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Objectives. To examine food insecurity and cardiovascular disease-related health outcomes among American Indians (AIs) in rural Oklahoma. Methods. We surveyed a cross-sectional sample of 513 AI adults to assess food insecurity domains (i.e., food quality and quantity) and obesity, diabetes, and hypertension. Results. Among AIs surveyed, 56% reported inadequate food quantity and 62% reported inadequate food quality. The unadjusted prevalence of diabetes (28.4% vs 18.4%), obesity (60.0% vs 48.3%), and hypertension (54.1% vs 41.6%) was higher among participants with inadequate food quantity than among those with adequate food quantity. These associations did not reach statistical significance after adjustment for age, gender, study site, education, and income. The unadjusted prevalence of obesity (60.7% vs 45.8%), diabetes (27.3% vs 18.8%), and hypertension (52.5% vs 42.5%)was higher among those with inadequate food quality than among those with adequate food quality, even after adjustment for age, gender, study site, education, and income. Conclusions. Tribal, federal, and state policymakers, as well as businesses and nonprofit organizations, must collaboratively take aggressive action to address food insecurity and its underlying causes, including improving tribal food environments, reducing barriers to healthy foods, and increasing living wages. [ABSTRACT FROM AUTHOR]

The author discusses the need for the improvement of health disparities among Native Americans living in the U.S (or American Indians and Alaska Natives). Topics include the life expectancy of Native Americans, which is the lowest of any racial or ethnic group in the U.S., the efforts of tribal communities and the National Institutes of Health (NIH) to implement the Interventions for Health Promotion and Disease Prevention in Native American Populations initiative, and the mistrust for medical research of many tribal communities.

Objectives. To better understand patterns of initiation among American Indians we examined age-related patterns of smoking initiation during adolescence and young adulthood in 2 American Indian tribes. Methods. We used log-rank comparison and a Cox proportional hazard regression model to analyze data from a population-based study of Southwest and Northern Plains American Indians aged 18 to 95 years who initiated smoking by age 18 years or younger. Results. The cumulative incidence of smoking initiation was much higher among the Northern Plains Indians (47%) than among the Southwest Indians (28%; P<.01). In the Southwest, men were more likely than women to initiate smoking at a younger age (P<.01); there was no such difference in the Northern Plains sample. Northern Plains men and women in more recent birth cohorts initiated smoking at an earlier age than did those born in older birth cohorts. Southwest men and women differed in the pattern of smoking initiation across birth cohorts as evidenced by the significant test for interaction (P=.01). Conclusion. Our findings underscore the need to implement tobacco prevention and control measures within American Indian communities. [ABSTRACT FROM AUTHOR]