Native Americans

Native Americans are identified as having pre-Columbian ancestors who were indigenous to the land within the nation’s boundaries. Native Americans are represented through distinct tribes, ethnic groups and bands. The terms Native Americans generally identify themselves with varies both geographically and generationally, with many older Native Americans referring to themselves as “Indians” or “American Indians,” and the younger generation identifying with the terms, “Indigenous” or “Aboriginal.” Within the United States, approximately 2.9 million people identify as a Native American. An additional 2.3 million identify as part of this culture and another race (Dayer-Berenson, 2014). There are 566 federally recognized tribal governments in the United States. Each tribe has its own unique political structure, social systems, clothing styles, types of shelter and foods, art and music styles, language, education, and spiritual and philosophical beliefs. A common similarity is the strong tie between Earth and nature among these tribes. The Alaskian Natives who make up 229 of these tribes are further divided into three groups: Indians, Aleuts, and Eskimos (Dayer-Berenson, 2014). In addition to these tribes, there is an additional 200 that are not federally recognized. Where and what tribe someone belongs to can depend on the amount of Indian blood they have; however the Cherokee tribe requires no minimum. Since this population can be so diverse the Indian Health Service, or IHS, was established to ensure that health care was provided; however with limited funding this has left those who depend on this service with inadequate healthcare. The Native American culture faces many challenges when attempting to access healthcare. With barriers such as high poverty levels, high-risk health behaviors, social factors, low educational levels, and chronic conditions the importance of accessing, sustaining, and receiving supportive and preventative care is extremely important (Purnell, 2014). Diseases of the heart, malignant neoplasm, unintentional injuries and diabetes are leading causes of American Indian and Alaskian Native deaths. The Native American culture also tends to die at higher rates when compared to Americans in the categories of liver disease and cirrhosis, suicide and chronic lower respiratory diseases (U.S. Department of Health and Human Services, 2007). Children are also effected by the lack of health care. The National Center for Health Statistics reports that, “the rate of inadequate prenatal and postnatal death among the American Indians were two to three times higher than those of white infants” (U.S. Department of Health and Human Services, 2007). Beyond infancy, the disparity continues reporting that “Thirty-nine percent of children within this culture are reported overweight and obese” (U.S. Department of Health and Human Services, 2007). Improving the health of this culture is very important; however at this time little is being done to ensure that adequate health care is received. The IHS, does include some access to specialty care and has established urban health clinics. Funding shortages and the lack of facilities and healthcare professionals has had a strong impact on the lack of care received and offered within this culture. The Affordable Care Act; however has provided an opportunity for Native Americans with the possibility of obtaining insurance and accessing needed medical care (Artiga, 2013). Providing competent healthcare is also a very important part of helping to close these disparities for this culture. The nurse should generally be aware of the Native American beliefs and honor those when caring for this patient. The nurse should refrain from being aggressive when asking questions, as self-disclosure is very important to this culture. Modesty and privacy are very important, so the nurse should always ask and explain what they are doing before assessing the patient. Lastly, the nurse should provide one-on-one education with the patient. The Native American culture responds best to demonstration. By creating a positive environment surrounding the care you are providing will gain trust and this culture may become more apt to seeking medical attention if they have had a good experience.

References

Artiga, S. (2013, October 7). Health Coverage and Care for American Indians and Alaska Natives. Retrieved from The Henry L. Kaiser Family Foundation: http://kff.org/disparities-policy/issue-brief/health-coverage-and-care-for-american-indians-and-alaska-natives/
Dayer-Berenson, L. (2014). Cultural Competencies for Nurses. Burlington, MA: Jones and Bartlett.
Purnell, L. (2014). A Guide to Culturally Competent Healthcare. Philadelphia, PA: F.A. Davis Company.
U.S. Department of Health and Human Services. (2007). Retrieved from Indian Health Services: https://www.ihs.gov/newsroom/factsheets/disparities/