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The Health Status of American Indians/Alaskan Natives
Aretha Ha
Grand Canyon University: NRS-429VN Family-Centered Health Promotion

April 10th, 2016

The Health Status of American Indians/Alaskan Natives Did you know that approximately 3.7 million American Indians (AI) and Alaskan Natives (AN) make up 2% of the total U.S. population? This classifies them as one of the smallest racial and ethnic population groups in the U.S. There are 567 federally recognized (AI/AN) tribes and more than 100 state recognized tribes with 78% of the AI/AN population living outside these tribal areas (OMH, 2012). This geographic distribution gives them less access to hospitals, clinics, and necessary health services. Geographic isolation, cultural barriers, environmental factors, low income, and many other interrelated factors directly contribute to AI/ANs lower health status compared to other Americans. This essay seeks to identify these health disparities that make this population least likely to get adequate needed health care.
Health Status
AI/ANs face an overall lower health status and higher rates of chronic conditions which shortens life expectancies compared to other racial and ethnic group. There is a wide range of life issues stemming from economic and social conditions that may account for the health disparities. Inadequate education, disproportionate poverty, discrimination in the delivery of health services, and cultural differences are just a few.
Life Expectancy The life expectancy of AI/ANs is 73.7 years. The U.S. average for all races is 78.1 years. What this means is that the average AI/ANs lifespan is 4.4 years or almost 6% less than the rest of the U.S. population. This decrease in life expectancy can be attributed to the prevalence of many chronic diseases such as cirrhosis, chronic liver disease, diabetes mellitus, cancer, unintentional injuries, assault/homicide, intentional self-harm/suicide, cancer, sudden infant death syndrome (SIDS), and chronic lower respiratory diseases (U.S. Department of Health and Human Services, 2016). The OMH states that AI/ANs are twice as likely to have diabetes as Caucasians. Also their infant mortality rate is 60% higher than that of Caucasians. Many of these negative health outcomes are preventable and result from “numerous health determinants such as exposure to risk factors, availability and accessibility of health care, individual behaviors and social factors (James, Schwartz, & Berndt, 2009).”
High Poverty One-third of AI/ANs have incomes below the federal poverty line with their average household income being $37,353 compared to $56,565 for Caucasians (OMH, 2012). This means compared to the 11% of Caucasians that live in poverty, an astounding 26% of AI/ANs live in poverty. A direct correlation can be seen with education where one in five AI/AN adult have not graduated from high school. Low income individuals are less likely to have higher paying jobs with benefits, therefore less likely to have access to employer sponsored health coverage or private insurance. And those insured are less likely to be able to pay the deductibles and co-payments. According to the CDC (2014) there are a staggering 28.3% of AI/ANs below 65 years without insurance coverage.
Health promotion behaviors and health status perception varies between AI/ANs tribes. Just as disparities in health status of AI/ANs have persisted throughout history, so has their mistrust of mainstream institutions (Jones, 2006). In conjunction with Western medicine, traditional practices (healers, ceremonies, herbal therapies) are also used to treat symptoms of their illnesses (Advocacy Unlimited, 2016). Their holistic view of community, nature, and spirituality as interconnected and interrelated where physical, emotional, and mental health is one unified force that guides their perception of health. Thus, illness occurs when there is a disharmony between these sources (Advocacy Unlimited, 2016). There are numerous factors that affect overall health from individual behaviors, heredity, predisposition to diseases, exposure to risk factors, and social factors such as education and income (James, Schwartz, & Berndt, 2009).
Although the members of the 564 federally recognized tribes are provided with federal health services, there is a shortage of providers and there are limits on eligibility and coverage for adults. James, Schwartz, & Berndt (2009) state that “almost half (47%) of uninsured AI/ANs do not have a usual source of care, which makes it more difficult for them to receive preventive services and timely care for acute health problems” (p.9). One approach to expanding AI/AN access to care could be expanding federal health services accessibility through policy reform. The expansion of federal funding and ensuring that health enrollment criteria fits the needs of the population, would greatly affect access to care. This improvement would meet health promotion prevention needs at all levels (primary, secondary, & tertiary) and decrease this population’s risk for serious health conditions.
American Indian/Alaskan Natives face many health challenges that require them to have good health care coverage and access to health care services. Health promotion prevention at all is especially important for this culture. However, this is particularly challenging with all the health disparities that AI/ANs must face. Their small population in correlation to other minority groups, plus their low income levels, puts them at great disadvantages when accessing education, high earning jobs, health insurance, and the comprehensive care they need for chronic health conditions. It is imperative that measures be taken to ensure this population’s promotion of health and longevity.

References
Advocacy Unlimited, (2000). Developing Cultural Competency: Cultural Knowledge, Awareness, Sensitivity, Competence. Retrieved from http://www.mindlink.org/online_courses/cultural_competency_6.html.
Centers for Disease Control and Prevention, CDC 24/7: Saving Lives, Protecting People, (2016). Health of American Indian or Alaska Native Population. Retrieved from http://www.cdc.gov/nchs/fastats/american-indian-health.htm.
Edelman, C., & Mandle, C.L. (2010). Health promotion throughout the life span (7th ed.). St. Louis: Mosby.
James, C., Schwartz, K., & Berndt, J. (2009). A profile of American Indians and Alaska Natives and their health coverage. Menlo Park, CA: Henry J. Kaiser Family Foundation.
Jones, D. S. (2006). The Persistence of American Indian Health Disparities. American Journal of Public Health, 96(12), 2122–2134. http://doi.org/10.2105/AJPH.2004.054262
U.S. Department of Health and Human Services, Indian Health Services. (2016, March). Disparities. Retrieved from https://www.ihs.gov/newsroom/factsheets/disparities/.
U.S. Department of Health and Human Services, Office of Minority Health. (2016). Profile: American Indian/Alaska Native. Retrieved from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62

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