Despite decades of research on the many health challenges facing Native Americans, no book has taken a comprehensive look at the health of Native American women – until now.
Researchers Jennie R. Joe and Francine C. Gachupin with the department of family and community medicine at the University of Arizona College of Medicine-Tucson are editors of "Health and Social Issues of Native American Women," recently released by Praeger Publishers.
Seventeen of the 18 researchers whose articles are included in the book are Native American.
Joe, who is Navajo, was director of the family and community medicine department's Native American Research and Training Center, or NARTC, from 1986 until July 2012 and now is professor emeritus of family and community medicine.
Gachupin, of Jemez Pueblo, joined the department in October 2012 as assistant director of NARTC. She also is assistant director of the Cancer Health Disparities Institute at the UA Cancer Center.
Both women are widely respected for their work with tribes throughout the United States, and Praeger Publishers approached them with the idea for the book.
"They wanted to hear from Native American women, from their perspective, about the problems the women are facing and trying to solve," said Joe. "I remembered that some years ago I was asked to write an article on the health of Native American men. So I went through the literature and I realized there's really nothing out there about the women. So this is our effort to fill a gap. And hopefully it will lead to (other books), because I think the interest is there."
Looking back a generation, Joe and Gachupin note some improvement in the health of Native American women.
"Maternal and child health has greatly improved, and so has treatment of infectious disease," Joe said. "But chronic diseases have become much more visible, and a lot of it is due to early onset of diabetes."
Some Arizona tribes have the highest incidence of diabetes in the world. Type 2 diabetes, previously diagnosed only in adults, now is common in children, more so among Native American children. For that reason, in 1991 and every year since, NARTC has hosted a week-long summer Wellness Camp for Arizona Native youth who have diabetes or are at high risk of developing the disease. The camp is attended by 30 or more youths each year.
Joe considers diabetes to be the most pressing health issue facing Native American women. "The reason I say that is because it's becoming more of an inter-generational problem," she said. "And if the mother and the grandmother and the daughter all have diabetes, it's a tragic situation. In the home, decisions about health care and what gets served at the table often rest with the woman. But poverty is a factor, and the cost of healthy food and the cost of other lifestyle changes that are recommended, like working out at a gym."
And there are other cultural factors, Joe said: "In some cultures, having a little more weight makes you more attractive because it says you come from a home that can afford enough food on the table."
Gachupin agrees that diabetes is a major health crisis for Native American women, but she lists many other problems – depression and anxiety, substance use, heart disease, domestic violence, cancer, arthritis and asthma – and concludes that Native American women are less healthy today than they were a generation ago. "Back then, more women relied on traditional diet," she said. "And they walked more, instead of just getting in a car and driving to wherever they needed to go."
Gachupin hopes the new book will lead to greater awareness about the challenges that Native American women face. "But also their resiliency," she said. "Native American women still serve as the focal point within the family, and they have the strength to persevere and carry the family forward."
The book's authors themselves are testament to that, she said: "They have really come from challenging backgrounds themselves and still have been able to seek education to better their families and their communities and be role models for their children."
Other UA authors who contributed to "Health and Social Issues of Native American Women" are Teshia G. Arambula Solomon (Choctaw Nation of Oklahoma), director, NARTC; Carol Goldtooth-Begay (Navajo Nation), graduate research assistant, NARTC; and Nina S. Wampler (Eastern Band of Cherokee), assistant research scientist, department of family and community medicine.