Native Americans, like any other group, and particularly minority groups, face their own special challenges in American society. These challenges can affect them in many ways, including health care practices.
One aspect directly related to these challenges is, unsurprisingly, poverty. Native American Indians are among the poorest groups in the United States, although there can be great disparity between tribes. Overall, the poverty rate among Native Americans is 25.8%, compared to 12.4% of the general population (the Minority Rights Group International). Carrie Billy, CEO of the American Indian Higher Education Association, points out that seven of the ten poorest counties in the United States are on reservation land in an article by Kelsey Sheehy on the need to expand the participation of minorities in STEM fields. According to the Minority Rights Group International, unemployment exceeds 90% on some reservations, and the jobs that do exist are often government jobs or jobs created by the tribe to help stem unemployment. Allotment practices in the late 1800s also stripped many of the amounts of land they would have needed to sustain themselves on their own (Indian Land Tenure Forum). It is no coincidence that Teach for America, for example, has only a handful of rural locations it serves, and the Navajo Reservation happens to be one of them.
The disappearance of culture has also led to a cycle of despair in many Native populations. According to The Minority Rights Group International, over 72 per cent of Native Americans speak English at home. Only around 154 native languages survive to this day, a tiny fraction of how many there once were, and many of these are in serious danger of extinction, with only a handful of speakers left at most. Native ways of life revolving around traditional practices are increasingly difficult to maintain with changing environments and wildlife, and alcoholism and apathy have contributed greatly to a lack of Native traditions being transmitted to downstream generations over many decades.
Life expectancy is the lowest among Natives of any group in the country, with suicide and accidents being among the leading causes (CDC). Native Americans also tend to have substandard access to medical care on reservations (the Minority Rights Group International), particularly in remote rural areas. Violent crimes are common, much more so than in the general population, and are frequently fueled by alcohol. The Minority Rights Group International tells us that violence on reservations is 10 times that of normal for the nation, and that incarceration rates are twice their proportion compared to the general populace. Health risks affecting Native populations disproportionately include infant mortality, HIV/AIDS, mental health issues, smoking and tobacco use, alcohol use/abuse, diabetes, obesity, and teen pregnancy (CDC). Native populations also are frequently discriminated against by the surrounding population, particularly if there are hunting and fishing controversies at hand (such as the Wisconsin spearfishing controversy in the 1980s and 1990s).
Some particular health statistics pointed out by the CDC about Native populations are particularly troubling. Native Americans had the second highest infant mortality rate of any group in 2006, for example. In 2009, they had the highest rate of smoking out of all groups. High school completion rates were the second lowest in 2009 as well. The rate of colorectal screening in 2008 was almost 10% less than among the white population. These are all serious factors indicating poor health and access to health care resources.
My recommendations to improve health care for Native American populations would be drastic intervention. Clearly, first of all, many Native groups in rural areas have substandard access to health resources. I would suggest that the government intervene here, more than it already has, and provide both better facilities and a greater number of staff. Mobile visits may also need to be expanded, since it would seem motivation for services would be higher the lower effort needed on the part of the patient. I would suggest increasing alcohol and tobacco education, particularly at the middle school level, since it seems many of these children begin these activities around the age of 12, as well as expand on existing alcohol treatment facilities that Native populations have access to. I would also strongly recommend better pre-and-postnatal counselling for mothers, particularly young mothers, on how to prevent SIDS, proper nutrition both pre and post-natal, and the dangers of co-sleeping, among other things. Extensive HIV/AIDS screenings, as well as screenings for other types of STDs, would also perhaps make a difference while also educating the population on the dangers of unprotected sex (which could also lower the birth rate, and perhaps by extension, the extremely high infant mortality rate). Educating the Native population on the importance of vaccination could also perhaps make an impact on the extremely high rate of communicable diseases.
There is clearly a public health crisis going on among Native American populations in the United States, and it is clearly a multi-generational cycle that is continuing with alarming prevalence. It is important that we, as Americans, step in to intervene in this. We have already robbed Natives of their cultures and ways of life. It is wrong to stand idly by while these factors then continue to rob them, this time of their health and prosperity. Intervention into this public health matter and concerted effort to improve the lives and health of the Native population is one of the most pressing poverty issues in the United States today.
References:
Center for Disease Control. “American Indian and Alaska Native Populations.” Retrieved
Indian Land Tenure Forum. “History of Allotment.” Retrieved from
http://www.iltf.org/resources/land-tenure-history/allotment on 3/14/2013.
Minority Rights Group International. “World Directory of Minorities and Indigenous
People: Native Americans.” 2009. Retrieved from http://www.the Minority Rights Group International/2615/united-states-of-america/native-americans.html on 3/14/2013.
Sheehy, Kelsey (June 28, 2012). “Minorities Need STEM Role Models Too.” US News
and World Report. Retrieved from http://www.usnews.com/news/blogs/stem-education/2012/06/28/minorities-need-stem-role-models-too on 3/14/2013.
