Disabled American Indians: A Special Population Requiring Special Considerations

It is well known that the health status of American Indians is below national averages and has been for many years. Identified health difficulties include a pattern of social problems, poverty, and disease that is unparalleled among other ethnic and racial minorities in the United States. The disabled American Indian, however, faces additional disadvantages in the form of major barriers to care and rehabilitation services. Further, the incidence of several serious disabling conditions among some tribes is thought to be well above that reported for the United States population as a whole. Fetal alcohol syndrome (FAS), bacterial meningitis, otitis media, diabetes, accidents/trauma, alcohol/drug abuse, and mental and emotional disorders cause disabilities among Indians at significantly higher rates than among non-Indians. Major disabilities include seizure disorder, developmental delay, language and speech delay, mental retardation, pulmonary disorders, vision problems, hearing loss, trauma from accidents, diabetes-related disabilities, and alcoholism. The severity of each problem, however, varies from one Indian group to another. Fetal alcohol syndrome (FAS) and fetal alcohol effect (FAE), disabling conditions which have been identified and categorized only since 1973, consist of a group of physical and developmental abnormalities present in infants, which are caused by maternal alcohol consumption during pregnancy. Characteristics of the disorder include impaired intrauterine and postnatal growth, abnormalities of facial development, and mental retardation. Cleft palate and health defects are often present as well. In the state of Alaska, to give just one example, the incidence of FAS among the native population was found to be 4.2 per 1,000, twice that reported on the Navajo reservation and in the urban Seattle, Washington area