Activating the Heart: Storytelling, Knowledge Sharing and Relationship (Christensen, Julia, Christopher Cox and Lisa Szabo-Jones, eds.)

Review by Eva Garroutt

American Indian Science Education: The Second Step

Recent years have witnessed an expansion of culturally relevant education programs for American Indian youth. These programs, which are a response to underachievement in scientific and technical fields, focus on curricula and methods that render science more accessible to Indian students. They do so by adapting to the "learning styles," the interactional and social patterns, the common knowledge, and the community needs that may distinguish Indian students from their non-Indian classmates. Many of the resulting programs are impressive, showing monumental dedication and tremendous creativity on the part of their staff. Indian science education has taken a giant step. Now, however, there is an opportunity to take another step. This article, while applauding the achievements of culturally relevant science programs, suggests that many such programs may carry with them unintended consequences. In order to clarify this assertion, I first examine some assumptions which tend to characterize mainstream science classrooms and some of the contrasting assumptions which may appear in various American Indian traditional thought systems. I discuss some specific examples of culturally relevant science programs, showing that the tendency is to overlook or deemphasize the differences just explored. I then argue that the outcome of such neglect is likely to be that American Indian traditional knowledge is severely damaged, even destroyed. I close by considering what science programs might look like if they pressed innovations in culturally relevant programming toward a second and more dramatic step that more explicitly insists upon the legitimacy of traditional American Indian models of inquiry into the natural world

Real Indians: identity and the survival of Native America

At the dawn of the twenty-first century, America finds itself on the brink of a new racial consciousness. The old, unquestioned confidence with which individuals can be classified (as embodied, for instance, in previous U.S. census categories) has been eroded. In its place are shifting paradigms and new norms for racial identity. Eva Marie Garroutte examines the changing processes of racial identification and their implications by looking specifically at the case of American Indians

Cultural Identities and Perceptions of Health Among Health Care Providers and Older American Indians

BACKGROUND: Differences in provider-patient health perceptions have been associated with poor patient outcomes, but little is known about how patients' cultural identities may be related to discordant perceptions. OBJECTIVE: To examine whether health care providers and American-Indian patients disagreed on patient health status ratings, and how differences related to these patients' strength of affiliation with American-Indian and white-American cultural identities. DESIGN: Survey of patients and providers following primary care office visits. PARTICIPANTS: One hundred and fifteen patients ≥50 years and 7 health care providers at a Cherokee Nation clinic. All patients were of American-Indian race, but varied in strength of affiliation with separate measures of American-Indian and white-American cultural identities. MEASUREMENTS: Self-reported sociodemographic and cultural characteristics, and a 5-point rating of patient's health completed by both patients and providers. Fixed-effects regression modeling examined the relationships of patients' cultural identities with differences in provider-patient health rating. RESULTS: In 40% of medical visits, providers and patients rated health differently, with providers typically judging patients healthier than patients' self-rating. Provider-patient differences were greater for patients affiliating weakly with white cultural identity than for those affiliating strongly (adjusted mean difference=0.70 vs 0.12, P=.01). Differences in ratings were not associated with the separate measure of affiliation with American-Indian identity. CONCLUSIONS: American-Indian patients, especially those who affiliate weakly with white-American cultural identity, often perceive health status differently from their providers. Future research should explore sources of discordant perceptions

Spirituality and attempted suicide among American Indians

American Indians exhibit suicide-related behaviors at rates much higher than the general population. This study examines the relation of spirituality to the lifetime prevalence of attempted suicide in a probability sample of American Indians. Data were derived from a cross-sectional sample of 1456 American Indian tribal members (age range 15-57 yr) who were living on or near their Northern Plains reservations between 1997 and 1999. Data were collected by personal interviews. Commitment to Christianity was assessed using a measure of beliefs. Commitment to tribal cultural spirituality (or forms of spirituality deriving from traditions that predate European contact) was assessed using separate measures for beliefs and spiritual orientations. Results indicated that neither commitment to Christianity nor to cultural spirituality, as measured by beliefs, was significantly associated with suicide attempts (ptrend for Christianity=0.22 and ptrend for cultural SPIRITUALITY=0.85). Conversely, commitment to cultural spirituality, as measured by an index of spiritual orientations, was significantly associated with a reduction in attempted suicide (ptrend=0.01). Those with a high level of cultural spiritual orientation had a reduced prevalence of suicide compared with those with low level of cultural spiritual orientation. (OR=0.5, 95% CI=0.3, 0.9). This result persisted after simultaneous adjustment for age, gender, education, heavy alcohol use, substance abuse and psychological distress. These results are consistent with anecdotal reports suggesting the effectiveness of American Indian suicide-prevention programs emphasizing orientations related to cultural spirituality.USA Religion Spirituality Suicide American Indians Measurement