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American Indian Women and Cardiovascular Disease: Response Behaviors to Chest Pain

Struthers, Roxanne PhD, RN; Savik, Kay MS; Hodge, Felicia Schanche DrPH

The Journal of Cardiovascular Nursing: May-June 2004 - Volume 19 - Issue 3 - p 158–163
Articles: Clinical Research

Cardiovascular disease (CVD) is currently the number one killer of American women. Consequently, CVD is a concern for all women, including ethnic women. However, little is known about CVD behaviors and responses to CVD symptomology among minority women, especially American Indian women. Response behaviors to chest pain require important actions. This article examines response behaviors to chest pain in a group of American Indian women participants of the Inter-Tribal Heart Project. In 1992 to 1994, 866 American Indian women, aged 22 years and older, participated in face-to-face interviews to answer survey questions on multiple areas related to cardiovascular disease on 3 rural reservations in Minnesota and Wisconsin. A secondary data analysis was conducted on selected variables including demographic characteristics, healthcare access, rating of health status, personal and family history of cardiovascular disease, and action in response to crushing chest pain that lasted longer than 15 minutes. Research findings report that 68% of women would actively seek healthcare immediately if experiencing crushing chest pain that lasted longer than 15 minutes. However, 264 women (32%) would take a passive action to crushing chest pain, with 23% reporting they would sit down and wait until it passed. Analysis revealed women reporting a passive response were younger in age (under age 45) and had less education (less than a high school education). These findings have implications for nurses and other healthcare providers working in rural, geographically isolated Indian reservations. How to present CVD education in a culturally appropriate manner remains a challenge.

Assistant Professor, University of Minnesota School of Nursing, Minneapolis, Minn. (Struthers)

Statistician, University of Minnesota School of Nursing, Minneapolis, Minn. (Savik)

Professor and Director, Center for American Indian Research and Education, University of Minnesota School of Nursing, Minneapolis, Minn. (Hodge)

The people who agreed to participate in the Inter-Tribal Heart Project and the local tribal governments made this work possible. The project was supported by a memorandum of understanding between the Centers for Disease Control and Prevention and the Indian Health Service and by the following Tribal Council Resolutions: 91-42 of the Menominee Tribe of Wisconsin, 157-91 of the Red Lake Band of Chippewa Indians, and 063-92-001 of the White Earth Reservation Tribal Council.

Corresponding author Roxanne Struthers, PhD, RN, University of Minnesota School of Nursing, 6-101 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.