Native American Healthcare Disparity: A Story of Neglect
By Raiaab Ajmal and Oliver Polachini, 10/22/2020
The Clash of Native Cultures and Modern Medicine
Representing just 1.7% of the total population of the United States of America, more than 5 million American Indian and Alaskan Natives live within and outside of various reserves all over the country. Throughout history, there has been a clear disparity between how indigenous populations and immigrant populations have been treated; However, much of the evidence regarding this issue remains largely undocumented, which obscures the prominence and severity of the U.S. government’s harms to the Native American community. In recent years, through the power of an amalgamation of platforms such as social media, awareness has increased about the disparity between amenities and rights, and with those, healthcare.
According to the Community Health and Program Services (CHAPS), health disparities are “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” Several factors can contribute to these disparities, including poverty and lack of education. So far, 574 tribes have been federally recognized. Therefore, due to this recognition, these tribes have the right to access healthcare benefits. However, several tribes are still fighting daily to receive recognition and obtain access to said benefits.
Indigenous populations often live by the phrase, “Our culture is medicine,” which alludes to the strong ties that indigenous populations have with their customs. They follow a certain lifestyle, allowing them all to live what they believe to be a fruitful and successful life. This culture or “medicine” consists of several elements, most of which are directly taken from the natural environment which they inhabit. These “medicines” include materials such as plants, which are used in great variety and in diverse conditions. Native peoples frequently utilize materials extracted from plants, such as tea tree oil, eucalyptus oil, kakadu plum and etc. These plant products offer medicinal and preventive benefits with regards to diseases related to obesity, cardiology concerns, blood flow and purity.
Around 78% of American Indians and Alaskan Natives have immigrated to urban areas over the past 3 decades, with every 7 out of 10 natives living in metropolitan areas. With this immigration, a need has arisen to focus on developing systems and strategies which incorporate culturally sensitive techniques into modern medicine. This demographic shift has led to initiatives such as the “Integration of traditional Indian medicine (TIM),” a warranted strategy defined by the World Health Organization (WHO) to “include diverse health practices, approaches, knowledge and beliefs incorporating plant, animal and/or mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness.”
However, since IHS healthcare services are primarily distributed in rural areas, many of the indigenous peoples residing in urban environments are overlooked, resulting in several individuals not receiving the healthcare they were promised. Much of these disparities also appear due to components which are often overlooked. Consisting of factors such as lack of awareness about healthcare rights, different opinions and beliefs and especially diverse cultures backgrounds, these disparities have led to disproportionately higher rates of obesity, cancer and diabetes.
A few of the largest hurdles to overcome are language barriers, lack of stable environments, high levels of destitution and poverty, lack of diversity in healthcare forces and more. Further, the larger the disparity in healthcare quality grows, the greater the stigma will become. Because of these economic and social standing divisions, many organizations are working tirelessly to help destigmatize and raise awareness about this topic. One of these organizations, The National Indian Council on Aging (NICOA) has worked over the years to make American Indian and Alaska Native individuals of all age groups aware of their rights and the factors contributing to the divide.
Although these organisations have helped change the lives of several Native Americans, several individuals still do not receive what they deserve, which is why the dissemination of information regarding this issue is not only important among indiigenous populations but for all United States residents.
According to the Community Health and Program Services (CHAPS), health disparities are “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” Several factors can contribute to these disparities, including poverty and lack of education. So far, 574 tribes have been federally recognized. Therefore, due to this recognition, these tribes have the right to access healthcare benefits. However, several tribes are still fighting daily to receive recognition and obtain access to said benefits.
Indigenous populations often live by the phrase, “Our culture is medicine,” which alludes to the strong ties that indigenous populations have with their customs. They follow a certain lifestyle, allowing them all to live what they believe to be a fruitful and successful life. This culture or “medicine” consists of several elements, most of which are directly taken from the natural environment which they inhabit. These “medicines” include materials such as plants, which are used in great variety and in diverse conditions. Native peoples frequently utilize materials extracted from plants, such as tea tree oil, eucalyptus oil, kakadu plum and etc. These plant products offer medicinal and preventive benefits with regards to diseases related to obesity, cardiology concerns, blood flow and purity.
Around 78% of American Indians and Alaskan Natives have immigrated to urban areas over the past 3 decades, with every 7 out of 10 natives living in metropolitan areas. With this immigration, a need has arisen to focus on developing systems and strategies which incorporate culturally sensitive techniques into modern medicine. This demographic shift has led to initiatives such as the “Integration of traditional Indian medicine (TIM),” a warranted strategy defined by the World Health Organization (WHO) to “include diverse health practices, approaches, knowledge and beliefs incorporating plant, animal and/or mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness.”
However, since IHS healthcare services are primarily distributed in rural areas, many of the indigenous peoples residing in urban environments are overlooked, resulting in several individuals not receiving the healthcare they were promised. Much of these disparities also appear due to components which are often overlooked. Consisting of factors such as lack of awareness about healthcare rights, different opinions and beliefs and especially diverse cultures backgrounds, these disparities have led to disproportionately higher rates of obesity, cancer and diabetes.
