Inequitable Burden of Disease on Reservations

 

Traditional medicine man, attempting to heal a sick tribesman. 

American Indian men and woman living on reservations today face great inequities when it comes to adverse health conditions. With more the 22 percent of all AI living on reservations this problem effects many people in an unjust manner and is something that needs be addressed.

Most reservations are characterized by poor living conditions and are riddled with numerous diseases. The Natives also suffer from obesity, mental health issues, and severe substance abuse in the form of alcohol and illegal drugs. There is also a very high rate of suicides in these communities. These isolated, hidden and forgotten communities are victims of severe health disparities and their residents are far more likely to suffer from ill-health and diseases in comparison to national averages for almost any health issue.

In addition to the health disparities described above, American Indians also face an extreme and disparity in cancer mortality rates. While there is a lower incidence of diagnosis of most types of cancers among AI they are more likely to be diagnosed during the late stages of cancer and are therefore far less likely to survive. It is not that they are somehow immune to cancer and that’s why the diagnosed incidence is lower, but it is because they are not able to get the proper medical help until it is unfortunately too late! This tragic disparity amounts to the unnecessary and avoidable death of fellow human beings due to decades of neglect, historical disenfranchisement, and the root cause of racism. 

 

There are ways to improve these inequitable conditions, but not with a ‘one size fits all’ approach. It is futile to expect the mainstream, federally run Indian Health Service to be seamlessly integrated into the multiple different Native American cultures. Understanding the cultural norms and having keen desire to develop trust are the first steps in building a strong, long-lasting relationship with these communities. In part this relationship can be established through means of cultural sensitivity and actively respecting the unique customs and practices of tribes. Health care workers need to find culturally acceptable ways in which to administer care, and working in conjunction with a traditional healer and/or medicine man will help assure that cultural norms are not being violated and the whole operation seen as being taboo. Being an integral part of the Native American communities will allow collection of vital data from which physicians, social and health care workers will be able to devise a palliative care plan that addresses the issues that these individuals will most likely face over their life time. A plan like this would make preventative care the focus, while at the same time trying to address issues that are keeping people away from the care that they need.

Presented by Spread & Dread: Casper Dawson, Jamie Vann, Jason Kramer, Martin Fellez