User:Rossc936/sandbox

Race and health in the United States

Introduction to C's Part (Native Americans)
Note to peer editor:

Hello, thank you for reading my sandbox! I arranged it so I took the relevant part of the main article and copy and pasted it here. My changes are in bold (but the only subsections I added were trends, inequalities in healthcare, and environmental). I originally tried to make citations as I went, but I realized that converting that to the main article would be more than copy-and-paste, so instead I've added the links and will convert those to real citations when I add it to the main article.

I would greatly appreciate a note about whether or not to expand the sections, especially the environmental one. I could add specific examples of things that affect them.

Bibliography for Native American Section (C):

Alcoholism: https://pubs.niaaa.nih.gov/publications/arh22-4/253.pdf

General health differences & causes of death: https://www.ihs.gov/newsroom/factsheets/disparities/

Environmental Health: https://www.apha.org/-/media/files/pdf/topics/environment/partners/tpeh/priorities_tribal_health_2018.ashx?la=en&hash=C06951A62A5E215BE6C99442A9E1E9DDD060B7C6

Part copy & pasted from the Article to my Sandbox (will most likely put edits in bold to keep track):

History[ edit]
American Indian and Alaska Native populations in the United States have experienced disproportionately negative health outcomes compared to non-Hispanic whites since colonists arrived at the continent in the 15th century, particularly due to epidemics introduced by colonial groups and violent encounters with colonists. A disparity in health outcomes between American Indians and Alaska Natives and the general U.S. population persists today, largely due to a lack of access to adequate medical care, language barriers, and decreased quality of medical services in regions with significant American Indian and Alaska Native populations. '''One of the elements of the inequality involves the lack of research that begins to look into access to medical care for Native Americans, and when research does exist, it tends to be broad and not focus on specific elements, including childhood. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567901/ ) As of October 2019, American Indian and Alaska Native people who are born today have a life expectancy of 73 years, compared to the 78.5 years for the general American population. (2)'''

The Indian Health Service (IHS) is a federal agency committed to serving the health needs of American Indian and Alaska Native populations. Two pieces of legislation, the Snyder Act of 1921 and Indian Health Care Improvement Act of 1976, obligated the United States government to provide healthcare to federally recognized Native American tribes. This responsibility moved to the IHS, housed under the U.S. Department of Health and Human Services, in 1955. The IHS currently serves over 2.3 million American Indians and Alaska Natives population from 573 different federally-recognized tribes.

Since its implementation, IHS has been criticized for its treatment of patients. Most notably, throughout the 1960s and 1970s, IHS forcibly sterilized thousands of American Indian and Alaska Native women. A study by the General Accounting Office of the United States government found that, between the years of 1973 and 1976, physicians at four IHS facilities – those in Albuquerque, Oklahoma City, Phoenix, and Aberdeen, South Dakota – sterilized a total of 3406 women, 3001 of which were of childbearing age at the time of sterilization.

The federal government has also been criticized for the lack of funding granted to IHS. Expenditures per capita for IHS have been substantially lower than those for other federally funded healthcare programs. Studies have found that physicians employed by IHS express a need for increased funding for the agency to adequately meet the healthcare needs of American Indians and Alaska Natives in the United States.

Because IHS serves only federally-recognized tribes, not all people in the United States that identify with this racial group have access to IHS resources. The American Indian and Alaska Native population includes, but is not limited to, those who are affiliated with federally recognized tribes – there are also state recognized tribes and unrecognized tribes, and individuals who do not live on tribal lands but identify as Native American. Thus, while IHS plays a role in the health outcomes of American Indian and Alaska Native identifying people in the United States, it is not the sole determinant of health outcomes for this census group.

