and 20-29 years are 32,397, 32,648 and 28,348 respectively while women at the age bracket 70-79 years and 80+ are 5,673 and 2,742 respectively. Men, on the other hand, at age brackets 0-9, 10-19 and 20-29 years are 32,651, 32,880 and 27,251 while those at age brackets 70-79 years and those at 80+ are 3,987 and 1,744 persons. These figures imply that, like most communities in America, the female population is slightly above that of men.

Education Levels

Navajo Indians are among the most uneducated society in the United States. It is estimated that for those above the age of 15 years, the Literacy levels are at 77 percent. An estimated number of 3,200 students of Navajo origin receives degrees annually in different institutions in the United States. Moreover, it is determined that there are over 45,593 Navajos who holder post-secondary certificate. There are also institutions of learning such as Dine College and Navajo Technical College that spur post-secondary education within the Navajo Nation. Additionally, the Navajo nation has over 167 public learning institutions mostly secondary level institutes. These institutions provide basic and tertiary education to Navajos and allow them to have proper exposure to literacy levels through the promotion of formal learning activities among the Navajos.

Socioeconomic Identifiers

Occupations among Navajo Indians

Original occupation for Navajos was farming crops such as beans, corns, and squash. Men were responsible for hunting and gathering. However, the current Navajos have diversified occupations but still have concentrations in butchering meat, mining, grinding meal and sawmilling (Frank, 2011). These occupations are mostly provided by the Navajos thus allowing them to acquire incomes for their daily upkeep. However, many literate Navajos occupy regular jobs such as teaching profession, engineering, and doctors in the U.S.A (Frank, 2011). The advancement of literacy levels among the Navajos has been critical for the development of vast opportunities of occupations that enables Navajos to diversify their income streams and lead decent lives. The future of Navajos seems lucrative since their siblings seem to have better exposure to formal education that would provide them with opportunities to venture into more profitable sectors of the economy.

Marital Rates among Navajos

Marriage rates are quite high especially among heterosexuals in Navajo nation. The kin groups are responsible for the arrangement of marriage ceremonies and dowry payments. In the past, most of the marriages were monogamous with polygamy accounting only 10 percent among Navajo married men. However, in modern society, only monogamous marriage is permitted. Marriage has been controlled and centered along nuclear family. This family enables the sharing of resources such as water and Maize fields. Most meals are taken together among the family members belonging to a nuclear family. The lineage that determines families is paternalistic implying that the family is recognized from the father’s lineage as opposed to mother’s lineage. Collective property is meant for the extended families and controlled by the representatives of the extended family. Marriage enhances socialization among the Navajos thus promoting ties and unity among the members of the Navajo Nation.

Employment Statistics among Navajos

The rate of unemployment among the Navajos Indians communities is among the highest in the country. Those employed as of the year ended in 2016 was 40,836. The unemployment rate was recorded at 56 percent in the same year. However, the portion of Navajos that were employed had/ and still have the capacity to meet their daily needs. Government and the locals should spur economic activities within the Navajo nation to promote formal employment opportunities within Navajo Nation. Such an attempt would reduce the levels of an unemployment rate that is currently above average.

Poverty Statistics in Navajo Nation

Due to high illiteracy levels and unemployment rates, most members of Navajos communities do not make decent income; thus, they live at high poverty levels.  Statistics show that 35.3 percent of Navajos lives below the country’s poverty line. This number is greater than the national average of 13.5 percent. This implies that poverty among the Navajos is higher in prevalence and deters human development index among the Navajos. The largest age group that experiences poverty among the Navajos is males belonging to age group 25-34 years of age. These males are mostly family heads and are obligated to fend for their families. Thus, most of their incomes go to family maintenance issues instead of investments. The low employment rates also reduce their ability to receive higher incomes that can spur their economic growth and development. Future generations can also experience poverty due to the concept of the vicious cycle of poverty in Navajo. However, there are formal education platforms that can provide a chance for social change and poverty eradication among the Navajos.

Average Annual Incomes among Navajo Indians

Average incomes among the Navajos remain quite low when compared to the national average income level.  In 2016 the average earning for this communities was $31,205, a figure that was way below the average of the U.S which stood at $57,617.  According to the U.S census bureau, the Navajo’s average incomes have been steadily improving at a higher rate than that of other American communities. Nevertheless, poverty continuous to rage within the Navajo nation due to the prevalence of low incomes that the Navajos earn cumulatively per year. If more radical steps are not taken to improve annual average earning of these individuals, then their quality of life will remain quite bad.

