FAMILY VIOLENCE

AND AMERICAN INDIANS/ALASKA NATIVES:

A REPORT TO THE INDIAN HEALTH SERVICE OFFICE OF WOMEN'S HEALTH

######## Principal Investigator: Laura A. Williams, MD, and MPH 

> **RESEARCH STAFF:**
>
> Yahola Simms, II
>
> Mayra Gomez
>
> Steve Gomez
>
> Carrie Chase, MS
>
> Nicole Seraki
>
> Shawn Gonzales
>
> Susan Dominguez

Special Acknowledgements to: Kathleen Brewer, Karen Artichoker, Cecilia
Fire-Thunder, San Diego City Police Dept., San Diego County Sheriff, Dr.
Theresa Cullen, Mike Martinez and Phillip White (American Indian
librarians), Sacred Circle Staff and Cangleska, Inc., Marlin Mousseau,
Brenda Hill, Wayne Weston, Rowena Elliotte, Nancy Hanes, Dr. Carrie
Johnson, Dr. Rose Clark , and Dr. Douglas G. Peter.

######### 

######### Executive Summary

**Introduction**

Under tribal tradition and law, many American Indian and Alaska Native
communities regarded women as scared and accorded women important
political and social status. These included, for example, their role as
clan mother and owners of family home. Historically, violence against
women was not widespread in indigenous communities, and the tribal
traditional response was swift to these incidences. However, U.S.
federal policies often undermined the traditional tribal leadership, law
enforcement response, and the tribe's economic stability. In American
Indian/Alaska Native (AI/AN) communities, there is severe economic
deprivation and high unemployment, accompanied by social problems such
as alcohol and substance abuse. A violent crimes, including violence
against women, is pervasive for example, the rates of sexual assault is
higher among American Indian women than any other ethnicity in this
country. In 1999, the Bureau of Justice Statistics reported that
American Indian women suffered 7 rapes or sexual assault per 1,000
compared to 3 per 1000 amongst Black, 2 per 1000 among White and 1 per
1000 among Asians (American Indian and Crime, 1999).

**[Definition and Research of Data on Indian Health]{.underline}**

For the purpose of this study Domestic Violence (DV) is defined, as a
range of verbal to physical behaviors that cause individuals to be
fearful of the situation at hand. Domestic Violence includes physical
abuse, sexual abuse, psychological abuse, and abuse to property and pets
(Ganley, 1989). Exposure to this form of violence has considerable
potential to be perceived as life-threatening by those victimized and
can leave them with a sense of vulnerability, and helplessness (Dutton,
1992).

The term "domestic violence" or "family violence" has been used to
describe acts of violence between family members, including adult
partners, a parent against a child, caretaker or partners against elders
and between siblings. While all forms of family violence are devastating
this monograph focuses only domestic violence. In this monograph:
Domestic violence is a pattern of purposeful coercive behaviors that may
include inflicted physical injury, psychological abuse, sexual assault,
progressive social isolation, deprivation and intimidation. These
behaviors are perpetrated by someone who is or was involved in an
intimate or dating relationship with an adult or adolescent victim aimed
establishing control of one partner over the other. *Family Violence
Prevention Fund: Clinical Guidelines on Routine Screening Family. San
Francisco, CA. Violence Prevention Fund.*

There is a lack of existing data/literature in multiple areas of health
for American Indians and Alaska Natives which was evident in the
research of literatures.

**[Methodology]{.underline}**

Dr. Laura Williams was commissioned to prepare a compendium of research
on violence against AI/AN women available in the academic literature.
Research staff availed themselves to an ample variety of databases
including PsychInfo, Pubmed, Medline, The Child Abuse, Welfare, Adoption
Database, Proquest, and Women\'s Resource International, Academic Search
Elite, Genderwatch, PAIS International, Proquest, EBSCO Host, Sociofile
and Biblioline. There was also various search engines used for federal
and state documents to identify government published reports and there
were multiple sources found on the World Wide Web. Three different
research staff compared and contrasted the research articles identified
and utilized a variety of approaches to the literature search with the
assistance of two Native American librarians.

Examples of some of the search terms utilized included but were not
limited to the following:

-   DV and Children

-   DV and Native American Children

-   American Indians and DV

-   DV and Native Americans

-   DV and Tribes

-   DV and Nations

-   DV and Urban Indians

-   DV and Rural Indians

-   DV and Indian Women

-   DV and Homosexual American Indians

-   DV and Gay American Indians

-   DV and Lesbian American Indians

-   DV and Elders

-   DV and Teens/Adolescents

-   DV and Pregnancy

-   American Indians and Domestic Assault

-   Abused American Indian Women

-   American Indians and Domestic Relations

-   Reservation-based Crimes

-   American Indian Victim\'s Rights and Services

-   American Indian Victim compensation services

Additionally, there was consultation with multiple experts in the field
of D.V. to assist with identifying information and resources. These were
individuals who currently work in the area of Domestic Violence and
American Indians in a variety of health care and community settings.
American Indian community leaders were also interviewed through several
means, personal interview, telephone interview and focus groups.