A few of the largest hurdles to overcome are language barriers, lack of stable environments, high levels of destitution and poverty, lack of diversity in healthcare forces and more. Further, the larger the disparity in healthcare quality grows, the greater the stigma will become. Because of these economic and social standing divisions, many organizations are working tirelessly to help destigmatize and raise awareness about this topic. One of these organizations, The National Indian Council on Aging (NICOA) has worked over the years to make American Indian and Alaska Native individuals of all age groups aware of their rights and the factors contributing to the divide.
Although these organisations have helped change the lives of several Native Americans, several individuals still do not receive what they deserve, which is why the dissemination of information regarding this issue is not only important among indiigenous populations but for all United States residents.
The Impact of COVID-19 on Native American Communities
The Indian Health Service, created in 1955 as an arm of the Department of Health and Human Services, runs 24 hospitals nationwide. The institution provides federal medical care to 2.2 million million Native Americans in the United States. However, despite the number of people that the institution serves, the Indian Health Service is said to provide substandard care. In 2017, the service spent $3,332 per patient, compared to Medicare’s $12,829 and Medicaid’s $7,789. This massive disparity is leading to a wave of tribal denunciations of the IHS, with some Native Americans seizing control of such hospitals claiming to be able to do a better job than the government itself.
One of the most popular examples of these is the Sioux San Hospital, built in 1898 as a school of adaptation to American culture. The school later served as a Native American tuberculosis hospital, which was taken over by the Indian Health Service right after the latter’s creation. Patients say problems were present in the hospital since its founding; however, the situation has worsened during the last 10 years. Problems include mass cases of misdiagnosis and negligence of proper treatment, which led to a 57-year-old woman’s death in 2011, the death of a patient one day after their discharge in 2014 and the latest, 6-month-old James Ladeaux, who had been told he had nothing but a cold. After the child showed more signs of illness, his mother, Ms. Black Lance took him to the hospital once again. Then, he was diagnosed with a life-threatening case of respiratory syncytial virus.
During the COVID-19 crisis, the hospital’s negligence is at an all-time high. Failure to recognize the illness among the population to inadequate treatment, its negligence has wreaked havoc among the indigenous community. Cases of diabetes are three times more common among the Native American population than other ethnic groups. Thus, the native population is one of the largest high risk groups in the nation. Due to the limited access to testing and real-time surveillance, these at-risk groups worry, as they are unable to properly track the number of cases and measures to be taken. Even on this occasion, the United States government has only invested a mere 40 million dollars in tribal health and in the Urban Indian Health Organization - far lower than requested by Native American health leaders. With such low income, it becomes harder than the ideal for supplies and resources to reach tribes and urban indigenous people in risk groups.
The United States faces a dilemma. After years of complaints from leaders of the Navajo Nation, the country failed to provide adequate funding towards Native American healthcare systems. This lack of funding left the community vulnerable to disease and preventable health conditions. As a result of the lack of resources, the rate of transmission among members of the indigenous community is 3.5 times higher than that of non-Hispanic Caucasians. Now, more than ever, the United States needs to improve its health services for indigenous people, as new health problems for this particular population are always on the horizon.
One of the most popular examples of these is the Sioux San Hospital, built in 1898 as a school of adaptation to American culture. The school later served as a Native American tuberculosis hospital, which was taken over by the Indian Health Service right after the latter’s creation. Patients say problems were present in the hospital since its founding; however, the situation has worsened during the last 10 years. Problems include mass cases of misdiagnosis and negligence of proper treatment, which led to a 57-year-old woman’s death in 2011, the death of a patient one day after their discharge in 2014 and the latest, 6-month-old James Ladeaux, who had been told he had nothing but a cold. After the child showed more signs of illness, his mother, Ms. Black Lance took him to the hospital once again. Then, he was diagnosed with a life-threatening case of respiratory syncytial virus.
During the COVID-19 crisis, the hospital’s negligence is at an all-time high. Failure to recognize the illness among the population to inadequate treatment, its negligence has wreaked havoc among the indigenous community. Cases of diabetes are three times more common among the Native American population than other ethnic groups. Thus, the native population is one of the largest high risk groups in the nation. Due to the limited access to testing and real-time surveillance, these at-risk groups worry, as they are unable to properly track the number of cases and measures to be taken. Even on this occasion, the United States government has only invested a mere 40 million dollars in tribal health and in the Urban Indian Health Organization - far lower than requested by Native American health leaders. With such low income, it becomes harder than the ideal for supplies and resources to reach tribes and urban indigenous people in risk groups.
The United States faces a dilemma. After years of complaints from leaders of the Navajo Nation, the country failed to provide adequate funding towards Native American healthcare systems. This lack of funding left the community vulnerable to disease and preventable health conditions. As a result of the lack of resources, the rate of transmission among members of the indigenous community is 3.5 times higher than that of non-Hispanic Caucasians. Now, more than ever, the United States needs to improve its health services for indigenous people, as new health problems for this particular population are always on the horizon.
