This is part of the ANKN Logo This is part of the ANKN Banner
This is part of the ANKN Logo This is part of the ANKN Logo Home Page About ANKN Publications Academic Programs Curriculum Resources Calendar of Events Announcements Site Index This is part of the ANKN Banner
This is part of the ANKN Logo This is part of the ANKN Banner This is part of the ANKN Banner
This is part of the ANKN Logo This is part of the ANKN Banner This is part of the ANKN Banner
Native Pathways to Education
Alaska Native Cultural Resources
Indigenous Knowledge Systems
Indigenous Education Worldwide
 

Testimony

Submitted to the
Alaska Natives Commission
in connection with a hearing at

Fairbanks, Alaska
July 18, 1992

ALASKA NATIVES COMMISSION
JOINT FEDERAL-STATE COMMISSION
ON
POLICIES AND PROGRAMS AFFECTING ALASKA NATIVES
4000 Old Seward Highway, Suite 100
Anchorage, Alaska 99503

TABLE OF CONTENTS

Witness List | Exhibit List | PDF Version

 

Deposition Exhibit #9 - Testimony of Margaret Wilson

 

TESTIMONY TO ALASKA NATIVE COMMISSION
July 18, 1992

This testimony was prepared in response to identified health needs of Alaska Natives residing in the Alaskan Interior.

WHY THIS POPULATION IS AT RISK

Prior to the presence of non-Natives in Alaska, aboriginal peoples congregated in non-competitive extended family groups. The family was both the chief socializing agent and the economic unit. This social organization relied upon informal response systems for decision making and for social control while Elders made known the cultural values.

Within a relatively short period of time, cultures which allowed Natives to survive in one of the earth's harshest environments have been nearly destroyed, leaving many Alaskan Natives in a state of cultural limbo. The problems that besiege us have not been historically prevalent in Athabascan culture; we know that this current solution is both tragic and unacceptable.

BEHAVIORAL HEALTH

A study by Dr. Bernard Segal, of the University of Alaska Anchorage, outlines prevalence and incidence rates and substance abuse patterns among Alaskan youth. Segal's 1988 study suggests that several noteworthy changes in drug taking behavior have occurred among Alaskan youth since an initial study reported in 1983. Overall, the lifetime experience of youth with one or more chemical substances has increased, especially experiences with marijuana, hallucinogens, and inhalants. Lifetime experience with marijuana is up 7.7%, while hallucinogen and inhalant experiences are up 9.4% and 9.1% respectively. Crack use was not reported in the initial (1983) study, however, a 4.7% lifetime experience was reported in 1988 (all are reported at 95% confidence intervals). Segal also reports that 5.8% of the students polled drink alcoholic beverages five or more times per week. In a more recent study Alaska Adolescent Health Survey 1990 in which over 5000 students were assessed the rates have increased dramatically. Marijuana usage was reported in 45.9%of males and 45.8% of females in grades 10-12 or ages 15 to 18. 22.2% of males and 20.5% of females in the 7th-9th grades or ages 12 to 14 admitted to marijuana use. While most teens have tried alcohol, 25% of 12th graders in larger communities (population over 2500) and 16% of smaller communities (population under 2500) drank either daily or weekly. Many start their drinking patterns early on. And many of these youth already have problems as a result of alcohol use and abuse. Although the use of inhalants (sniffing glue, gas or paint) is not as common in our region it is a problem and the population using it is much younger. The use of cocaine in rural areas is increasing but because of the cost is usually not the drug of choice in the rural setting.

The above information suggests that substance abuse is epidemic among youth in the Interior region. Our observations suggest that, as they are elsewhere, drug use incidence and prevalence rates are even higher among high school drop-outs. While drop-out rates are not offically calculated in Alaska, it is known that rural Native students drop out at a higher rats than do their non-Native urban counterparts. This suggests that rural Native drop-outs are even more likely, than those polled by Segal, to have or to develop a substance abuse problem.

In 1987 alone there were 641 youth age 17 and under who were treated for substance abuse in programs supported by the Alaska State Division of Alcoholism and Drug Abuse (ADA). This figure does not include adolescents who were treated at private for profit inpatient facilities such as Charter North.
A variety of other factors contribute to, and are associated with, adolescent alcohol and drug abuse. The following social conditions and problems have been identified as significant indicators which suggest that Alaskan Native youth represent a vulnerable, multi-risk population.

