Elizabeth Knurek, MPH, Health Services Division, Inter-Tribal Council of Michigan, Inc, 2956 Ashmun Street, Sault Ste. Marie, MI 49783-9286, 906.635.4208, elizabeth@itcmi.org

Statement of problem: Infant mortality rates among Native Americans in Michigan are 2 to 3 times higher than rates for Whites. Similar disparities in infant mortality and other perinatal indicators exist in other Native populations across the country, including Native Hawaiians. Awareness of these disparities and further understanding of the unique underlying contributing factors have been hampered by data challenges and a lack of visibility of Native issues.

Methods: Summary data from six Healthy Start projects serving Native populations, including Hawaii, was reviewed. Additional national level data for Native populations was also reviewed. For more in depth analysis, State vital record data from MI was matched with data from the Maajtaag Mnobmaadzid Healthy Start program.

Findings: Native populations experience similar disparities in infant mortality and other perinatal indicators such as prenatal care use and maternal smoking. In reviewing national and local data, domestic violence, in particular, emerges as a strong underlying factor. Birth weight issues vary by population, with disparities evident in rates of both high and low birth weight. The goal of Healthy Start is to close the racial disparity gaps and to improve perinatal outcomes. Analysis of race specific multi year averages suggests that while these disparities persist, the infant mortality rate gap between Native Americans and Whites is closing in Michigan. The ability to attribute this improvement to the Healthy Start program remains challenging. While initial analyses failed to demonstrate a program effect, additional years of data may provide the statistical power necessary to establish an effect.

Learning Objectives:

• Participants will be able to identify perinatal indicators for which Native populations experience high disparity
• Participants will gain understanding of the specific data challenges that exist when studying perinatal outcomes for Native populations
• Participants will be able to identify perinatal outcome trends common to Native Americans and Native Hawaiians.

Keywords: Perinatal Health, Indigenous Populations

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Inter-tribal Council of Michigan HRSA, MCHB, Healthy Start
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am an employee of the Inter-tribal Council of Michigan, which receives grant funding from HRSA