This is the final report from the Navajo Area Indian Health Service (IHS) on mortality patterns and hospitalized morbidity on the Navajo Indian Reservation. The primary purpose of the study was to document changing causal patterns of morbidity and mortality of the Navajo in order to apprise the IHS of the types of services that are currently most needed, and of needs which may be projected in the near future. The data presented in this study was derived from three sources. The first came from the hospital discharge records of all Navajo patients seen in the IHS and IHS contract hospitals in the IHS Navajo, Phoenix, and Albuquerque Areas from 1972 to 1978. The second data set was population estimates of Navajos residing in different land management districts on the Reservation in 1975. The third set was economic data gathered from a random sample of households from each management district in 1974. The descriptive details of mortality and morbidity are presented in charts and graphic representations. The socioeconomic data were analyzed through multiple stepwise regression, and are presented in a set of regression tables. Relevant comparative and historic demographic data were drawn from the literature and presented in a series of charts and tables. The major findings of the study are as follows: 1) Navajo children's physical health has improved since 1955; 2) the health of elderly patients has declined; 3) preceding observations may be explained as much by changing family, social, and economic patterns, as by any changes in the administration of Indian health care; 4) the incidences of infectious diseases has declined; 5) the instances of accidental death and injury, and mental health related problems have increased; 6) socioeconomic factors impact upon the Navajos in causal terms for most categories of disease or accident; and 7) these same factors affect the Navajo's ability or inability to make themselves available to services. The authors suggest that services be expanded to provide care to the chronically ill and elderly both at home and in nursing homes. In addition, they recommend that IHS prepare to manage programs designed to provide services to children with behavioral, learning, and emotional problems. These children may be referred by families or the schools, which would require institutional linkages and community education programs. The report concludes by suggesting that the development of large scale extractive industries on the reservation increases the opportunity for occupational and environmental hazards, which may have direct impact on the health of the population.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-04).
Kunitz SJ. Temkin-Greener H. Changing patterns of mortality and hospitalized morbidity on the Navajo Indian Reservation. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-04). 1980