Addressing Healthcare Challenges Faced by Native American Communities

This report analyzes the significant health disparities experienced by Native Americans in the United States, highlighting lower life expectancies and higher rates of chronic diseases, suicide, and PTSD compared to the general population. It examines barriers to healthcare access, including issues with the Indian Health Services (IHS) such as underfunding and staff shortages, alongside social determinants of health like poverty, lack of education, and employment opportunities. The report emphasizes the need for primary healthcare approaches, including health promotion, cultural competency, and community participation, advocating for policy changes and culturally sensitive healthcare practices to address these disparities and improve the health outcomes of Native American communities. The report also highlights the importance of addressing social challenges, such as poverty and lack of education, which contribute to the healthcare gap.

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In the context of the United States, it is seen that the health of the Native Americans is
much lower, as compared to the other populations present in the given area. Studies have shown
that on an average,the natives of American Indians as well as Alaska live for an average of 4.4
years, which is quite less in comparison to the rest of the population present in the US. They are
also seen to face a lot of discrimination in terms of the various health indicators. This paper aims
to highlight the obstacles that are faced by these concerned populations during the process of
health care service assessment as well as the various initiatives that are undertaken in order to
establish healthcare.
In accordance to the statistical data that is obtained, there have been evidences of
disparity already seen (Butler et al., 2016).According to this, it is seen that Native American
Indians are 520% more chronic liver disorders likely to die as a result of the causes which are
mainly alcohol-related. They often experience elevated rates of long term liver diseases along
with cirrhosis that is 368% greater than that of the general US population. Reports also showed
that Native Americans die from that of tuberculosis as well as from diabetes for about 450% and
177% higher rates respectively which is in comparison to the rest of the members of the given
nation (Purnell et al., 2016). The studies have suggested that the rate of suicides in the Native
Americans are about 1.5 times higher especially in the age group of 15 to 34 age while for Post-
traumatic stress disorder the rates are found to be three times higher in comparison to the other
individuals of the United States. This data that is obtained points out the fact that there is an
existence of a wide gap in healthcare between the white Americans and the natives where there is
a clear exhibition of inequity along with inequality present in the context of healthcare sessions
of the nation.

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Apart from these issues, a significant issue deals with the access to efficient healthcare
services that in turn has an impact on the health quality of the common people of the nation.
Reports have shown that the Indian Health services also called the IHS had benefitted the nation
through the provision of direct care along with the provision of funds to the majority of the
members who belong to about more than 560 federally recognized tribes, which they have been
doing for about a decade now. In spite of this, the obtained data shows that about 215 of the
Native Americans have been still found to be uninsured and this is seen to reflect about twice the
number of US rates. The primary barriers faced by the HIS which have been reported in the
studies includes the struggles related to the retention and which is plagued by about 25%
vacancy rate which is similar both the nurse practitioners as well as the physicians (Moghaddam
et al., 2015). The other barriers involve the reduced amount of funding. The reports evidently
state that HIS is funded merely by $3107 per member however the national US healthcare spends
per capita which is seen to exceed $8000 in addition to the Medicaid costs which is$5, 736 for
every member. However there also exists a discrepancy in process of allocation of healthcare
funds to that of the Native Americans along with the various social determinants of health which
can provide an idea for the purpose of impacting the lives of the individuals. There are several
social challenges that are faced by these people which includes increase in the rate of the child
and domestic abuse in addition to the rates of homicide and poverty which in turn has an effect
on the Native Americans(Updergraff et al., 2015).

