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Sexual Assault Services Coverage on Native American Land

Juraska, Ashley MPH1; Wood, Lindsey2; Giroux, Jennifer MD, MPH3; Wood, Eric PhD4

doi: 10.1097/JFN.0000000000000025
Original Articles

ABSTRACT Native American women experience higher rates of sexual assault than other women in the United States, yet there is limited information on the accessibility of forensic services for Native American victims of sexual violence. This study used geographic information systems technology to map known sexual assault examiner (SAE) and sexual assault response team (SART) programs in the United States (n = 873) in proximity to 650 census-designated Native American lands. Analysis was repeated for 29 Indian Health Service and tribal-operated facilities that self-identified that they provide sexual assault examinations. Network analysis showed that 30.7% of Native American land is within a 60-minute driving distance of a facility offering SAE or SART services. Indian Health Service and tribal-operated facilities increased accessibility to SAE services on 35 Native American lands. This study shows gaps in coverage for more than two thirds of Native American lands, including 381 lands with no coverage, highlighting the need for expanded SAE and SART services near or on Native American land.

Author Affiliations: 1Great Plains Tribal Chairmen’s Health Board, and currently Data Quality Manager, Women’s Health and Family Planning Association of Texas; 2Earth Resources Technology, Contractor to U.S. Geological Survey Earth Resources Observation and Science Center; 3formerly with Indian Health Service Division of Epidemiology and Disease Prevention, and currently with the Great Plains Area Indian Health Service and placed with Great Plains Tribal Chairmen’s Health Board/Northern Plains Tribal Epidemiology Center; and 4U.S. Geological Survey.

Dr. Giroux is a Federal employee. This article is a U.S. Government work and, as such, is in the public domain in the United States of America. The findings and conclusion of this report are those of the authors and do not necessarily represent the official position of the Indian Health Service, the Centers for Disease Control and Prevention, or the Department of Health and Human Services.

In 2010, the Centers for Disease Control and Prevention paid the Indian Health Service Division of Epidemiology and Disease Prevention for Dr. Giroux to lead intimate partner violence work; this project was part of that effort.

Ashley Juraska, MPH, 12309 Indian Mound Dr., Austin, TX 78758. E-mail:

Received January 24, 2014; accepted for publication March 27, 2014.

© 2014 by the International Association of Forensic Nurses. All rights reserved.