Mental health[ edit]
American Indian and Alaska Native identifying people are more likely to have unmet mental health needs and to experience major depressive episodes than the non-Hispanic white population. Compared to only 5.4% of the non-Hispanic white population, 6.7% of American Indian and Alaska Native adults reported having needs for mental health services that had been unmet in the last twelve months. Furthermore, 8.3% of American Indian and Alaska Native adults reported experiencing a major depressive episode in the past twelve months, whereas only 7.4% non-Hispanic white adults did so. American Indian and Alaska Native adolescents are also more likely to have experienced a major depressive episode in their lifetime, with 16.7% of adolescents reporting such an episode compared to 14.4 of non-Hispanic white adolescents. The 2014 White House Report on Native Youth noted that Native Americans between the ages of 15 and 24 years were 2.5 times more likely to commit suicide than the national average (https://boardingschoolhealing.org/education/impact-of-historical-trauma/ ) Rates of post-traumatic stress disorder (PTSD) are also higher for American Indians and Alaska Natives than the general United States population.

'''Historical trauma is also an issue faced by Native Americans. Dr. Maria Yellow Horse Brave Heart first described historical trauma for Native Americans in the 1980s as, "cumulative emotional and psychological wounding", which in turn affects both physical and mental health. The traumatic events she references include imprisonment and genocide, among other causes. She outlines the six steps of the historical trauma as follows: 1) First Contact (including the grieving period and following colonization period), 2) Economic Competition, 3) Invasion (causing more death and grieving), 4) Reservation Period, 5) Boarding School Period (focusing on the destruction of cultural aspects, including family structure and language), and 6) Forced Relocation. (https://dodgingbullets.org/historical-trauma-the-effects-of-learned-helplessness-in-american-indian-children-2/ ).'''

Some critics of current mental health practices have argued that mental health professionals working with American Indian and Alaska Native communities should adjust their practices to patients' cultures, particularly by increasing attention to spirituality. There have also been efforts to increase understanding of how the symptoms of DSM-recognized disorders may differ in indigenous communities as a result of different cultural practices.

American Indian and Alaska Native youth are slightly less likely than non-Hispanic white youth to receive specialty mental health services, they are significantly more likely to receive non-specialty mental health services such as counseling from social workers, school counselors, and pediatricians."See Main Article: Alcohol and Native Americans"'''(insert link to main article about Native Americans and alcoholism) Alcoholism in American Indian and Alaska Native populations has often been studied, although the rates found depend on both the statistics used and how the statistics are divided. One study from 1995 found that 26.5% of deaths for American Indian and Alaska Native men were alcohol related, while about 13.2% were for women. Another study from 1996 found that in 1993, 34% of adolescents (grades 7-12) reported they had ever been drunk. Historically, the perceived rates of alcoholism in Native Americans lead to the myth that they are genetically more prone to alcoholism. This myth has been called into question, with modern researchers instead focusing on how historical trauma and PTSD are correlated with alcoholism.'''

Maternal and child health[ edit]
Maternal mortality rates are 4.5 times higher for American Indian and Alaska Native women than they are for non-Hispanic white women in the United States. Between 2008 and 2012, 5.3% of American Indian and Alaska Native women giving birth were diagnosed with gestational diabetes compared to just 3.7% of non-Hispanic white women.

American Indian and Alaska Native women also are less likely to receive prenatal care than non-Hispanic white women in the United States. Only 60.4% of American Indian and Alaska Native women receive prenatal care in their first trimester, compared to 81.6% of non-Hispanic white women. Additionally, American Indian and Alaska Native women are significantly more likely to not begin receiving prenatal care until their third trimester – 9.3% of American Indian and Alaska Native women compared to 2.9% of non-Hispanic white women. Whereas only 0.8% of non-Hispanic white women do not receive any prenatal care throughout their pregnancy, 2.3% of American Indian and Alaska Native women go entirely without prenatal care.

The infant mortality rate for American Indian and Alaska Native populations also exceeds that of non-Hispanic white identifying people in the United States. American Indians and Alaska Natives experience an infant mortality rate of 8.4 per 1000 live births, compared to 4.1 per 1000 non-Hispanic white live births. Additionally, 15.2% of infants born to American Indian and Alaska Native women are born prematurely compared to just 10.7% of infants born to non-Hispanic white women.

