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While people in any sector of society in the United States may encounter such problems as substance abuse and domestic violence, American Indian and Alaskan Native communities appear to be disproportionately affected (Health, United States, 2002, With Chartbook on Trends in the Health of Americans, National Center for Health Statistics, Hyattsville, Md, August 2002). For reasons that are both historical (loss of cultural identity, for example) and ongoing (such as prejudice and poverty), these problems have persisted, despite numerous attempts at intervention, among Indians on reservations and in cities.
Mitka M. Two New Projects to Help Native Americans End Substance Abuse and Domestic Violence. JAMA. 2002;288(15):1834-1837. doi:10.1001/jama.288.15.1834-JMN1016-2-1