######### SUMMARY OF FINDINGS

**[Summary of Research Articles and Materials Identified]{.underline}**

-   Data for the last 10 years 1992-2002 are included in this report.

## **[Total Journals from Psychology, Medical and Social Science Literature]{.underline}**

-   9940 general abstracts (70.89%) include Domestic Violence or
    analogous key words

-   2894 Native Americans/American Indian/Indigenous/Canadian Indians
    (29.11%)

***[I. Psychology Literature]{.underline}***

-   5059 general abstracts on violence on families (85.48%)

-   735 of the articles referred to Native Americans (14.52%)

***[II. Social Work]{.underline}***

-   1894 general abstracts (87.25%)

-   277 of the articles referred to Native Americans (12.75%)

***[III. Sociofiles]{.underline}***

-   2987 general abstracts (61.35%)

-   1882 of the articles referred to Native Americans (38.65%)

**[Review of General Health Data for American Indians/Alaska
Natives]{.underline}**

The health disparities are evident in this population as compared with
all other races. For example, age-adjusted death rates (1994-1996) in
the area of accidents, suicide and homicide are equal to and greater
than 50% higher when compared to the quotient: US all races (Indian
Health Service 1998-99).

In 1994-1996, the Indian Health Service age-adjusted mortality rates
were reported as being greater then the general population by the
following percentiles:

-   Alcoholism- 627%

-   Tuberculosis-533%

-   Accidents-204% \*

-   Diabetes Mellitus- 249%

-   Pneumonia and Influenza-71%

-   Suicide-72%

-   Homicide-63% \*

##### National Adult Urban Indian Mortality Data

The leading cause of death for American Indians and Alaska Natives is
disease of the heart. According to the Indian Health Trends (1998-99)
the leading causes of death:

1.  Heart Disease

2.  Cancer

3.  Accident\*

4.  Diabetes

5.  Chronic Liver Disease

6.  Cerebrovascular Disease

7.  Pneumonia and Influenza

8.  Suicide

9.  Chronic Obstructive Pulmonary Disease

10. Homicide

\*Note the categories for accident, and homicide may be reflecting data
relevant to domestic and/or intimate partner violence. Available data
from the Center for Disease Control estimates 75%, of female American
Indian homicide victims knew their assailants, and nearly a third, are
killed by family members.

**[General Socio-Demographic Data]{.underline}**

Census data indicate that there were approximately 1.8 million American
Indians or 2% of the total population of the United States in 1991.
Currently, there are over 2 million American Indians and estimates
report that there could be as many as twice that number, or 4.2 million,
in the United States by the year 2050 (U.S. Bureau of the Census, 1991).

## Demographic Factors distinguishing American Indian population are:

-   Median age nearly 8 years younger than other racial groups

-   American Indians are the most common group to report Hispanic

Ethnicity

Total Number of Federally Recognized Nations- 565 (330 Nations and 226
Alaska Native Villages). 23 Nations have State recognition only and
numerous others lack both Federal and State recognition. Note these
Nations continue to affirm their Sovereign Status.

Most Commonly Reported Nations are Cherokee, Navajo (Dene), Chippewa,
Sioux (Lakota), Choctaw, Pueblo and Apache.

There are 209 North American Native Languages.

### Regions with the Highest Number of American Indians

## 

## The American Indian population is more highly concentrated in specific areas of the country. For instance, 54.1% of American Indians live on reservations or trust lands located in the Western mountain states. More specifically, Alaska, New Mexico, Oklahoma, South Dakota, and Montana are the states with the highest percentages of Native Americans (Slater & Hall 1996). 

**[General Crime Data]{.underline}**

According to 1999 report published by US Department of Justice, between
1992- 1996 the average annual rate of comparative violent victimizations
for ages 12 and older, by ethnicity was:

-   124 per 1,000 Native Americans

-   61 per 1000 Blacks

-   49 per 1,000 Whites

-   29 per 1000 Asians

There are four types of non-fatal violent victimizations:

-   Rape/Sexual assaults

-   Robberies

-   Aggravated Assaults

-   Simple assaults

American Indians had the highest rates overall. About 7 in 10 violent
victimizations of American Indians involve an offender who is described
by the victim as someone of a different race\--a substantially higher
rate of interracial violence than experienced by white or black victims.
About half the violent victimizations experienced by American Indians
involve an offender with whom the victim had a prior relationship, about
the same percentage as found among other victims of violence.

About 1 in 6 violent victimizations of American Indians involved
offenders with whom the victim had a prior relationship.

  ----------------------- ----------------------- -----------------------
  Victim-Offender         All Races               American Indians
  Relationship                                    

  Intimates               11%                     8%

  Family Members          5%                      7%

  Acquaintances           34%                     38%

  Strangers               51%                     46%
  ----------------------- ----------------------- -----------------------

Each year 150 American Indians are murdered (equal to the per capita
rate in the general population).