Environmental Racism
'''Native American tribes in 2012 occupied 95 acres of various ecosystems across the United States. Climate change affects the wildlife and resources that many tribes rely on, and activities such as fracking threaten their access to clean water. Alaskan Native Americans use surrounding resources for approximately 80% of their diets and have faced coastal flooding as a result of climate change, so they are an especially vunerable group (https://ehp.niehs.nih.gov/doi/pdf/10.1289/ehp.118-a64). The tribes will sometimes be willing to stay on the same land they have occupied for many years, even if the environment becomes threatening, which leads to health problems such as consuming contaminated water(https://www.yaleclimateconnections.org/2012/06/native-americans-and-a-changing-climate/).'''

'''One of the most recent examples of environmental effects on American Indian and Alaska Native people is the Keystone XL Pipeline affair, which involves a 1,200 mile pipeline crossing through the territory of the Fort Belknap Indian Community of Montana and the Rosebud Sioux Tribe South Dakota. While then-President Barack Obama halted construction in 2015 following protests citing fears of water contamination and the lack of research on the impact for Native communities, President Donald Trump approved construction shortly upon entering office. In 2018, Native groups put forward a lawsuit against the 2017 permit citing a failure to respect historically-established borders and to conduct a risk assessment(https://www.npr.org/2018/09/10/646523140/native-american-tribes-file-lawsuit-seeking-to-invalidate-keystone-xl-pipeline-p). In October of 2019, over 380,000 gallons of crude oil were spilled by the Keystone Pipeline in North Dakota, affecting nearby wetlands (https://nypost.com/2019/10/31/nearly-400000-gallons-of-oil-spill-from-keystone-pipeline-in-north-dakota/) '''

Inequalities in Health Care
'''Native Americans face issues when trying to receive healthcare, including a lack of funding for medical programs, and a lack of qualified medical professionals within reasonable distance, especially with particularly secluded tribes. ('''https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/native-american-crisis-in-health-equity/).

Trends
[figure out how to add table from citation 2 about causes of death]

Beginning of Darren's Part
History

Italicized parts are what I wrote.

Asian Americans have been a prominent group in the United States for the past 200 years. According to the U.S. Census Bureau, there were estimated to be more than 22 million Asian Americans in the United States as of 2018.[115] The five most prominent subgroups amongst Asian Americans are: Chinese Americans, Indian Americans, Filipino Americans, Vietnamese Americans and Korean Americans.[116]

Asian immigration in large numbers began in the 19th century with significant populations of Chinese Americans, Korean Americans and Japanese Americans entering the United States. However, in the 20th centuries, other groups such as Indian Americans began to immigrate in larger numbers due to more specialized jobs available in the United States.[117]

Asian Americans have often been subject to racism like other minority groups within the United States. This can be seen in events like the Japanese Internment camps like Camp Manzanar that were built during World War II for Japanese Americans to live in and were subject to inhumane treatment.[118]

As Asian Americans have not been coming to America in the numbers of Hispanic immigrants and African Americans, there have been less instances in which they have been used in medical trials and unfairly compensated. In addition, as the wave of migration of Asians to the United States has happened more recently, the history of this group in the United States is relatively young. As a result, there have not been governmental efforts to address health disparities between Asian Americans and the general populations like there have been with other groups like Hispanic Americans, African Americans, and Native Americans.[119]

Asian Americans are the fastest-growing major racial or ethnic group in the United States according to a Pew Research Center analysis of U.S. Census Bureau data ''. As this race has become more of an integral part of US population more initiatives have been implemented such to address health needs specifically such the Initiative on Race implemented by President Clinton to eliminate health disparities in and among all racial and ethnic groups  Further research within the past 20 years has shown that Asian Americans are at high risk for hepatitis B, liver cancer, tuberculosis, and lung cancer, among other conditions . The Asian American cancer burden is unique as the are the only racial/ethnic population to experience cancer as the leading cause of death and it has unusual aspects such as experiencing proportionally more cancers of infectious origin, such as human papillomavirus‐induced cervical cancer, hepatitis B virus‐induced liver cancer, and stomach cancer, than any other racial/ethnic population and, at the same time, experiencing an increasing numbers of cancers associated with “Westernization.” Similarly, Asian Americans have  a heightened risk of type 2 diabetes as its presence makes up 21% of the Asian American population, twice as high as non-Hispanic whites . Finally, Cardiovascular disease, the leading cause of death for all Americans, continues to disproportionally affect the Asian Americans who are disadvantageous in society due to various social determinants. These social determinants leading to health disparity include but not limit to lack of language proficiency, health illiteracy due to lower education attainment, racial discrimination, economic instability and poor community engagement.''

