Denny Clark H, Holtzman Deborah, Cobb Nathaniel
Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Albuquerque, New Mexico, USA.
MMWR Surveill Summ. 2003 Aug 1;52(7):1-13.
PROBLEM/CONDITION: In the United States, disparities in risks for chronic disease (e.g., diabetes, cardiovascular disease, and cancer) and human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are evident among American Indians and Alaska Natives (AI/ANs) and other groups. This report summarizes findings from the 1997-2000 Behavioral Risk Factor Surveillance System (BRFSS) for health-status indicators, health-risk behaviors, and HIV testing and perceived risk for HIV infection among AI/ANs, compared with other racial/ethnic groups in five regions of the United States.
1997-2000.
BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (i.e., persons aged > or =18 years) population. For this report, responses from the 36 states covered by the Indian Health Service administrative areas were analyzed.
Region and sex-specific variations occurred in the prevalence of high-risk behaviors and health-status indicators. For example, the prevalence of current cigarette smoking ranged from 21.2% in the Southwest to 44.1% in the Northern Plains, and the awareness of diabetes was lower in Alaska than in other regions. Men were more likely than women to report binge drinking and drinking and driving. For the majority of health behaviors and status measures, AI/ANs were more likely than respondents of other racial/ethnic groups to be at increased risk. For example, AI/ANs were more likely than respondents of other racial/ethnic groups to report obesity (23.9% versus 18.7%) and no leisure-time physical activity (32.5% versus 27.5%).
The 1997-2000 BRFSS data demonstrate that health behaviors vary regionally among AI/ANs and by sex. The data also reveal disparities in health behaviors between AI/ANs and other racial/ethnic groups. The reasons for these differences by region and sex, and for the racial/ethnic disparities, are subjects for further study. However, such patterns should be monitored through continued surveillance, and the data should be used to guide prevention and research activities. For example, states with substantial AI/AN populations, and certain tribes, have successfully used BRFSS data to develop and monitor diabetes and tobacco prevention and control programs.
Federal and state agencies, tribes, Indian health boards, and urban Indian health centers will continue to use BRFSS data to develop and guide public health programs and policies. The BRFSS data will also be used to monitor progress in eliminating racial and ethnic health disparities. Regional Indian health boards, tribal epidemiology centers, and Indian Health Service Area Offices can use the findings of this report to prioritize interventions to prevent specific health problems in their geographic areas. Moreover, tribes and other institutions that promote AI/AN health care can use the report to document health needs when applying for resources.
问题/状况：在美国，美国印第安人和阿拉斯加原住民（AI/ANs）与其他群体相比，在慢性病（如糖尿病、心血管疾病和癌症）、人类免疫缺陷病毒（HIV）和获得性免疫缺陷综合征（AIDS）的风险方面存在明显差异。本报告总结了1997 - 2000年行为风险因素监测系统（BRFSS）关于AI/ANs健康状况指标、健康风险行为、HIV检测以及对HIV感染的感知风险的调查结果，并与美国五个地区的其他种族/族裔群体进行了比较。
1997 - 2000年。
BRFSS是一项基于州的针对非机构化成年平民（即年龄≥18岁的人群）的电话调查。本报告分析了印第安卫生服务行政区域覆盖的36个州的调查回复。
高风险行为和健康状况指标的患病率存在地区和性别差异。例如，当前吸烟率在西南部为21.2%，在北部平原为44.1%，阿拉斯加对糖尿病的知晓率低于其他地区。男性比女性更有可能报告酗酒和酒后驾车。对于大多数健康行为和状况指标，AI/ANs比其他种族/族裔群体的受访者面临更高风险的可能性更大。例如，AI/ANs比其他种族/族裔群体的受访者更有可能报告肥胖（23.9%对18.7%）和没有休闲时间进行体育活动（32.5%对27.5%）。
1997 - 2000年BRFSS数据表明，AI/ANs的健康行为在地区和性别上存在差异。数据还揭示了AI/ANs与其他种族/族裔群体在健康行为方面的差异。这些地区和性别差异以及种族/族裔差异的原因有待进一步研究。然而，应通过持续监测来关注此类模式，并利用这些数据指导预防和研究活动。例如，拥有大量AI/AN人口的州和某些部落已成功利用BRFSS数据制定和监测糖尿病及烟草预防控制项目。
联邦和州机构、部落、印第安卫生委员会以及城市印第安健康中心将继续利用BRFSS数据制定和指导公共卫生项目及政策。BRFSS数据还将用于监测消除种族和族裔健康差异方面的进展。地区印第安卫生委员会、部落流行病学中心和印第安卫生服务地区办公室可利用本报告的结果，对其地理区域内预防特定健康问题的干预措施进行优先排序。此外，促进AI/AN医疗保健的部落和其他机构在申请资源时可利用该报告记录健康需求。
