title: Female Sterilization and Poor Mental Health: Rates and Relatedness among American Indian and Alaska Native Women.
abstract: OBJECTIVE
  To describe the reproductive and mental health of American Indian and Alaska Native (AI/AN) women, an understudied population.
  
  
  METHODS
  Data from the 2004 Behavioral Risk Factor Surveillance System survey were analyzed to determine the 1) prevalence of female sterilization among a nationally representative sample of reproductive age AI/AN women and 2) the association of female sterilization and poor mental health among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women.
  
  
  RESULTS
  Nearly 25% of AI/AN women reported female sterilization, a prevalence higher than the comparison racial/ethnic groups (p < .005). Adjusting for sociodemographic characteristics, AI/AN women reporting female sterilization had nearly 2.5 times the odds of poor mental health compared with AI/AN women not reporting female sterilization (p = .001). The same magnitude of relationship between female sterilization and poor mental health was not found for non-Hispanic White, non-Hispanic Black, and Hispanic women.
  
  
  CONCLUSIONS
  The prevalence of female sterilization is greater among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women, and AI/AN women reporting female sterilization have higher odds of reporting poor mental health. Common cultural experiences, such as a shared ancestral history of forced sterilizations, may be relevant, and could be considered when providing reproductive and mental health services to AI/AN women.
authors.affiliation: University of California, Berkeley, School of Social Welfare, Berkeley, California; University of California, Berkeley, School of Public Health, Berkeley, California. Electronic address: christinacackler@gmail.com.
authors.forename: Christina J J
authors.initials: CJ
authors.lastname: Cackler
authors.affiliation: University of California, Berkeley, School of Social Welfare, Berkeley, California.
authors.forename: Valerie B
authors.initials: VB
authors.lastname: Shapiro
authors.affiliation: University of California, Berkeley, School of Public Health, Berkeley, California.
authors.forename: Maureen
authors.initials: M
authors.lastname: Lahiff
mesh_terms: D000328:Adult; D000072957:Alaska Natives / Q000523:psychology* / Q000706:statistics & numerical data; D040343:Behavioral Risk Factor Surveillance System; D044383:Black People / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D004930:Inuit / Q000523:psychology* / Q000706:statistics & numerical data; D008603:Mental Health / Q000208:ethnology*; D008875:Middle Aged; D015995:Prevalence; D013245:Sterilization, Reproductive / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American