Introduction
Native Americans, often known as American Indians, refer to members of the indigenous peoples of the American Continent. It is frequently used to refer to those groups whose ancestral lands were in what is now Canada and the United States. All descendants of the indigenous inhabitants of North, South, and Central America who still identify with their tribe or local community are included in this demographic. A total of 5.7 million individuals were expected to be American Indian and Alaska Native alone or in conjunction with one or more additional ethnicities as of 2019 (Office of Minority Health, 2022). 1.7 percent of Americans identify as American Indian or Alaska Native (OMH, 2022). In several areas of mortality, American Indians continue to have higher death rates in comparison to other Americans, including chronic lower respiratory disorders, cirrhosis of the liver, diabetes mellitus, accidental injuries, assault/homicide, and purposeful self-harm/suicide.
Health Disparities and Issues
Socioeconomic Factors Affecting Health
American Indians’ health inequalities are brought on by the following socioeconomic factors:
- Poverty – there are significant issues related to low income and the inability to afford crucial goods among American Indians.
- Low levels of education and literacy – the education provided to American Indians is insufficient.
- Unemployed – finding a job is a common problem for American Indians.
- Language differences – tribes have different languages, and many individuals do not speak English.
- Improper access to medical treatment.
- Limited transportation options.
- Difficulties related to finding nutritious food.
- A dearth of housing alternatives.
- Environmental circumstances.
Mines
There are several issues related to the poor health of American Indians. One in a long line of insults is the old mines on and nearby Native American territories in the western United States. The legacy will last for future generations due to the large number of sites and the vast amount of garbage (Lewis et al., 2017). Furthermore, the mines represent just one episode in the tale of environmental injustices committed on Native American territories. Similar articles might be developed concentrating on the effects of oil and gas development, military base legacy, and strip mining on tribal territory. The Standing Rock Sioux camp’s opposition to the Dakota Access Pipeline received support from tens of thousands of people representing tribal groups across the nation (Lewis et al., 2017). This shows the common topic felt by tribes not only in the Western USA but also across the country and the world. Their rights to guard health and heritage have been continuously eroded in pursuit of resource development.
Poverty
Since 28.3 percent of American Indians live below the poverty line, the highest rate of any group, they have a history of medical inequality (Center of American Indian Resilience, 2022). In addition to having high poverty rates, American Indians born today have life expectancies that are 73.7 years and 4.4 years shorter than those of the other races in the United States (CAIR, n.d.). The shorter life length that American Indians experience may be related to poverty. In addition, disorders including diabetes, liver disease, and others that are readily preventable are more common in American Indians.
Food Insecurity
The majority of reservations are thought to be food deserts, where it is difficult to find healthful food. Food deserts are regions of the nation that lack fresh produce and other wholesome whole foods and are typically located in underdeveloped communities. This is mostly brought on by a dearth of supermarkets, farmer’s markets, and sources of healthful food. A person or group of individuals with the first type of food insecurity do not possess enough to eat. The second type of food insecurity occurs when a person or group lacks access to enough nourishing and culturally acceptable food to eat. Poor health in adults and children, sadness and anxiety in adults and adolescents, and adolescent suicide thoughts have all been linked to food poverty.
Health Promotion
Current Health Promotion
Tribes and communities who identify as American Indians benefit from the traditional and cultural teachings and practices that encourage strong, resilient bodies and good lifestyles. Tribal chiefs said that neither the general public nor government authorities were in favor of these practices. Seven strategies that strengthen ties to the community, household, and culture and can lower risks for chronic illness among American Indians were identified during convenings held by CDC with tribal cultural leaders.
Suggested Health Promotion Approach
As previously mentioned, one of the primary issues for American Indians is alcohol and tobacco abuse, which leads to severe illnesses. In preventive health promotion, three types of prevention are used: primary, secondary, and tertiary. The primary strategy is dedicated to preventing issues in general, and therefore, to prevent tobacco and alcohol abuse among American Indians, social advertisements should be used (Kisling & Das, 2022). They should be widespread in the sources of information, as well as provided to schools, to prevent further development of abuse in communities. The secondary strategy is dedicated to detecting illness at an early stage, and therefore, smokers and drinkers should regularly see doctors, which is an issue for American Indians. Allowing affordable check-ups, providing more hospitals to communities, and promoting healthcare could help solve these issues. Tertiary strategies are related to treating patients who are ill already and to helping people whose health condition was affected by alcohol and tobacco, and proper medical treatment should be provided to American Indian communities.
Suggested Cultural Considerations
When developing a care plan, it is necessary to consider that:
- Minority populations of all races, including the American Indians community, are more susceptible to developing chronic illnesses.
- Patients with chronic diseases are more likely than other patients to attend medical facilities, which increases their contact with doctors and other healthcare professionals.
- If initiatives to improve culturally competent results for doctors and providers are not implemented, patients may experience detrimental health effects (Nahian & Jouk, 2022).
- A lack of cultural awareness will hinder patient-physician communication, raising the possibility of misdiagnosis and undermining public confidence.
- In the past, ethnic minorities have expressed a lack of relationship with doctors, little engagement in medical choices, and low satisfaction.
Conclusion
The most appropriate model for developing such a plan is Purnell’s model for cultural competence. It focuses on giving a basis for understanding the varied cultural characteristics, enabling nurses to properly perceive patient characteristics, including motivation, experiences, and ideas about healthcare and sickness (Purnell, 2019). Twelve domains make up the Purnell model: an overview of the history, family roles, communication, workforce challenges, high-risk behaviors, bio-cultural ecology, pregnancy, nutrition, death rituals, healthcare practices, spirituality, and healthcare professionals. Considering that factors related to these domains, including workforce challenges, high-risk behaviors, ecology, and nutrition, are significant issues for American Indians, this model seems appropriate. Therefore, it can be adopted when developing a care plan for American Indians and used to design prevention strategies dedicated to addressing several issues that lead to common problems in health among American Indians.
References
Lewis, J., Hoover, J. & MacKenzie, D. (2017). Mining and environmental health disparities in Native American communities.Current Environmental Health Reports, 4, 130–141.
Center of American Indian Resilience (2022). American Indian health equity/disparities.
Kisling, L.A. & Das, J. (2022). Prevention Strategies. StatPearls Publishing.
Nahian, A. & Jouk, N. (2022). Cultural Competence In Caring For American Indians and Alaska Natives.
Office of Minority Health. (2022). Profile: American Indian/Alaska Native.
Purnell, L. (2019). Update: The Purnell theory and model for culturally competent health care. Journal of Transcultural Nursing, 30(2), 98-105.