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**

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**

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**

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

## Total Journals from Psychology, Medical and Social Science Literature

· 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***

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

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

***II. Social Work***

· 1894 general abstracts (87.25%)

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

***III. Sociofiles***

· 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**

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**

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**

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.

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**

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**

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**

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.

Family Violence1.docPage 1 of 3