American Indian victims reported their offender to be under the
influence of alcohol in 46% of all violent victimizations. American
Indians serving a sentence due to a conviction of violence reported in
about 70% of the incidents, they had been drinking.

The number of American Indians per capita confined in state and federal
prisons is 38% above the national average. However, the rate of
confinement in some local jails is estimated to be nearly 4 times the
national average. (Department of Justice Report 1999)

#### **American Indian Justice System**

Total Tribal Law Enforcement Agencies according to recent report by
Bureau Justice System identifies 135 Tribal Law Enforcement Agencies and
1,731 full-time sworn officers.

Total US Bureau of Indian Affairs Officers- 339

63,000 American Indians are under the care, custody or control of the
criminal justice system on an average day. This is approximately 4% of
the American Indian population age 18 or older

In 1997 about 16,000 American Indians were held in local jails\-\-- a
rate of 1,083 per 100,000 adults, the highest of any racial group

Multiple American Indian domestic violence experts cited that "the
tribal courts lack the infra-structure to prosecute to the highest
degree". Individuals may be sentenced to six months in jail, however,
due to lack of space may only serve one month of a six-month sentence.
One expert bluntly asked, "How do you think the women feel when they see
the perpetrator of the crime in the local grocery store? They haven't
even had time to heal from the rape or abuse and there they are right
there in front of them."

#### **Most Common Location of Crimes Involving American Indians**

About 40% of the Indian population resides in rural areas; however,
violent crime was highest in urban areas at a rate of 207 per 1,000
versus 89 per 1,000 in rural areas.

#### **Gender/Ages of American Indian Crime Victims**

-   In accordance with national distribution, 6 in 10 of the violent
    crimes experienced by American Indians had been committed against
    males.

-   52% of the violent crimes committed against American Indians
    occurred among those age 12 to 24 years.

-   2% of the violent crimes against American Indians were against the
    elderly (age 55 and older).

**[American Indians, Socio-economic levels and Crime]{.underline}**

The highest number of victimizations occurred at the highest poverty
rates of less than \$10.000 per year (182 victimizations per 1,000
persons compared to whites at 74 per 1000)

**[Intimate and Family Violence]{.underline}**

Intimate and Family Violence each account for about 9% of all violent
victimizations experienced by American Indian victims, about the same
percentage as found among all victims of violence. The National Justice
System reported this data, however, according to the Center for Disease
Control and Native American Experts in the field, no reliable data exist
on the incidence/prevalence of IPV amongst AI/AN population according to
the CDC's, National Center for Injury Prevention and Control. The 1985
National Family Violence Resurvey determined one-year prevalence rates
in the general population.

-   15.5% of 204 American Indian Couples reported violence in their
    relationship

The most striking distinction among American Indian victims of violence
is the racial difference of offenders in intimate violence incidents
when contrasted with family violence. Among violence victims of all
races, about 11% of intimate victims and 5% of family victims report the
offender to have been of a different race. However, among American
Indian victims of violence, 75% of intimate victimizations and 25% of
family victimizations involve an offender of a different race.

According to a recent article published in 2001 Journal of Family
Practice by Dr. Donald Clark, the following statistics are notable:

-   Research indicates that 30% of women in the U.S. experience DV
    sometime in their lives.

-   24% of all women going to a hospital emergency room and 30% of those
    with injuries could be victims of DV.

-   DV and pregnancy data demonstrate 3.9% to 8.3% of pregnant women
    sustain physical abuse during their pregnancy.

-   A review of female homicides in New Mexico found a
    disproportionately higher rate among Native American women. DV was
    the cause in almost 50% of Native American homicides**.**

**[CONCLUSION]{.underline}**

The literature states that gender-based trauma has emerged as one of the
most serious public health problems facing women today. As an American
Indian physician and researcher, the articles and information available
on American Indian/Alaska Natives demonstrate the severity of the
problem, however, overall all community level data is NOT readily
available. For example, for certain American Indian groups no articles
exist in the literature such as disabled American Indian women and
Domestic Violence. It is well known that AI/populations have one of the
highest rates of disabilities compared to other ethnic groups. There is
also a paucity of literature on young women and the violence perpetrated
against them such as date rape, and paucity is also evident in the elder
women literature. Only one article on pregnant AI/AN women was
identified yet it is a well documented phenomenon that pregnancy is one
of the highest risk times of Domestic Violence in a women's life cycle.
There is also no data or literature on the American Indian/Alaska Native
lesbian population.

Some of the challenges presented to American Indians/ Alaska Natives
include developing programs that collects accurate community level data
and developing interdisciplinary systems that deal directly with the
problems described in this manuscript. This is also a call to County,
State, Federal, Private Foundations assist American Indian/Alaska Native
communities in providing the support and resources necessary to
adequately address the data and program funding needs of this
population.