title: The meaning of death to adolescents in an American Indian community.
abstract: BACKGROUND
  A high rate of premature death exists among young Native Americans in North America. To understand the qualitative effect of this phenomenon, we undertook this study to explore the meaning of death to adolescents in a Salish American Indian community.
  
  
  METHODS
  Standard methods of ethnography were employed: community entry, open-ended in-depth interviews using key informant sampling, audiotape and field note transcription, review of field notes for key themes, and community feedback. Interviews were conducted with seven elders and 21 adolescents in a Pacific Northwestern American Indian community selected by key informants. Probe questions and narrative accounts primarily focused on personal experience with premature death among family and peers.
  
  
  RESULTS
  The primary themes in the study were the subjects' personal exposure to death, alcohol and drugs. Spirit Sickness (a culturally defined illness experience), and healing.
  
  
  CONCLUSIONS
  There are persistent beliefs in Spirit Sickness among adolescents and young adults in the Salish Indian community. Personal exposure to death is a precipitant of this potentially fatal illness experience. Clinicians working with Salish Native Americans should recognize potential beliefs in this illness experience among the youths.
authors.affiliation: Department of Pediatrics, University of Washington, Seattle.
authors.forename: D C
authors.initials: DC
authors.lastname: Grossman
authors.forename: R W
authors.initials: RW
authors.lastname: Putsch
authors.forename: T S
authors.initials: TS
authors.lastname: Inui
mesh_terms: D000293:Adolescent; D001293:Attitude to Death; D003469:Culture; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D007406:Interview, Psychological; D015205:Northwestern United States; D000297:Psychology, Adolescent