SUICIDE - A 1986 study of suicide rates among Alaskans reported by Hlady and Middaugh reconfirmed the established finding that suicide in epidemic in Alaska, especially among young Native males. During 1984-1985, the proportion of Alaskans committing suicide that were Natives (33%) was significantly larger than the proportion (14%) of Natives among the population. For all races, the average annual age-adjusted rate was 21.0 per 100,000 population per year. Among Natives it was 42.9 suicides per 100,000 population per year, 2.2 times the White age-adjusted rate of 19.1 suicides per 100,000 population per year, (pg.14). Of 57 Alaskan Native suicides in which the blood alcohol level was tested, 79% had detectable levels of blood alcohol compared to 48% of the 110 White suicides tested, (pg.16). Clearly, the risk of suicide increases when alcohol use is involved.

This year, the Interior Native population has experienced an explosive increase in the number of suicides completed, a number of which were carried out in public. Within the TCC region in the past year, we have experienced 12 completed suicides, ranging in ages from 16 to 72. We are gravely in need of effective intervention measures but limited resources constrain our efforts to a limited response. Limited staffing precludes a simultaneous response to crisis calls from the villages, continuation of full service levels to urban beneficiaries, and the provision of routine itinerant clinical and prevention services. Our ability to do more with less has reached a critical point. The TCC Community Health Services has established a Suicide Task Force in the past year and have come up with a prevention plan that consists of three elements that combine both short-term, suicide crisis intervention and long term community development and educational efforts. We know that this will require major effort and more funding.

HOMICIDE - According to the Alaska Office of Alcoholism and Drug Abuse, over 80% of all homicides in the state are alcohol related. The homicide rate in Northern Alaska is even higher than that seen statewide. In 1987, homicide was the seventh leading cause of death. Homicide rates in the rural areas of the TCC region are 50% higher than those in the urbanized Fairbanks North Star Borough and nearly 50% higher than the statewide average.

ACCIDENTAL DEATH - Alaskans from rural communities are also at great risk of accidental death. Accidents are the number one killer of Northern Alaskans, accounting for 24.7% of all deaths for the five year period 1979-1983. Motor vehicle accidents were the most frequent cause of accidental death each year from 1979-1983, followed by water-related accidents, aircraft accidents, and firearms. Accidents claimed 424 lives in Northern Alaska during this period.

In Alaska, alcohol involvement in motor vehicle fatal accidents for 1987 was 58%. Juveniles, ages 16-20 made up only 6.8% of Alaska Drivers in FY-87, but were involved in 21% of alcohol-related traffic deaths and 13% of all alcohol related accidents (Alaska State Office of Alcoholism and Drug Abuse). With the arrival of ATVs and snowmachines the accident rates are higher because of alcohol involvement.

Water related accidents are the second most frequent cause of accidental death. In the northern region, outside the Fairbanks North Star Borough and the highway corridors, water related mishaps are the leading cause of accidental death. Most of the victims of drowning and boating accidents are Native males. No hard data exists to show a relationship between alcohol use and water-related accidents but we are confident such a pattern exists.

Overall, Natives account for a much larger percentage of accidental fatalities than their proportion of the population would suggest. In 1981, accidental deaths am Alaska Natives accounted for 38.8% of all such deaths in the Nothern region, while Natives at that time represented only about 20% of the population (Alaska Department of Health and Social Services, 1982b).

TEENAGE PREGNANCY - Early pregnancy is also identified as a potential factor in adolescent substance abuse. Of the 345 children born to rural Interior Native mothers, 14.8% were born to mothers age 19 and under. In one of our interior villages this year alone we had 4 teenage pregnancies, all these girls were still in high-school.

For the years 1980-1984, the average annual birth rate for rural Interior mothers under age 19 was 12.1% (Alaska Department of Health and Social Services, Vital Statistics Annual report, 1981, 1982, 1983, 1984. Juneau, Alaska. 1983, 1985, 1987).

While Native teens (15-19) comprise only 18 percent of the population in this age group, they represent 43 percent of the teen births. It is well established that children born to young mothers have greater risk of developing health problems, of being physically abused or neglected and of becoming substance abusers later in life.

Poverty and unemployment contribute greatly to substance abuse problems. In the Northern region, most of the communities outside the Fairbanks North Star Borough are considered to be "poverty areas" by federal designation (U.S. Dept. of Health, Education and Welfare, 1978). Because of the extremely high costs of food, shelter and utilities; the federal guidelines for poverty are much too low. In many rural Alaskan communities, upper income bracket families have actual purchasing powers below those of urban "poverty level" families. These vast differences in living costs cause real impoverishment far in excess of "on paper" poverty. Year around paid employment is extremely limited and a significant proportion of rural Alaskans live in poverty.

