Fetal Alcohol Syndrome in Native Americans and the Overall Population.
How many people are affected by FASD?
On a given day in the United States:
10,500 babies are born:
1 of these babies is HIV positive
3 of these babies are born with Muscular Dystrophy
7 of these babies are born with Spina Bifida
12 of these babies are born with Down Syndrome
40 of these babies are born with an Autism Spectrum Disorder.
100 of these babies are born with a Fetal Alcohol Spectrum Disorder.
Sources: US Census Bureau, Center for Disease Control and Prevention, Muscular Dystrophy Association, Spina Bifida Association, National Institute of Health: Child Health & Human Development, Autism Society of America, National Organization on Fetal Alcohol Syndrome.
Fetal Alcohol Spectrum Disorders are 100 percent preventable but they continue to have a high incidence compared to other environmental and genetic disorders. Furthermore, Native American communities see some of the highest rates of FASD. In a CDC report incidences of Fetal Alcohol Syndrome per 10,000 total births for different ethnic groups were as follows: Asians 0.3, Hispanics 0.8, whites 0.9, blacks 6.0, and Native Americans 29.9.1 While different studies have come up with slightly different estimates, there is no doubt that the prevalent rate of FASD in Native American populations is a significant problem that needs to be dealt with.
Why are Native American communities seeing such high rates?
To answer this question, the risk factors associated with the disease must first be identified. Alcoholism is one of the most common problems among Native Americans. An increased incidence of alcoholism leads to an increased incidence of FASD. Cultural influences, patterns of alcohol consumption, nutrition, and metabolic differences have been suggested as additional contributing factors in the incidence of FASD in Native American communities.2
The underlying causes of these health disparities are complex. Many Native American communities are still feeling the effects of what has been deemed “a legacy of trauma”. Their history is filled with violence, oppression, displacement, and a loss of self-determination, which has had a lasting effect on past and future generations. Also, many reservations have high levels of poverty and inadequate access to health care making it more difficult to treat mental and physical problems. The demographic make-up of the population might also have an impact. Native American communities have a mean age of 24, 10 years younger than the mean age of the overall population. Younger people may be more likely to engage in risky behaviors such as binge drinking.3
It has also been suggested that because of their relatively recent contact with alcohol Native Americans do not have the same tolerance for alcohol as European populations. However, this idea should be viewed with caution. An article by Don Coyhis and William White shares a much more likely point of view.
“The initial response of Native tribes to alcohol availability following European contact was not one of drunken mayhem and widespread alcoholism. The early responses to alcohol varied within and between tribes and varied over the course of early contact, but one thing is clear: the development of alcohol problems in Indian communities emerged slowly and out of the changing relationships between Indians and Europeans, not as a function of any innate vulnerability to alcoholism.”4
What needs to be done to develop an intervention that will successfully remedy the problem?
As a researcher and interventionist, the most important thing to remember when addressing alcoholism and FASD is that assumptions cannot always be inferred from other Native American populations. To develop a successful intervention these risk factors must be understood in the context of the experiences and history of the specific population of interest.
Sources
1. May, Philip A. and J. Phillip Gossage. Estimating the Prevalence of Fetal Alcohol Syndrome: A Summary. National Institute on Alcohol Abuse and Alcoholism. <http://pubs.niaaa.nih.gov/publications/arh25-3/159-167.htm>
2. Aase JM. The Fetal Alcohol Syndrome in American Indians: A High Risk Group. Neurobehav Toxicol Teratol 1981;3:153-6.
3. Limon, Connie. "Fetal Alcohol Syndrome in Native American Cultures." EzineArticles 17 March 2008. 01 May 2008 <http://ezinearticles.com/? Fetal-Alcohol-Syndrome-in-Native-American-Cultures&id=1052642>.
4. Coyhis, Don and William White. “Alcohol Problems in Native America: A New and Provocative History.” Counselor. August 2006, v.7, n.4, pp.54-56.