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In association to the problem of poor educational qualification there is also a lack of
opportunities of proper employment and poverty which is considered to be one of the major
concerns of the disparities in healthcare. Out of the total population, about 28% of the Native
Americans were experiencing in poverty in 2014, which is in contrast to the about 15.5
Americans according to the US census Bureau. On an average, the household income was found
to be $ 37,222 for the Native Americans in comparison to that of the national average which was
$53,657. Therefore there are variations present in the gap of healthcare status existing between
the Native Americans and the other people of the nation (Bailey et al., 2017).In the absence of
economic stability, the Native Americans are witnessed to be lacking the health insurances and
hence they might not seek any medical care. Almost one in every four Native Americans seem to
be lacking the health insurances as compared with that of 11.7 percent that is the uninsured rate
for entire US population. According to the studies it is evident that while 83.2 percent of the
Americans were seen to complete their high school between the years 2014-2015.This was just
about 71.6 % of the Native Americans who had finished their education. About 19.8% of Native
Americans held a bachelor’s degree or higher while the same was 32.5 % for the Americans.
Among the several approaches of care, the ones that are useful in terms of improving the
health conditions of the Native Americans are referred to as the primary approaches of
healthcare. Therefore there is a need to focus more on the methods of prevention and support
which are required to be undertaken by the primary healthcare professionals(Assari, 2018). It is
required of the health care nurses to develop models of health promotion along with the
establishment of the sessions of health education for the sake of the communities which would
be addressed on the various different frameworks including the ecological model, Ottawa
charter, health belief model, and many others. Additionally the various policies which are of

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significance are required to be established along with the leaders of the society of the Native
Americans in order to ensure that their initiatives are at par with the health requirements of
different native communities (Walls et al., 2015).It should be kept in mind that the primary
healthcare services need to incorporate the 5 important steps which are public or community
participation,accessibility, appropriate use of technology, health promotionas well as
intersectoral collaboration.
For the professionals associated with nursing, it is important to be fully aware with the
cultural considerations that are associated with the care of the Native Americans. Additionally
care should also be given to their traditional aspects like the shaking of hands, careful listening to
the cultural needs and displaying respect to their members of the team and other such factors like
showing respect to the women during their “moon” time, allocation of same sex professionals
like that of patients, and many others(Quinn et al., 2015). It is important for the nurses to be
careful of the different cultural traditions of these people in order to make them feel important
respected so that their sense of autonomy and dignity is respected.
In order to conclude it can be stated that these Native Americans have undergone a lot of
suffering as a result of the huge gap that exists in the equality of health because of which these
people have a lower life expectancy in comparison to the other Americans. From the report it
was identified that the main social determinants of health were poverty, employment,education,
addiction and many others. Therefore it is expected of the nurses to advocate for the prevalent
concerns to the authorities who are concerned and also for the development of health education
and sessions of promotions in order to set up efficient primary health care centers. Finally there
is a need to ensure cultural competency for the people.

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References:
Assari, S. (2018). Health disparities due to diminished return among black Americans: Public
policy solutions. Social Issues and Policy Review, 12(1), 112-145.
Bailey, Z. D., Krieger, N., Agénor, M., Graves, J., Linos, N., & Bassett, M. T. (2017). Structural
racism and health inequities in the USA: evidence and interventions. The
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Butler, M., McCreedy, E., Schwer, N., Burgess, D., Call, K., Przedworski, J., ...& Kane, R. L.
(2016). Improving cultural competence to reduce health disparities.
Moghaddam, J. F., Momper, S. L., & Fong, T. W. (2015). Crystalizing the role of traditional
healing in an urban Native American health center. Community mental health
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Purnell, T. S., Calhoun, E. A., Golden, S. H., Halladay, J. R., Krok-Schoen, J. L., Appelhans, B.
M., & Cooper, L. A. (2016). Achieving health equity: closing the gaps in health care
disparities, interventions, and research. Health Affairs, 35(8), 1410-1415.

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Quinn, D. M., &Cooc, N. (2015). Science achievement gaps by gender and race/ethnicity in
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Updegraff, J. A., Brick, C., Emanuel, A. S., Mintzer, R. E., & Sherman, D. K. (2015). Message
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in a diverse sample of Americans. Health Psychology, 34(1), 20.
Walls, M. L., Gonzalez, J., Gladney, T., &Onello, E. (2015). Unconscious biases: racial
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