American Indians need the Voice of Epi

Commentary on:

Treatment with Respect to Tradition

By DIANE COCHRAN, Billings Gazette, April 12, 2009

Epidemiology may not be able to determine definitive answers for an individual’s health, but it can certainly give a voice to people’s health. Statistics speak loudly. Unfortunately, they are thrown around so often that people have become calloused to numbers. They tell you silly statistics to combat your hard earned statistics, “90% of statistics are false.” When read in context, it usually only requires an ounce of common sense to decipher bogus figures from well-planned studies.

“People from native cultures live an average of 2.4 fewer years than do Americans of all other races. Their disease rates, especially for diabetes, are significantly higher, as is their infant mortality rate.”

I don’t doubt it. I’m surprised it’s not even more than that. Does that include the skyrocketing number of teenage suicides? I heard diabetes is endemic with American Indians. Are there trends in different tribes? What is being done to bridge this gap? Ask questions.

“American Indians are much more likely to die from diabetes, accidents, homicide, suicide, and alcoholism than are other Americans, partly because they are half as likely as people in other populations to received needed medical care.”

Oh look, the next paragraph addresses a number of my questions and confirms a few hypotheses that I raised. In fact, I have even more questions now. The power of epidemiology rests solely on the shoulders of the DATA – the quality, the robustness, the timeliness. How are programs to be evaluated? What are the most important outcomes of our health system? It usually doesn’t take high-level complicated multivariate analyses to realize that some of the most dire circumstances have been in front of our faces the entire time.

It is only when you have the numbers that you can begin to advocate for marginalized societies who can’t speak up for themselves. It is only when you have the numbers that you can say, ‘We shouldn’t be sleeping at night because the disparities are so great.’ It is only when you have the numbers that you can say, high mortality rate is the symptom – the real disease is unemployment. And from there, you’re not using antibiotics or surgery to rescue one, but you’re using policy and grassroot programs to prevent entire groups of people from jumping into the proverbial river.