Disparities Within the Native American Healthcare System

 
Written by Allison Baker
 
 
 
         Over time Native American communities have been in constant battle over the need for more improved healthcare. I would like to focus on the lack of healthcare both mentally and physically within this blog post. While there is access to healthcare within Native communities, it is not up to par in comparison to non-Tribal communities.
            First I would like to point out that a lack of access to mental health resources negatively impacts the communities. Without help for issues such as alcoholism, suicide, and depression there becomes an increased rate of death. In an article that I read written by Annie Belcourt, she states that “as a collective, American Indians and Alaska Natives live more challenging and shorter lives” (Belcourt). In her article she speaks about her experience of pursuing a doctoral degree in clinical psychology. She mentioned that growing up she never realized the inequalities that existed amongst her healthcare system until she started going through her program and learning what things are like in the non-Tribal healthcare system. She speaks about the family and friends that she herself had lost due to a lack of proper care both mentally and physically. She even exclaims that she “nearly lost one child due to lack of access to proper medical care” (Belcourt).
            In general, Indian Health Services is the core provider of healthcare for the Tribal communities. Overall, Indian Health Services has improved over the years. It has not, however, improved quite enough. What put it into perspective for me is the following portion of Belcourts article:
American Indians continue to have lower life expectancies than other Americans and lose more years of productive life. They also have the nation’s highest rates of death due to suicide. High rates of premature death due to diabetes, cardiovascular disease, cancer, and accidents plague Native Americans (Belcourt).
            Belcourt attributes many of these issues to the ways of life that Tribal communities are forced to live in on their reservations. They are generally surrounded by poverty, giving them “limited access to health care, adequate housing, quality education, and adequate law enforcement services” (Belcourt). There is also a large amount of physical abuse that occurs amongst the community. This could be sexual or domestic abuse, but could also vary into other categories. This exposure to trauma can often lead to a lower quality of life which then can translate into bad health. Aside from physical trauma, there is also the factor of historical trauma within the communities. We often neglect to remember that there are still living tribal members that participated in Indian boarding schools, which intended to erase Native American culture and shift their culture to become more Westernized. There is still a lot of tension surrounding the topic, and many are still permanently damaged from the experience. To this day, there are many Native American cultures that no longer exist because of the forced Americanization that went on during these times. Languages, rituals, and members permanently lost because of forced assimilation.
            There is also a lack of funding for Indian Health Services. According to Belcourt, “federal funding only provides for 54% of needed services” (Belcourt). This leaves the rest of the services to be provided for through the Tribal communities. There is also the issue of location. There are not very many Indian Health Services facilities, especially in areas off of the reservation. This results in Indians utilizing treatment that is not through Indian Health Services, which can lead to unfair prices. In Indian Health Services facilities, there can also be a lack of employees as well as proper training. This can cause long wait times for often urgent procedures, as well as inadequate treatment.
            There does seem to be hope for better healthcare amongst Tribal communities. According to Belcourt, organization such as the National Council of Urban Indian Health, the National Indian Health Board, and the National Congress of American Indians are constantly working towards equitable healthcare. There are initiatives to provide accurate information regarding ways to increase life expectancy and mental/physical health that are being shared amongst healthcare providers. This will help cut back on “obesity, violence, suicide, and substance abuse prevention” (Belcourt). There is also work being done to change the way that health services are being provided as well as funded within Native communities. This would ensure more efficient and effective implementation of healthcare. Some communities are even working on bringing back some of their traditional methods. This movement is assisting with the push for adequate healthcare because it means that people do not have to go without when in need of smaller remedies. It allows major issues to be dealt with at healthcare centers while traditional remedy can bring back both a sense of community as well as a healing method.
            Reading the thoughts and opinions of a Tribal member being trained in the healthcare services industry has really opened my eyes to the disparities that Native communities face. It was not until understanding her shock of seeing how non-Natives are treated in comparison to Natives that I knew the issue was far greater than I ever could have imagined. There is no remedy to this solution, but I do hope that one day the issue can be resolved so that equitable healthcare is available to all.

 
Works Cited
“Limited Health Funding for AIANs.” Public Health Post. Accessed March 22, 2019. https://www.publichealthpost.org/databyte/limited-health-funding-american-indians-and-alaskan-natives/.
“Native Americans Are Fighting Against Health Care Inequality.” GOOD, January 26, 2018. https://www.good.is/articles/native-american-health-care.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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