In a report provided by an Indian Health Service (IHS) spokesperson, American Indian and Alaska Native people have experienced lower health status for decades, as well as a lower life expectancy (6 years less than all races in the U.S. population) and an unequal disease burden when compared with other Americans. These disparities could be due in part to inadequate education, which triggers high poverty levels, poor social conditions and economic adversity. What this boils down to is the majority of American Indians are unable to afford needed health insurance for their families.
The IHS was established in 1955 through federal action, treaties and laws, to provide health care for the American Indian population. This agency is responsible for dealing with Indian Health issues, which is a nationwide effort, and is part of a “public trust created when native people of this continent exchanged, with and without choice, their land and natural resources for certain protection and services (3).” Congress appropriates funds for operating Indian Hospitals and Indian Clinics, which are either run by the IHS or the tribes. Eligibility for basic services from any of these facilities is based on membership in any federally recognized tribe.
“A misconception exists today that our Indian health care is free. It is not. It has been paid for by the blood and tears of our ancestors and by the land our people were forced to give away.” – Dr. Brenda Stone
The benefits entitled American Indians by the U.S. government are insufficient to cover the costs of health care for this population group. According to an IHS spokesperson, when you compare the average American health plan benefits with those the IHS provides, the IHS can only provide from 54% to 59% of these same benefits. Also mentioned in the report were cultural differences and discrimination in delivery of health care services (4).
With disease affecting the older Native American and Alaska Natives, higher mortality rates are causing our population to be younger, which may be another barrier for gaining adequate health care from sources other than the IHS.
Transportation is also a problem that faces this group of people, as the biggest majority of them live in rural areas, or on reservations that may be many miles away from the nearest hospital, making access to appropriate health care even more out of reach for many.
Another very important barrier that may contribute to an increase in disparities for American Indians is the lack of specialty care for patients. IHS does not have specialty care units such as cancer treatment centers, and therefore these patients will go through a contract health referral system and be contracted out to other medical centers that specialize in the type of treatment and care needed.