The social epidemiology and construction of risk for Fetal Alcohol Syndrome in Native American communities

Fetal alcohol syndrome (FAS) is characterized by craniofacial dysmorphology, growth deficiencies, and central nervous system dysfunction. The results of FAS are generally mild to moderate retardation, as well as social dysfunction andlack of social attainment. FAS is entirely preventable by not consuming alcohol during pregnancy. Despite this, FAS remains a factor within the general population, with abnormally high rates among Native Americans. This monograph explores the ways in which sociocultural factors play a role in the construction of FAS as a threat in the Native American community, through an examination of FAS as a public health intervention. By examining the determinants of FAS as cultural factors from the standpoint of social epidemiology, including those underlying economic and political factors that place certain ethnic and cultural groups in a state of disenfranchisement, we are able to see how public health interventions that examine such factors can meet immediate clinical demand as well as address long-term cultural stigma and disenfranchisement. Programs that wish to address FAS in Native American communities must address the lack of community resources, such as alcohol abuse counseling, needed to support educational efforts. In addition to this, long-term studies must address how to effectively implement such programs, as well as addressing underlying economic needs that have been shown to be related to alcohol abuse.