Health Characteristics

Birth and Death Rates

The Navajos have a higher birth rate particularly on teenagers, and a higher death rate when compared to the entire American society. Birth rates among Navajos are 20 per 100 teenagers especially in the regions of Nakaibito. In overall birth rate is estimated to be 250 live births per 1,000 females. On the other hand, infants’ mortality in this communities, is at 22.1 per 1,000 live births, and the overall death rate is at 996.50 per 100000 persons. This figure shows that mortality rate is still higher among the Navajos as compared to the average population of U.S. Low incomes due to higher unemployment rates prevalent within the Navajo can be directly linked to potentially higher death rates among infants in that the parents are not able to access the best insurance covers for their children. Despite the existence of Universal Health Coverage; most Navajos still have little ability to make appropriate protection through signing up for better insurance covers especially within the private sector.

Leading Cause(s) of Death

The dominant cause of deaths among the Navajo Indians is accidents and other unintentional injuries. This cause of death accounted for 18.9 percent of all deaths recorded among the Navajo Indians between the year 2006 and 2009. This implies that the Navajos can prolong their life expectancies if they become careful when driving and reduce dangerous exposures to accidents that can terminate their lives prematurely. Other leading causes of death among the Navajos include Heart disease, Cancer, Liver Cirrhosis and suicides. These causes of death are, however, lower as compared to the rates of death claimed by accidents solely. Special interest can be given to accidents, Cancer and Heart Diseases as the three main causes of the majority of deaths among the Navajo Indians in the U.S.A. These causes of death claim above-average deaths recorded among Navajo Indians making them of special interest under mortality and morbidity among the Navajos.

Overview of Health Issues Currently Impacting the Navajo Indians

Diabetes

Diabetes is a common disease among Native American due to their genetics composition and lifestyle. The prevalence of diabetes to this communities is at 16 percent of the total Navajo population. The mortality rate among Navajo Indians due to diabetes is at 47.77 per 100,000 people. The social cost of higher prevalence of diabetes among the Navajos is massive due to needs for issues such as amputation that occurs due to dire consequences of diabetes. Increased funding for health insurance also occurs due to increased costs of treatment for kidney failure that accompanies diabetes. Risk factors for diabetes include smoking, lack of proper physical exercise among Navajos, and genetics. To eliminate this health issue in the community, then addressing the risk factors is inevitable.

Cancers

Cancer is another health concern that faces the Navajos people in the USA. The prevalence of this health issue is at 8 percent for all the Navajo Indians. Among the female Navajos; breast cancer and colorectal cancers are the most prevalent. However, male Navajos reports prostate cancer for 85 cases per 100,000 males. Uterine and colorectal cancers follow the prostate cancer in the degree of manifestation among men in Navajo nation. The mortality rates among Navajos due to cancer-related an issue is 103.5 per 100,000 people. Risks factors for these cancers include alcohol, tobacco usage, and diet that promote the development of malignant cells among the Navajo Indians.

Barriers to Care among the Navajo Indians

There are a number of obstacles to care provision among the Navajos. Firstly, most of the communities live in rural setups that are separated by vast geographical terrains. Accessing the 12 clinics is a notable problem among the Navajos. Thus, they are less acquainted with the affairs of regular health checkups. Secondly, the Navajos have average incomes that are below the U.S’ average. For this reason, it is not easy for the Navajos to access proper and inclusive insurance covers from various healthcare providers. Most of them also live far away from hospitals and clinics in their setups. These problems reduce Navajo’s ability to receive proper and adequate medical checkups and treatment from hospitals and clinics available in their midst.

National Health Education Programs Addressing Diabetes and Cancer among the Navajo Indians

Many national programs address issues of diabetes among the youths and adults alike in Navajo Nation. Shiprock is one of the programs that are aimed at solving problems of diabetes among the Navajo Indians. The program aims to provide personalized care for persons suffering from this condition within the Navajo Nation. Moreover, self-awareness of the prevalence of diabetes among the youths in Navajo has been spurred by the initiatives of this program. The program allowed Navajos to understand that 1 in every 5 of them was diabetic. Thus, the program allows the Navajo Indians to understand and protect themselves from cases of exposure to diabetic risks.

Indian Health Services is a national program that is part of the Department of Health in the U.S. The government allocates funds to HIS in each fiscal year. Such fund allows IHS to provide direct medical services to the Navajos in their nation. Public health services for the Navajo focuses on the current issues facing the nation with a special focus on diabetes and cancer using the data from Center for Disease Control that provide the need to assist Navajos to promote their healthcare by reducing effects of diabetes, and treating cancer. Thus, IHS is a proper program that allows for identification/ screening of both cancer and diabetes.

