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Preventable disparities between AI/ANs and Whites in maternal and infant health status persist.

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The incidence of hip fracture in nursing home residents far exceeds that in noninstitutionalized older people. Linkage of MDS and Medicare hospital claims data is a useful tool for epidemiological surveillance regarding events in nursing homes that are likely to result in hospitalization.

A high proportion of Navajo women with GDM progressed to NIDDM. Postpartum counseling and periodic GTTs are recommended.

We conclude that the simpler case ascertainment and data collection strategies employed by NRMI 2 result in process and outcome measures that are comparable to the more rigorous methods utilized by the CCP. Outcomes that are more difficult to measure from retrospective chart review such as stroke and recurrent myocardial infarction must be interpreted cautiously.

Obesity is a particularly important challenge to the health status of Native Americans. This challenge is manifest in the increasing rates of non‐insulin‐dependent diabetes mellitus among Native Americans. Most studies of Native American infants, preschool children, schoolchildren, and adults have confirmed a high prevalence of over weight Historical studies suggest that for many Native American communities the high rates of obesity are a relatively recent phenomenon. The specific reasons for the increase in obesity among Native Americans have not been determined, although it has been hypothesized that Native Americans have a genetic predisposition to over weight in a “westernized” environment of abundant food and decreased energy expenditure. Few detailed studies of diet or of physical activity levels of contemporary Native Americans have been published. Community‐based interventions to modify diet and activity levels to prevent obesity in Native American communities are needed. Preliminary evidence from two formative school‐based programs in the Southwest suggest that Native American communities are receptive to school‐based interventions, and that such programs may be able to slow the rate of excess weight gain and to improve fitness in schoolchildren. Because of the cultural diversity among Native Americans, future studies should focus on collecting community‐ and region‐specific data, and should emphasize the need for obesity prevention through culturally appropriate community‐and school‐based behavioral interventions.

A survey measuring heights and weights of 1969 schoolchildren residing on the Navajo Indian Reservation was conducted in 1989. The findings were compared with National Center for Health Statistics (NCHS) reference data and with surveys of Navajo children from 1955, 1968, and 1981. Approximately twice as many children exceeded the 95th percentile of weight-for-age (11.2% of girls, 12.5% of boys) than would be expected for the NCHS reference population. The mean weight-for-height z scores exceeded those for the NCHS reference population for all ages in both sexes. Compared with data from 1955, mean heights increased 6.1% among boys and 4.4% among girls whereas mean weights increased 28.8% among boys and 18.7% among girls across all age groups. The data suggest that there has been a secular change in height, weight, and obesity in Navajo Indian children over the past 35 y.