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December 16, 1992

Alcohol-Related Deaths of American Indians

JAMA. 1992;268(23):3317. doi:10.1001/jama.1992.03490230047023

To the Editor.  —The article on pedestrian and hypothermic deaths among Native Americans in New Mexico1 parallels the experience of the Whatcom County Medical Examiner's Office in Northwest Washington. In our community the incidence of sexual assault of Native American women2 and homicide of and by Native American women is similarly disproportionate. Alcohol is similarly a major feature in these assaults.At issue is the statement that was made in the accompanying Editorial that "the surrounding communities and individuals must recognize tribal sovereignty" and the conclusion that "[t]he strategy for solving alcohol-related problems must be comprehensive and must acknowledge tribal sovereignty."3As long as the American Indian community insists on being considered a third world nation, demanding special social and economic welfare-type handouts, a significant segment of its population will perceive themselves as second-rate citizens and seek escape in self-destructive social and health behavioral practices. Poor self-esteem,