John, R., Hennessy, C. H. & Denny, C. H.  (1999).  Preventing chronic illness and disability among Native American elders.  In M. L. Wykle & A. B. Ford (Eds.), Serving minority elders in the 21st century (pp. 51-71).  New York: Springer.

    It is only in the last 40 years that systematic public health efforts have been targeted to the American Indian population. These health care initiatives have resulted in remarkable improvements in American Indian health and longevity, however, chronic and degenerative diseases are increasing among the IHS American Indian service population. Risk factors for conditions that disproportionately affect older adults in this population could be greatly reduced by culturally appropriate disease prevention, health promotion programs, and health/wellness education. Without concerted efforts to prevent or delay the onset and severity of chronic illness, the health status of American Indians will continue to be worse than among more privileged groups.