Special Diabetes Program for Indians is the third national program that allows tribal natives especially Navajo nation to receive proper care to deter effects of diabetes. This program is funded annually by the federal government. The funds are directed to the Tribal Leaders through their committees. The leaders enhance coordination of activities undertaken within their territory and encourage people to seek services from the SDPI. This program enhances outreach to remote locations within ethnic Navajo regions and promotes screening for diabetes and provision of relevant medication services.

On cancer, the Navajo Cancer Workgroup is one of the most significant national efforts to help the community on this health issue. This workgroup which was founded in 1999, supports and improves all efforts placed by Navajo Nation leaders to improve cancer care and prevention particularly by utilizing and advancing the community cancer data. One of the significant program played by this organization is to create awareness of cancer to the Navajo population. This entitles showing how cancer is screened and the reason for regular screening, and possible medication available. The program has been highly successful and continues to impact positively on this area.

Future Healthcare Challenges Facing Navajo Indians

There are a number of challenges that would impact healthcare within Navajo Nation. For instance, there are the highest prevalence rates for diabetes in the population within the Navajo Indians. This implies that diabetes is and will still be a challenge in the future. This condition would be managed if proper awareness for diabetes would be passed to the residents of the Navajo Nation. However, most people within the Navajo Nation have little access to clinics and hospitals within their locality. This inadequate access reduces their ability to receive proper healthcare and health information within the required period. The government has enrolled proper programs to support health issues within this nation, but accessibility is still a problem that must be addressed to ensure that locals have proper access to hospitals and clinics.

Cancer forms the second challenge that affects Navajo Indians. This problem is prevalent within the Navajo Nation and has been controlled using little efforts. However, cancer’s prevalence is still high within the Navajo Nation. This issue possesses a challenge to the Navajo Indians; making them highly vulnerable to premature deaths that could be prevented. There should be proper efforts to deter issues of cancer among the Navajo Indians by proposing proper diet and lifestyle behaviors that can lead to the control of cancer’s prevalence. The third health care challenge in the future is a probable increase in the rates of heart attacks. Navajo Indians have little incomes compared to the total average for the U.S. Thus; they have little ability to involve in controlled programs that can assist them to manage heart conditions in advance. Most public programs have little ability to reach all persons, and there is a need for adequate private funded programs to assist them in managing their condition. Thus, lack of sufficient finances and access to clinics and hospitals reduces access and addressing of diabetes and cancer among the Navajo Indians.

‘’Points to Remember”

• Navajo Indians’ are Native Americans recognized by the federal government of the United States of America
• Navajo Indian’s have a population estimated at 320,000 as of the year 2018; this population has risen from 286,000 obtained from the census conducted in the year 2010 in the U.S.A.
• Main Cause of deaths among the Navajo Indians is accidental/ unintended deaths
• Current health issues affecting Navajo Indians include Cancer and diabetes which forms the second and third most leading causes of death among the Navajo Indians
• Barriers to healthcare provision for Navajo Indians include lack of proper access to hospitals and clinics and inadequate finances to seek and receive proper and private healthcare

Case Study

Peter Harrison is a 27-year-old Navajo Indian. Peter has a Body Mass Index of 34.5kg/m2 and was recently diagnosed with diabetes type 2 at a local clinic. He lives in New Mexico in a rented apartment. Peter is a graduate from a local university where he graduated with a degree in Business Management. He decided to open a personal business in New Mexico City and runs the enterprise as a sole proprietor assisted by Mr. Calisto Major who hails from Utah region. They are long-term friends and have a mutual relationship that allows them to work as a team. Peter likes a sedentary lifestyle and likes watching Television programs especially after closing his business premises in the evening. Although Peter is single currently, he is straight and thinks of getting married soon when he is thirty years old.

Case Study Question

1. Identify risk factors for Mr. Peter’s current conditions.
2. How can Mr. Peter mitigate his medical conditions and improve his health?
3. How can Mr. Peter promote his lifestyle behaviors and influence his friend to live and lead a positive lifestyle?

Conclusion

The above report has presented a health analysis of, Navajo Indians using Purnell Model for cultural competence show that, cancer and diabetes are the current health issues facing the Navajo Indians because of their genetics, smoke habits, and lack of adequate physical exercise. It has been revealed that native Indians have little incomes compared to the average of the U.S.A, and as a result, they had little ability to access proper and privatized medication needs that require hefty financing. The community also faces the health problem of cancer and diabetic. The government has promoted programs such as IHS and Shiprock that allows for proper awareness creation to the Navajo in their nation. These programs are funded by the federal government and enhance the provision of public health services to people of Navajo Indians. The government needs to ensure that they improve connectivity within the Navajo Nation and promote access to medical facilities such as hospitals and clinics to Navajo Indians. Lack of proper access to these facilities reduces the chances of rendering proper health services to residents.