Preventive health care among rural American Indians in New Mexico.
BACKGROUND
Incidence of and mortality from cardiovascular disease, cancer, diabetes, and other chronic diseases are rapidly increasing among American Indians; however, the utilization of preventive services for these conditions is not well characterized in these ethnic groups.


METHODS
We interviewed 1,273 American Indian adults in New Mexico, ages 18 years and older, by telephone regarding routine health checks, including blood pressure, blood cholesterol, mammograms, clinical breast exams, Pap smears, influenza and pneumonia vaccinations, and diabetes using items from the CDC Behavioral Risk Factor Surveillance System.


RESULTS
We found that utilization of preventive service was surprisingly high among rural American Indians. Routine health checks and blood pressure checks within the past year were reported by more than 70% of the population. Blood cholesterol checks (41.1%) and pneumonia vaccinations (30.7%) were less commonly reported. Utilization of cancer screening for the most common women's cancers was also high. Most women reported ever having a Pap smear test (88.3%), a clinical breast examination (79.5%), and a mammogram (75.6%). The prevalence of diagnosed diabetes (8.8% overall and 26.4% for ages 50 years and older) greatly exceeds the nationwide prevalence.


CONCLUSIONS
The utilization of preventive services delivered by a unique governmental partnership is high among American Indians in New Mexico and, except for cholesterol screening, is comparable with rates for the U.S. population. Because cardiovascular disease is on the rise, more attention to preventive services in this arena is warranted. The high and increasing prevalence of diagnosed diabetes suggests that aggressive diabetes screening and interventions are needed.
Gilliland
F D
FD
Department of Medicine, New Mexico Tumor Registry, University of New Mexico Health Sciences Center, Albuquerque 87131, USA.
Mahler
R
R
Hunt
W C
WC
Davis
S M
SM
D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D016001:Confidence Intervals; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000517:prevention & control; D009516:New Mexico / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011159:Population Surveillance; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012494:Sampling Studies; D012737:Sex Factors; D012959:Socioeconomic Factors
D002784:Cholesterol