American Indians Hit Hard By Swine Flu
Map: Nationwide Reports Of Flu-Like Illness
Although H1N1 has proven less deadly than originally anticipated, it has taken a serious toll on American Indians.
According to a recent report released by the Centers for Disease Control and Prevention, the mortality rate from the virus is four times higher among American Indians and Alaska Natives than any other racial or ethnic group.
Phil Stago and his family were hit particularly hard by the virus.
They live in a tiny house in the tiny town of Winslow, Ariz., just outside the vast Navajo Nation. On a recent morning, his 2-year-old watched cartoons and snuggled with her dad. The baby rocked in a swing.
The mellow day was quite a switch from the drama the household experienced in September, when Stago says swine flu wiped out his family for a whole month.
Stago's son got it first — itchy throat, fever and aches. Then 2-year-old Alicia picked up the virus. She's feeling much better now, but when her newborn sister, Gabriela, caught swine flu, things got scary.
Stago took her to an Indian Health Service hospital nearby when her fever hit 100 degrees.
"They secluded us from her, and they put her in a little tent of oxygen," Stago says. "[We] had to wear the whole full isolation gowns and gloves and mask. That was pretty scary."
Indigenous People More Vulnerable
When patients require more intensive care than Gabriela did, they're sent to Flagstaff Medical Center, about an hour west of Winslow.
One day during the peak of the second wave of the swine flu virus, the intensive care unit was almost full of American Indians on respiratory ventilators.
The scene reflects a statewide trend. In Arizona, of the more than 1,500 people who have been hospitalized for swine flu, 13 percent have been American Indian. Yet American Indians make up only 5 percent of Arizonans.
Aboriginal Australians and First Nations groups in Canada have reported similar disproportionate findings.
There are plenty of theories as to why indigenous people are more at risk. John Redd, an epidemiologist for the Indian Health Service, says that crowding and poor housing, both risk factors for influenza, are more present in indigenous populations around the world.
In addition to poverty, Redd also points out that American Indians are prone to diabetes and asthma. When you combine swine flu with these pre-existing conditions, the outcomes are worse.
Access to health care is also an issue. There are a dozen Indian health care centers scattered throughout the Navajo Nation, but the reservation is the size of West Virginia.
Cindy Galloway, who works at a family health center that serves American Indians in the Flagstaff area, believes there are other factors contributing to the higher mortality rates.
"They are more stoic people. They don't complain, frankly," Galloway says.
She says it's typical for American Indian patients to wait until their symptoms become severe before they seek treatment.
"People will tolerate feeling bad longer and thinking it's going to go away," Galloway says. "When finally after four or five days they can't even take a deep breath, then they realize that this could be more serious."
Indian Health Service officials say many people have been exposed to swine flu or have been vaccinated now, so there's hope that the next possible wave of the virus, which could come as early as January, won't be as severe.
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So far, swine flu has proven less deadly than originally anticipated. But it has taken a serious toll on one demographic category: American Indians and Alaska Natives. They are four times more likely to die of H1N1 than members of any other racial or ethnic group. That's according to a report released this month by the Centers for Disease Control and Prevention.
Laurel Morales of Arizona Public Radio tried to find out the reasons for that disparity.
LAURA MORALES: It's a quiet morning at Phil Stago's home. He and his family live a tiny house in the tiny town of Winslow, Arizona, just outside the vast Navajo Nation. His 2-year-old watches cartoons and snuggles with her dad while the baby rocks in a swing. The mellow morning is quite a switch from the drama the family experienced in September. The Stagos were hit hard by swine flu.
Mr. PHIL STAGO: It just totally wiped them out for about a month. The whole family was sick for about a month.
MORALES: Stago says first his son got it � itchy throat, fever and aches - then 2-year-old Alicia picked up the virus.
(Soundbite of baby)
MORALES: She's feeling much better now. But when her newborn sister, Gabriela, caught swine flu, things got scary. They live in a rural desert town. Luckily, there's an Indian health service clinic and a hospital nearby. And the baby was taken to the hospital as soon as her fever hit 100.
Mr. STAGO: They secluded us from her, and they put her in a little tank of oxygen. Had to wear the whole - full isolation gowns and gloves and mask. That's pretty scary.
MORALES: Flagstaff Medical Center, about an hour west of Winslow, is a referral hospital for nearby reservations. On this day, at the peak of the second wave of the swine flu virus a few weeks ago, the intensive care unit is almost full of American Indian people on respiratory ventilators.
Pulmonologist Michael Reedy(ph).
Dr. MICHAEL REEDY (Pulmonologist): We locally are certainly seeing a large percentage of Native Americans affected.
MORALES: That's true across the state. In Arizona, of the more than 1,600 people hospitalized for swine flu, 13 percent have been American Indian. Yet American Indians only account for 5 percent of all Arizonans. In Canada, First Nation groups, and in Australia, Aboriginal tribes, have reported similar disproportionate findings.
There are plenty of theories and speculation as to why indigenous people are more at risk. John Redd is an epidemiologist for the Indian Health Service.
Dr. JOHN REDD (Epidemiologist, Indian Health Service): When you think of risk factors for influenza - crowding, for example; poor housing - those are more present in many indigenous populations around the world.
MORALES: In addition to poverty, Redd also points out that American Indians are prone to diabetes and asthma. When you combine the swine flu with these pre-existing conditions, the outcomes are worse.
Access to health care is also an issue. There are a dozen Indian health- care centers scattered throughout the Navajo Nation, but the reservation is the size of West Virginia. Native American clinical nurse manager Cindy Galloway believes there's something else.
Ms. CINDY GALLOWAY (Clinical Nurse Manager): They are more stoic people. They don't complain, frankly.
MORALES: Galloway says it's typical for an American Indian patient to wait until their symptoms become severe before they seek treatment.
Ms. GALLOWAY: And that's what I've seen, is that people will tolerate feeling bad longer and thinking it's going to go away. When finally after four or five days they can't even take a deep breath, then they realize that this could be more serious.
MORALES: Indian Health Service officials say many people have been exposed to swine flu or had been vaccinated now. So, there is hope that the next possible wave of the virus, which could come as early as January, won't be as severe.
For NPR News, I'm Laura Morales in Flagstaff. Transcript provided by NPR, Copyright National Public Radio.
