Native American cultures include:

• American Indian
• Alaska Native and Native Hawaiian tribes

They are rich with history, tradition, spirituality and art. There are 562 federally recognized tribes across the United States. Each has its own distinctive identity. One thing many tribes share in common is alcohol problems and other health disparities.

Native Americans experience significant health issues when compared with the general population. They have higher death rates from:

• Alcoholism
• Tuberculosis
• Diabetes
• Accidents
• Suicide
• Homicide
• And other causes

Their life expectancy is 6 years lower than the U.S. average.

Native Americans have some of the highest rates of fetal alcohol syndrome in the United States. The rates are as high as 1.5 to 2.5 per 1,000 live births among some tribes. Among other tribes, the rates are comparable to that of the general population in the United States.

What is one of the most significant public health problems for Native Americans?

• Alcoholism

Native Americans are five times more likely than whites to die of alcohol-related causes. This includes liver disease. They have higher rates of drunk driving and related deaths than the general population.

Some Native American tribes are leading the way toward preventing and treating alcohol problems in Indian Country through education, training, and other strategies.

Fetal Alcohol Spectrum Disorders is an umbrella term that describes the range of effects which can occur in an individual whose mother drank alcohol during pregnancy. These effects may include:

• Physical
• Mental
• Behavioral
• And/or learning disabilities
• All with possible lifelong implications

The term, Fetal Alcohol Spectrum Disorders, is not used as a clinical diagnosis. It refers to conditions such as:

• Fetal alcohol syndrome
• Alcohol-related neurodevelopment disorder
• And alcohol-related birth defects

At least 40,000 babies are born with an FASD each year, costing the United States up to $6 billion.

Why is Fetal Alcohol Spectrum Disorders a problem among Native Americans?

• Underlying causes of health disparities are complex
• The history of Native Americans is filled with violence, oppression, displacement, and loss of self-determination
• The legacy of trauma is believed to be a factor in many problems including alcohol abuse
• Poverty and inadequate access to health care plays a role
• Native American communities are very young, with a median age of 24, which is almost 10 years younger than the overall population. This difference magnifies the impact of binge drinking and risky behaviors that are more common among youth in general.

FASD, alcoholism and alcohol abuse are very serious problems in some Native communities. However, in some tribes, alcohol uses is similar to or lower than the general U.S. population. The stereotype of the drunken Indian is misleading.

Human services are greatly needed to address FASD in Native American communities. Human services include:

• Prevention efforts

Assessment of 10 trial reservations and five urban Indian Community Health Centers showed prevention services were limited or nonexistent.

What can be done by Human Service workers and teams?

• Incorporate tribal practices, combining mainstream, evidence-based strategies with traditional elements such as talking circles and ceremonies
• Address alcohol issues in families to break the cycle of alcohol abuse
• Incorporate collaborative, holistic approaches at home and school for people with an FASD, such as training in effective parenting and teaching strategies

The Substance Abuse and Mental Health Services Administration’s FASD Center for Excellence is working with tribal leaders to:

• Develop culturally appropriate resources
• Provide training on prevention and intervention
• And identify best practices

Human service workers can build on the cultural strengths of Native American communities to support positive outcomes at all stages, from early intervention for infants to adult support services. Pregnancy is a sacred time for many Native Americans. Many tribes share the belief that individuals must consider the impact of their decisions on the next seven generations. Preventing alcohol abuse during pregnancy is a powerful way to protect future generations and ensure that all children have a healthy start, free of FASD.

“Alcohol consumed during pregnancy increases the risk of alcohol related birth defects.” (Surgeon General’s Advisory on Alcohol Use in Pregnancy, February 21, 2005.) Alcohol is a teratogen, a substance than can harm a fetus. When a pregnant woman drinks alcohol, it passes through her blood and enters the fetus through the placenta. The harmful effects of alcohol may be seen in virtually every part of the fetus, which includes:

• Brain
• Face
• Heart
• Liver
• Kidneys
• Eyes
• Ears
• Bones

These effects can affect a person’s health for a lifetime.

Source: US Department of Health and Human Services, Substance Abuse and Mental Health Administration, Center for Substance Abuse Prevention

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Written by: Connie Limon For more information about pregnancy visit: For more information about Human Services Occupations and Responsibilities, visit: