Influenza and Pneumococcal Vaccination Among Native American Elders in a Primary Care Practice

Abstract

MORE THAN 2 million Native Americans (hereafter referred to American Indians [AIs]) and Alaska Natives (ANs) live in the United States.¹ The number of urban dwellers has increased dramatically since World War II; only 25% of AIs/ANs reside on reservations and trust lands and 60% reside in cities.¹ Although vast strides have been made in recent years, AIs/ANs still lag behind the general population for major health status indicators.² Infectious diseases such as tuberculosis and gastroenteritis have been replaced as the leading causes of death by diabetes mellitus, cardiovascular disease, and hypertension.³ It is not surprising, then, that AI/AN life expectancy is 8 years less than nonnative peoples and is accompanied by higher age-specific mortality rates than the population at large.^4,5 Yet, despite the emergence of chronic health conditions and increased mortality rates, virtually no information exists on the implementation of preventive measures among AIs/ANs.