Native American Women
When you see a new trail,
or follow a footprint you do not know, follow
it to the point of knowing.
of Charles Eastman, Santee Sioux
The term “Native American” or “American
Indian” encompasses many tribes of
native peoples. In North Carolina alone,
there are thirteen recognized tribes and
organizations, including the Coharie, Eastern
Band of Cherokees, Haliwa-Saponi, Lumbee,
Meherrin Indian, Occaneechi Band of Saponi
Nation, Sappony and Waccamaw Siouan. There
are approximately 99,551 Native Americans
in North Carolina, about one percent of the
population (2000 U.S. Census). This number
is probably underestimated. North Carolina
is one of six states (excluding Alaska) with
the highest populations of Native Americans.
data on cancer in Native Americans is limited
because not all Native American communities
are part of cancer registries, and Native
Americans are not always identified as
such on health forms. Also, Native Americans
have a low participation rate in any type
of cancer clinical trials or research.
is the risk of breast cancer for Native
Cancer among Native Americans is
becoming a growing concern. Within the
last few generations, cancer has become
the leading cause of death for Alaska Native
women and is the second leading cause of
death among American Indian women.
good news is that Native American women
have among the lowest incidence rates
of breast cancer of the major ethnic groups.
However, their survival rates from breast
cancer are among the lowest of all ethnic
groups. For all cancers, Native American
women are much less likely to survive
than white women.
What special challenges
do Native American women face?
A lack of access to health care
often causes breast cancer detection to
come late for Native American women, leading
to their relatively poor survival rate.
Native Americans are second only to
Hispanics in lacking health insurance,
and have shortages of healthcare professionals
in many communities. Also, Native Americans
are among the poorest ethnic groups
in the United States.
The Indian Health
Service (IHS) was established to provide
federally-funded health care for Native
Americans. However, access to health
care is determined by place of residence
and degree of Indian blood or tribal enrollment.
Native Americans are not recognized,
served or counted as Native Americans
by the federal government unless they
fall within certain definitions. In
North Carolina, only one tribe, the
Eastern Band of Cherokee, is eligible
for federal Indian Health Services.
Native American women do not have medical
care close by. Even when Native American
women qualify for federal Indian health
care, mammography is relatively new to most
IHS health programs. Some IHS facilities
do not have mammography equipment, so women
have to be referred elsewhere, and
follow-up may be nonexistent. Native
American women who desire a mammogram
often go without for these and other
Many Native Americans do not have a
primary healthcare provider they see
for preventive health services or medical
Culturally, a variety of beliefs
exists on how Native Americans might
perceive the issue of cancer in their
lives. Healthcare providers working with
a Native American woman with cancer and
her family members may be unaware of
cultural differences in communication
styles and ways of discussing disease.
example, some people in the Native American
communities feel that ill health is part
of the normal aging process. American Indians
may be less likely than others to seek
out care for problems that can be treated.
What Can Native American Women
- You may choose
to have traditional beliefs and practices
as part of your total care. If you are
practicing traditional medicine in conjunction
with your doctor’s
care, let your doctor know
so that your medical care
can be coordinated. Some
traditional Native American
therapies may have effects
on some breast cancer medications
- If you are
age 40 or above, get regular mammograms
and breast exams (talk to your healthcare
provider about how often). Spread the
word to women you know to do the same.
- If you have been diagnosed
with breast cancer, think about seeking
treatment from one of the three Comprehensive Cancer Centers
in North Carolina or
from another large cancer center. See our
listing of North
Carolina Hospitals and Cancer Centers).
- If you need help paying
for mammograms or treatment, see Financial
and Other Assistance on page 127. Check your eligibility for IHS
services. If you do not
qualify for or are not near an IHS facility, check your local
health department or
community health clinic for low-cost mammography
and breast exams.
- Be an advocate for
your health care. If you have been diagnosed
with breast cancer, become informed about your diagnosis, treatment,
and long-term follow-up
care. Participate in making decisions about your care. Use
this Resource Directory
to help you learn more about your options and to find additional
resources for more information.
as much and as openly as possible with your health
care providers. If you are not comfortable talking openly
with a provider, look
for another provider whom you can trust.
- Think about joining a Native
American breast cancer advocacy
organization (See Resources).
Center for American Indian Research and
Publishes the American Indian Women’s
Cancer Resource Directory. Geared for Californians,
but helpful for women in other states.
Intercultural Cancer Council
Supports research to eliminate the unequal
burden of cancer among racial and ethnic
minorities and medically underserved populations
in the United States. Offers fact sheets
about Native Americans and cancer.
Native American Cancer Research (NACR)
303.838.9359 or 800.537.8295 (Survivors’ Network)
NACR is a community based, Native American,
non-profit resource that has educational
materials about breast cancer, breast health
and clinical trials in Native Americans,
including videos of Native American breast
cancer survivors tallking about diagnosis,
treatment and recovery. Hosts the Native
American Cancer Survivors Network at http://natamcancer.org/community.html.
Native C.I.R.C.L.E.: The American Indian/Alaska
Native Cancer Information Resource Center
and Learning Exchange
A resource center providing cancer-related
materials to healthcare professionals and
the public. Has free brochures on cancer
and breast cancer for Native Americans.
Office of Minority Health Resource Center
Call the toll-free number to order the free “Breast
Cancer Resource Guide for Minority Women.” Also
available online at www.omhrc.gov/omhrc/publications/bcrg2005.pdf.
Books and More
The Acorn Gathering: Writers Uniting Against
Cancer, by Jan and Shawna Chandler, Huda
Orfali, Duane Simolke, Timothy Morris Taylor
and Bill Wetzel (2002). Native Americans,
Hispanics, African Americans, and gays write
essays of the fight against cancer, prejudice
“Stories of My Sisters: Interviews
with Alaska Native Breast Cancer Survivors” (1996).
This free video features interviews with
a number of Alaska Native breast cancer survivors,
discussing diagnosis, screening, support
and survivorship. Contact Native C.I.R.C.L.E.,
877.372.1617 or www.mayo.edu/nativecircle.
Through the Looking Glass: Breast Cancer
Stories Told by Northern Native Women, by
Lorelei Anne Lambert Colomeda (1996). A book
about breast cancer and the health of Native
Americans. Describes the complexity of health,
environment, spirituality and survival of
Native American women.
Clinical Trials Education for Native Americans
Site has online lessons about clinical trials
for Native Americans.
Medline Plus: Native American Health
Covers news, nutrition, screening, research,
organizations, statistics and other issues
specific to Native Americans.
Native American Healing,
from the American Cancer Society
From home page, enter “Native American
Healing” in the Search box at upper
right and click, “Go.” This complementary/alternative
therapy page describes Native American healing
and how it can benefit as complementary therapy
North Carolina American Indian Breast Health
This project of the Carolina Mammography
Registry aims to get an understanding of
breast health in North Carolina’s American
Indian women. If you are 40 years of age
or older, see the website to complete the
North Carolina Commission of Indian Affairs
Has links to information and resources for
Native Americans in North Carolina. Lists
the thirteen recognized tribes and organizations
in North Carolina.
Triangle Native American Society
Includes links to Native American organizations
and resources across North Carolina.