Module 2: Historical and Socioeconomic Health Risks

Goal of Module 2:
To examine the historical and sociological factors that put Native communities at increased risk for HIV infection.

Addressing HIV/AIDS is not an easy task in itself. Addressing HIV/AIDS among Native populations is even more difficult. It involves the health and psychosocial effects of many other issues: a traumatic history, homophobia and discrimination, poor communication, poverty, and substance abuse. In order to address HIV/AIDS among Native populations, it is essential to understand and respond to these historical and social barriers.
Contents

6 Poverty

This module discusses the impact of HIV/AIDS on Native Americans and the health and psychological legacies of contact and colonization.

Topics include:

  1. History and Trauma


  2. Impacts of Contact and Colonization


  3. Discrimination and Homophobia


  4. Effective Communication


  5. Biological Factors


  6. Poverty


  7. Violence and Powerlessness


  8. Trust and Lack of Confidence


  9. Substance Abuse


  10. Healthcare Funding for Native Communities


  11. Structural Barriers to Intervention/Prevention

Sexually transmitted diseases, like AIDS, tend to be diseases of poverty because they are intensified by conditions of economic hardship. Poverty limits access to health education, quality healthcare, and proper medical treatment. Thus the low economic status of many Native people places them in a potential high-risk category. The government found that a three-year average poverty rate (1998-2000) for Native Americans was similar to African Americans and Hispanics; among these, the Native rate was highest.22

Poverty is often accompanied by poor health, poor diet, diseases, and chronic stress—which weakens the immune system and leads to chronic diseases. These factors make Native people more vulnerable to HIV and AIDS. Among other diseases, tuberculosis and diabetes weaken the immune system, which in turn increases the progression of HIV to AIDS. Poverty also impacts behavior. It has been found, for example, that mothers living on a minimal budget tend to place their families first and give up treatment and medication for themselves.23,24
  • Study trends among poor Native people in your community. Consider where poor people live, where they work, general family size, and general education level.

  • Identify factors that make it hard for poor people to get healthcare. Besides lack of funds, why might poor Native people pass up health education and treatment?

22Dalaker J. Poverty in the United States: 2000. US Census Bureau; September 2001.

23Vernon I. Killing Us Quietly: Native Americans and HIV/AIDS. Lincoln: University of Nebraska Press; 2001:49.

24Campbell C. Women, Families & HIV/AIDS: A Sociological Perspective on the Epidemic in America. Cambridge: Cambridge University Press; 1999.