As illustrated above, substance abuse and other conditions are clearly an overwhelming problem in rural Alaska. The implication for continued social problems, loss of traditional values and lifestyles, family breakdown, and decreased quality of life for Alaskan Natives is obvious.

SEXUAL ABUSE/PHYSICAL ABUSE - According to the Adolescent Health Survey 1 in 4 females report being sexualy abused and nearly the same amount 23% report physical abuse. Who do these abused youth tell? NO ONE. The magnitude of abuse is vast as it is in other places.

MATERNAL AKD CHILD HEALTH

The Tanana Chiefs Conference leaders and member village show a grave concern about FAS and its effect on the future of Alaska Native people. Every village in the region (43) participated in voluntary toxic fetal effects information and planning meetings in 1990. These meetings served to inform community members about toxic fetal effects and to gather ideas on how best to prevent FAS in the Interior communities. The proposed program represents an important part of this region-wide toxic fetal effects prevention effort.

The problems cited below suggest an urgent need for FAS, Alcohol Related Birth Defect (ARBD), and other toxic fetal effects prevention education services for the rural Interior population.

FETAL ALCOHOL SYNDROME - Alaska Natives suffer the highest rates of FAS of any studied population in the world. The statewide FAS rate for Alaska Natives is 4.3 per 1,000 live births as reported in 1989 by the Alaska Area Native Health Services, Community Health Services, statewide screening program. FAS rates among the Tanana Chiefs Conference region population are higher still at 4.6 per 1,000 live births. The FAS incidence rate of 4.6 per 1,000 live births reflects only cases which meet all three FAS diagnostic critiria: growth deficiency, altered morphogenesis, and mental retardation. In the Interior, this rate means one to two Native babies are born with FAS annually. This does not address the needs that these children born, with FAS face in the future.

ALCOHOL RELATED BIRTH DEFECTS - Maternal drinking is linked to Alcohol Related Birth Defects (ARBD), which range from moderate to severe. These include growth retardation, increased risk of anomalies, behavioral effects, mental retardation, and increased mortality. It is estimated that for every child born with FAS, 10 are born with ARBD. The estimate rate for Interior Alaska would be 46.0 per 1,000 live births. Other factors contribute to the high incidence of FAS and ARBD in the Interior region and suggest an urgent need for FAS/ARBD prevention and early intervention services.

AT-RISK-MOTHERS - For the calendar year 1987, 19% of the prenatal patients at the Alaska Area IHS were identified as "at-risk" from substance abuse. In the TCC region, that translated to 60 per year.

YOUNG POPULATION - The Alaskan population in general is very young, with about 29% under 15 years of age. Among Alaska Natives, about 4,000 or 33% are under 19 years. In general, mothers who are 19 or younger or over 35 are
more likely to have complicated pregnancies and to deliver children with physical problems than are women aged 20-34. In the Interior, 19.4% of Native children were at high-risk due to their mother's age (19 and under), while 8.7% of non-Native children were at such risk.

HIGH BIRTH RATE - For the Interior region, the Native Alaskan birth rates of 26.7 births per 1,000 population exceeds the statewide five-year annual average of 24.2 per 1,000 population by 10.8% and the national average of
15.7 births per 1,000 population by 70.1%. The Native birth rate in the Interior is very similar to that of the Interior population as a whole.

LOW BIRTH WEIGHT - The number of babies born weighing less than 5.5 pounds is an indicator of high-risk pregnancies. Natives experienced considerably higher low-birth weight rates both in the Interior (61.2%) and in the state (59.6%) than did non-Natives (48.4%, 45.5%) in 1984.

INFANT MORTALITY - Native infant death rates in Alaska and the United States have been declining for the past several years. From 1955 through 1982, the death rate for Indian infants in the U.S. fell by 82%. The rate is now similar to the U.S. population as a whole, although in Interior Alaska the experience has been more variable. Because of the small population size, cosiderable fluctuation in annual rates can occur randomly. Six-year average rates are more appropriate when studying occurrences in small communities.

The six-year (1979-84) annual average rate gives che Interior's non-Natives an infant mortality rate of 10.41 compared with a national rate 11.76. The rate for Native infants is different from non-Native infants with a rate of 19.74 for Interior Alaska Natives. The difference between the Interior Alaska Native and the national rate is 68%. The Interior's Native infants are more than half again as likely to die during infancy than were their counterparts nationwide.

