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Use of Biomedical Services and Traditional Healing Options Among American Indians: Sociodemographic Correlates, Spirituality, and Ethnic Identity. Novins, Douglas K. MD; Beals, Janette PhD; Moore, Laurie A. MPH; Spicer, Paul PhD; Manson, Spero M. PhD; the AI-SUPERPFP Team Medical Care. Volume 42(7) July 2004 pp 670-679 Study Population The 2 participating tribes are among the larger tribes in the United States and represent both the diversity and common experiences of this population. The 2 tribes belong to different linguistic families, have different histories of migration, subscribe to different principles for reckoning kinship and residence, and have historically pursued different forms of subsistence. They share similar histories of colonization, including dramatic military resistance and externally imposed forms of governance. Unemployment and poverty are widespread, but both tribes vary considerably in acculturation, education, and income. Data were collected between 1997 and 1999. Once located and found to be eligible, 73.7% and 76.8% agreed to participate from the Southwest (n = 1446) and Northern Plains (n = 1638) tribes, respectively.
Use of Biomedical Services Biomedical service use was much more prevalent for physical than psychiatric problems among participants from both the Southwest (40.9% vs. 6.4%, respectively) and Northern Plains (59.1% vs. 6.8%). Those from the Northern Plains were more likely to use biomedical services for physical health problems than those in the Southwest, but the 2 tribes did not differ in terms of the prevalence of biomedical service use for psychiatric problems.
The characteristics of users of biomedical services are shown in the left-hand columns of table 2. For both tribes, users of biomedical services for physical health problems were more likely to be from the older age groups and reported higher scores on the spirituality and white identity scales. The prevalence of biomedical service use increased with educational level and percent of life spent on the reservation. In the Northern Plains tribe, biomedical service use for physical problems was also associated with female gender and being married. In contrast, there were very few characteristics that distinguished users from nonusers of biomedical services for psychiatric problems. In the Northern Plains, use of biomedical services was associated with a greater percentage of life spent on the reservation. Use of Traditional Healing The estimated prevalences of the use of traditional healing for physical health and psychiatric problems are summarized at the top of the right-hand columns in table 2. Use of traditional healing was more common for physical than psychiatric problems among participants from both the Southwest (22.9% vs. 7.8%, respectively) and Northern Plains (8.4% vs. 3.2%). In addition, use of traditional healing was more prevalent in the Southwest than the Northern Plains for both physical health and psychiatric problems. For both tribes, use of traditional healing for both physical health and psychiatric problems was associated with higher scores on the spirituality and American Indian identity scales. Individuals from the older age groups were more likely than individuals from the younger age groups in both tribes to report using traditional healing for physical problems. In the Southwest tribe, use of traditional healing for physical health problems was associated with being married. In the Northern Plains tribe, use of traditional healing for psychiatric problems was associated with having spent a greater percentage of life on the reservation.
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