Maternal and child health

In 2002, it was reported that Asian American births accounted for 5.2% of the births in the United States. One study that compared births among Indian Americans and non-Hispanic white Americans revealed that Indian Americans had significantly lower birth weights than did non-Hispanic white Americans. It was also revealed that Indian American mothers and non-Hispanic white American mothers had similar rates of adequate prenatal care.[120] In addition, when the infant mortality rates were compared between the groups, Asian Americans (excluding Pacific Islanders) had a lower rate than did non-Hispanic white Americans. However, Pacific Islanders had an infant mortality rate that was much higher than did the Asian Americans and the non-Hispanic white Americans.[121] Similarly, Asian Americans had a maternal mortality rate that was lower than that of non-Hispanic whites as well as the national average in the United States.

The demographic overview of Asian Americans shows that the birth rate for Asian American and Pacific Islander women is higher than for all other groups except Hispanic women, those mothers tend to be older on average than mothers of other races with the highest rate of births occurring among women aged 30-34 years, older than for other groups, and teen birth rates are overall lower for this population.  

''One of the main concern remains the disparity of prenatal care utilization among Asian American women in communities across the United Sates and research has shown that subgroups of Asian American mothers are less likely than others to receive early and adequate prenatal care. According to HealthIndicators.gov, explaining the data, “APNCU is a measure of prenatal care utilization that combines the month of pregnancy prenatal care begun with the number of prenatal visits. Rates can be classified as “intensive use,” “adequate,” “intermediate,” or “less than adequate.” For this measure, adequate prenatal care is defined as a score of either “adequate” or “intensive use.””''

On a more positive note, The rate of mortality for Asian American and Pacific Islander babies is 4.78 per 1,000 live births, lower than what is found the general population.

Mental health

There are not many studies concerning mental health outcomes among Asian Americans. Mental health in this group is reported to be relatively better than that of the general population. The Chinese American Psychiatric Epidemiological Study (CAPES) was commissioned to determine the incidence of mental health problems in the DSM III in Chinese American populations. The results of the study showed that roughly 4.9% of the population of Chinese Americans experienced depression this compares to 17.1% of White Americans were classified as clinically depressed.[122] However, this may not be entirely indicative of the true trends with respect to mental health in the population of Asian Americans. According to the NGO Mental Health in America, 5.4% of Americans identify as Asian American, and 13% of this population reported having a diagnosable mental illness in the past year.[123] This proportion of Asian Americans experiencing depression is lower than that of non-Hispanic white Americans. This may be a result of underreporting or lack of diagnoses in the Asian American community due to cultural stigmas surrounding mental health. [124]

''Further the cultural factors play an important role in assessing the statistics related to mental health in this population. Mental illness is highly stigmatized in many Asian cultures, so symptoms are likely underreported. Asian Americans thus express more somatic symptoms than their European American counterparts when under mental or emotional distress. Because of this kind of cultural variation in mental disorders and expression of symptoms, lack of health care access, and an underutilization of mental health resources, researchers have difficulty obtaining accurate statistics about Asian American mental health''

''Further, many of the Asian American are prone to the same conflicts from language barriers a different language and intergenerational conflicts. For instance, a varying English proficiency among immigrant Asian parents can be a source of conflict between parents and children. One study shows that in immigrant Chinese families, the level of English proficiency in the parental generation correlates with indicators of child and adolescent psychological well-being.''

Beginning of Jillian's Part
Jillian please copy and paste here