The Health Status of the American Indian
Bonnie Watkins
Grand Canyon University

The Health Status of the American Indian

The American Indian has long been without adequate healthcare. It was without choice that they were forced trade their land and resources for care and protection offered by the Anglo-Americans ("Barriers," 2016). In 1955 the Indian Health Service was created to provide healthcare to the American Indians. Although the intent was good, this service has lacked the necessary resources to provide proficient care to the American Indian. Unfortunately, little has changed, and the American Indian continues to lack the resources necessary to obtain adequate medical care.
Studies show that since the early 1960’s disparity in health status exists between the American Indian and the Anglo American. It consistently documented poorer health, with an increase in diseases such as cardiovascular, diabetes, cancer, and depression. From the report: Invisible Tribes: Urban Indians and Their Health in a Changing World findings were: * 30 percent of American Indians/Alaska Natives adults suffer from depression ("American Indians Urban Needs," 2007). * American Indians/Alaska Natives have higher prevalence of diabetes ("American Indians Urban Needs," 2007). * Cardiovascular disease is the leading cause of death among American Indians and Alaska Natives ("American Indians Urban Needs," 2007).
One of the biggest challenges is the inability to access adequate healthcare. Many live in poverty and do not have the means necessary to obtain the medications and treatment they need to combat illness and disease. The Indian Health Service clinics on the reservations do to not have the equipment or trained professionals to properly diagnosis and treat the illness, and for chronic illness such as cancer, heart disease, or diabetes the American Indian is referred to a major hospital or clinic at the closest city. The facility is too far away for to travel to, or they do not have sufficient insurance to cover the cost of treatment. The lack of resources for medical care often contribute the rising number of Native Americans that suffer from depression and alcoholism. Low income coupled with no health insurance creates serious limitations on the ability to manage diseases such as diabetes. The government food commodities given to low income families may provide cheese, flour, sugar, and lard but these are items that are high in starches, carbohydrates, and cholesterol. These foods, if not eaten in moderation, coupled with a sedentary lifestyle, contribute to diabetes and heart disease ("Cultural Competency," 2010). There are multiple barriers to receiving adequate healthcare. As previously stated, lack of transportation is a big problem, many live either in rural areas or on reservations, often miles away from the nearest healthcare facility. There is a lack of specialty care units such as cancer care clinics, cardiac clinics, and available diabetes management centers ("Barriers," 2016). The barrier to healthcare may be inadequate communication stemming from the beliefs of the Native American. An example of this type of communication barrier is that the Navajo believes that a heavy body indicates both health and happiness (Tripp-Reimer, Choi, Kelley, & Enslein, 2001, p. 16). This would be an excellent opportunity for education about weight management and disease processes (i.e.: heart disease, diabetes,). The healthcare provider should be aware that the in the Native American cultures it is part of their heritage not to show pain, or to judge how severe an illness based on how much pain it causes. Prior to seeking medical assistance, they may have already had rituals for healing, (which frequently involve the use of herbs), to restore the body, mind and spirit to one. These rituals are very important and should be incorporated into educational programs. Of the three levels of health promotion prevention, I feel the one that would be the most effective is the primary one. I feel that teaching is the key to seeing a decrease disease processes such diabetes, cardiovascular disease, cancer and alcoholism. We should teach the importance of diet and exercise, and the signs and symptoms of diabetes and heart disease. Proper nutrition, healthy snacks, vaccinations are keys to good health. Targeting the younger generation will not only see a decrease in disease in their generation, but they will take this education and available resources back with them to educate their elders. We also need to educate the educators to ensure cultural competence. They should be culturally sensitive to the Native American view that body and soul are one, health is synonymous with the harmony of body and soul with nature ("Cultural Competency," 2010). The Native American values include: group emphasis, extended family, holistic problem solving, and religion as a way of life ("Cultural Competency," 2010). In additions to the primary level of health promotion, we should also apply the secondary approach with proper health screening at area clinics, lobbying for government funding to put in place additional clinics, home health nurses for rural areas, and farmers markets to increases the availability of fresh fruits and vegetables at affordable prices. Finally, adding the tertiary approach by providing transportation to specialty clinics for treatment of chronic diseases. Lobbying for lower healthcare costs for the Native Americans who gave all and received little in return. Putting in place treatment programs for those diagnosed with depression, alcoholism, and drug abuse. Providing much needed assistance to treat the diseases already in place will result in better outcomes.

References
Barriers for American Indian. (2016). Retrieved from http://www.cherokee.org/cancer/CancerandAmericanIndians/BarriersforAmericanIndians.aspx
Cultural Competency: Serving American Indian Patients. (2010). Retrieved from http://publichealth.com/manuals/CulturalComptency3-10-10.pdf
Significant Health Care Needs of American Indians and Alaska Natives Living in Urban Areas Go Unmet. (2007). Retrieved from http://www.rwjf.org/en/library/articles-and-news/2007/11/significant-health-care-needs-of-american-indians-and-alaska-nat.html
Tripp-Reimer, T., Choi, E., Kelley, S., & Enslein, J. (2001). Cultural Barriers to Care: Inverting the Problem. Retrieved from http://spectrum.diabetesjournals.org/content/14/1/13