Health Disparities among American India population

Health Disparities among American India population

Introduction

The American Indian population has struggled with the challenge of disparities in access to health care for many years. Health disparity continues to affect both the American Indian and the Native communities in Alaska (Jones, 2006). The problem of health disparity across the Native American populations is historical and is mainly propagated by the lack of proper data, poor nurse leadership, and few American Indian nurses (Bauer & Plescia, 2014; Sarche & Spicer, 2008). The disparity in health among the American Indian communities has resulted in a high prevalence of chronic infections, especially in older people. This health problem has been strongly associated with the poor health services seeking behavior of the Native Americans. A variety of factors have been associated with the health disparities in Native Americans across the Alaska region. Poverty is one factor that has been implicated as causation of disparity in access to health services. Health resource distribution remains poor among the American Indian population, particularly human resources. A previous study has shown that there are very few American Indian nurses to serve in the Native American communities (Geana et al., 2012). The limited number of native nurses within the American Indian communities limits the provision of culturally tailored health care information. Culturally customized health information has been shown to impact health behaviors, underscoring the importance of this information in improving health-seeking habits and overall health outcomes.

Besides, an inadequate approach to nurse leadership may affect access to healthcare among underserved communities. Poor nurse leadership is a significant challenge among the American Indian nurses ameliorating the disparity in health care. Culturally sensitive nurse leadership is a considerable asset for influencing the community’s health-seeking behavior and improved health outcomes (Keltner, Kelley, & Smith, 2004). For instance, a good nurse leadership composed of nurses drawn from the American Indian community can help to impact the people in the community to improve access to health services by registering in health insurance schemes and creating a positive attitude towards health service delivery in the city. The prevailing chronic diseases in the community can, therefore, be addressed. The health challenges in this community can be solved by enhancing the availability of American Indian nurses to serve the community in a culturally sensitive approach and developing a good nurse leadership in the community (Keltner et al., 2004). This paper discusses the impact of health disparity among the American Indian population and proposes an evidence-based nursing action that can be implemented to address the health care problem.

Background

Historically, the problem of health disparities among the American Indian population in Alaska has been dated back to 400 years ago. The profound health disparity is manifested in the health outcomes of this population. The CDC estimates that the American Indian population has a lower life expectancy and are significantly affected by chronic diseases (Arias, Xu, & Jim, 2014). In Arizona, which harbors the majority of the American Indians, has 22 recognized American Indian tribes. The analysis of health disparity in the Arizona American Indian (AI) population, showed that when compared to the other ethnic groups, 33.0% of the American Indians were overweight versus 26.8% other ethnic groups. The prevalence of obesity among the AI was estimated to be 76.7%; diabetes was the highest at 21.4% versus 8.0%. Hypertension was also recorded to be slightly higher in the AI population (32.9% versus 27.6%).

A significant risk factor associated with the high rate of chronic diseases among the AI was the lack of doctor visits or the frequency of hospital visits. The analysis showed that only a few AI had a personal doctor or health provider (63%). Consequently, the majority of the AI did not know their health status and rarely engaged in physical activities (Adakai et al., 2018).

The AI communities cited the lack of community-based nurses as one of the etiology of their poor health outcomes. Currently, there are very few nurses of the AI origin within the community to serve the population is a culturally sensitive approach. Some AI communities may not be able to communicate their health problems effectively to the white nurses who serve the community. There is, therefore, a need to increase the number of AI nurses in the AI communities (Adakai et al., 2018).

Cultural and historical factors

The cultural and historical factors associated with the disparity in health among the AI people include the introduction of western education, which replaced the traditional way of learning that the AI was practicing. From the period of 1878, the introduction of orphanage and schools led to abandoning the native culture and adoption of western civilization. However, some clans of AI maintained their culture, including the use of traditional medication. They believed that the new mode of treatment was not effective. These beliefs resulted in poor health-seeking behaviors (La Belle et al., 2005). Moreover, some religious beliefs barred them from seeking medical services. The historical period of colonization also contributed to the current health challenges facing the AI communities. Colonization by the current USA used brutal approaches to acquire land and property. The trauma caused by the colonization regime lingers on among the AI communities passed from generation to generation. During the colonization period, there was an outbreak of infectious diseases in the AI population. These diseases are believed to have bee transmitted from the colonizers to the AI people who had no immunity to such infections.

Impact of the problem

The AI population is significantly affected by the health disparity problem. The high prevalence of chronic infection has led to physical disability among some people whore are severely ill. The obese people in the community become physically immobile and reduces their productivity. Besides, people with chronic heart diseases are unable to engage in vigorous physical activities. Spiritually, the AI population have been deprived of their traditional way of worship by the dominant American churches in the areas where the AIs reside (Adakai et al., 2018). This has significantly transformed their spiritual beliefs and relationships. In terms of culture, AI has abandoned their religion and corm to modern American culture. Their approach to health has also been changed by the introduction of hospitals in their community (Adakai et al., 2018). The disparity in health has resulted in some chronic illness, which eventually affects the brain and develops into mental illnesses. The environment and neighborhood have been transformed significantly, resulting in the AI population, adapting the modern way of life introduced by the Americans (Adakai et al., 2018).

Nursing action

The problem of health disparity in the AI population can be adequately addressed through the implementation of public health approaches based on community health interventions (Geana et al., 2012). Management of health programs at the grassroots level by engaging tribal leaders within the community can help promote health. This approach should be a community-centered with the AI cultural factors being considered in improving health in the community. For example, the role of AI culture can be operationalized through increasing the number of native nurses who are drawn from the community and speak their language (Geana et al., 2012). Such nurses stand a better chance to effectively communicate and educate the people in a more culturally sensitive manner. The nurses from the community and operating within the communities will enhance health education among the local people and influence the local community leaders to help them in advancing health programs. Setting up health-centered within the community is another approach that is effective in enhancing access to friendly health services considering the nurses working in the health facilities are drawn from the community. Through the establishment of health facilities, clinical diagnosis, treatment, and monitoring of chronic diseases can be achieved (Geana et al., 2012).

Summary

The health disparity challenges facing the AI population have a historical background since the colonization period. The research by the Center for Disease Control (CDC) reveals that the AI population bears a higher burden of chronic diseases compared to the other ethnic groups. This disparity in health has been associated with some cultural and historical factors, including colonization, religion, traditional practices, and a drastic change in the environment introduced by the American colonizers. The health disparity problem faced by the AI population has had a significant impact on their health, spiritual, and cultural orientation of the AI communities. Health disparity challenges among the AI population can be addressed adequately through the implementation of a community-centered health improvement action. The action includes the use of community-based nursed who will promote culturally sensitive health education and the application of community-based health centers. The health centers will improve clinical diagnosis, treatment, and monitoring of chronic infections.

References

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Arias, E., Xu, J., & Jim, M. A. (2014). Period life tables for the non-Hispanic American Indian and Alaska Native population, 2007–2009. American Journal of Public Health, 104(S3), S312–S319.

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Jones, D. S. (2006). The persistence of American Indian health disparities. American Journal of Public Health, 96(12), 2122–2134.

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La Belle, J., Smith, S., Easley, C., & Charles, G. (2005). Boarding school: Historical trauma among Alaska’s native people. Anchorage AK: The National Resource Center for American Indian, Alaska Native, and Native Hawaiian Elders.

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