SUDDEN INFANT DEATH SYNDROME (SIDS) - is the single greatest cause of death in the post neonatal infancy period. Recent research reports have linked SIDS deaths to prematernal cocaine use. One study reported a nearly 4,000% increase in SIDS incidence among infants born to cocaine-using mothers. (American Journal of Diseases of Children, May 89, Vol. 143, pg. 583). The Native mortality rate for SIDS (4 per 1,000 live births) exceeds the total national rate for all infant deaths.

PRENATAL CARE - In 1981, over 25% of pregnant women in the Northern region in Alaska did not receive prenatal care in their first trimester. The majority of women delaying care until the third trimester were Native. According to Northern Alaska Health Resources Association's Health System Plan for 1985-1989, prenatal service delivery in the Interior is not comprehensive enough and needs better coordination among service providers.

SEXUAL RELATIONSHIPS - Because of known high rates of sexually transmitted diseases and high incidence of substance abuse in rural Alaska there is great concern that HIV/AIDS will take hold and spread quickly. At the present time the diagnosed cases of AIDS is relatively low as is the number of HIV positive people. Again, according to Adolescent Health Survey, the average age of first sexual intercourse for females is 14 years of age and for males is 13.2 years. The first choice of contraception for both females and males is condoms; the second choice for females is birth control pills. Typically, as everywhere else, many teens get more misinformation than information and mostly from their peers.

PRESENT SERVICE - We have several rural alcohol and mental health programs in our subregions. We have hired more village based para-professional counselors and emphasized training for all our counselors. We have 4 alcohol recovery camps, one of which is open year round and staffed by Native people. We have emphasized family treatment as a unit and focused on traditional values. We are holding more workshops in the villages which focus on alcohol and alcohol-related problems. This year we have held 4 workshops in different villages and some of the subjects addressed are suicide, FAS, HIV/AIDS/SIDS, self-esteem, parenting, forgiving, children of alcoholics. We publish HUNK ZOO monthly, which addresses substance abuse prevention for our school age children. We have a substance abuse prevention trainer, an PAS prevention coordinator, and an HIV/AIDS prevention educator, all of whom travel constantly during the school year to reach our school age population.

We have health and safety educators in each of our subregions and we do a variety of health promotion and injury prevention activities. Yet we fall short because of lack of adequate travel funds and lack of current material. We have attempted to work with the 7 school districts within our region trying to supplement their health education.

Our youth program has been active without adequate funding. We have been able to sponsor some of our youth for our TCC Conference and we have never been sorry. These young people have already impressed us with their abilities to move ahead and address and identify issues that are significant to them.

Since the late 1800's, the influence of religious groups, traders and American government policy has contributed greatly to the breakdown of village social organization. Moreover, changes in the economic life of Native communities, from subsistence to a cash economy, have resulted in further social disruption. Poverty has also resulted in increasingly limited or resisted subsistence resources. Torn between two cultures many Natives have turned to alcohol, suicide and violence as a way of alleviating the anger and confusion of losing the old ways and of not belonging to the modern world. These trends are more pronounced among the youth.

Many in our population suffer from low self-esteem and are poor decision makers. Unfortunately because of inadequacies with school funding many of our youth are not prepared for higher education. We need to start focusing on teaching the Athabascan language in our schools along with cultural activities; we need to prepare our youth for professional and vocational training; we need more positive role models. We need to start strengthening our family unit so that the provision of spirituality and culture can be met. We need to acknowledge domestic violence, sexual/physical abuse and depression as problems and stop denying that these problems exist. We need to nurture our youth because that is where our future lies, and we need to encourage them to take an active part in their well-being and we need to address the problems and difficulties that face our male population.

SOURCES:
Alaska Dept. of Health & Social Services.
Alaska Vital Statistics Annual Report, 1984
Juneau, Alaska. 1987.

Northern Alaska Health Resources Assn.
Health Systems Plan, 1985-1989.
Fairbanks, Alaska. 1985.

The State of Adolescent Health in Alaska
Dept. of Health & Social Services
Office of Prevention
Juneau, Alaska 1989-90.

Prepared by Margaret Wilson
Community Health Services Director
Tanana Chiefs Conference
122 First Avenue Fairbanks AK 99701


This document was ocr scanned. We have made every attempt to keep the online document the same as the original, including the recorder's original misspellings or typos.

 
 

Go to University of AlaskaThe University of Alaska Fairbanks is an affirmative action/equal opportunity employer and educational institution and is a part of the University of Alaska system.

 


Alaska Native Knowledge Network
University of Alaska Fairbanks
PO Box 756730
Fairbanks  AK 99775-6730
Phone (907) 474.1902
Fax (907) 474.1957
Questions or comments?
Contact
ANKN
Last modified May 12, 2011