Introduction
The health of ethnic minorities is among the most important questions related to the healthcare system in the United States. Due to some disparities linked to populations’ economic status, access to resources, and other factors, specific approaches to health promotion are needed to encourage the well-being of minorities. This paper focuses on the unique problems of American Indians and Alaskan Natives (AIAN), health-related differences between this and other groups, and improvement strategies.
Group Identification and Description
AIAN is the minority group that includes the representatives of a few hundred indigenous tribes except for Native Hawaiians. According to the Office of Minority Health (2018), this ethnic minority presents about 2% of the U.S. population. Concerning the health status, as the Centers for Disease Control and Prevention (2017) reports, about 27% of people from the group aged 1-64 are uninsured compared to the national average not exceeding 10%. More than 13% of them are in poor health, which is about two times as large as the average value (CDC, 2017). As is clear from the data, the chosen population’s current health status is far from perfect.
The health situation of the minority population is heavily influenced by race and ethnicity that are related to economic inequality. More than a quarter of the AIAN population live in poverty, and only 60% of them are urban citizens, which impacts their access to healthcare (OMH, 2018). Another factor linking ethnicity and poor health is the population’s territorial isolation associated with underdeveloped hospital infrastructure (OMH, 2018). Therefore, AIANs’ health status has to deal with some culture-specific factors.
Health Disparities and Nutritional Challenges
The AIAN population in the United States experiences a range of health disparities contributing to its present health situation. In addition to the mentioned health insurance rates, the group is in a disadvantageous position when it comes to an average life span and the quality of living (OMH, 2018). The same is true in relation to morbidity rates for some chronic health conditions. Compared to White Americans, AIANs are statistically more likely to develop type II diabetes, cancer, and cardiovascular disease (Adakai et al., 2018). With that in mind, the population’s health risks present a particularly important research topic.
As for nutritional challenges, they exist due to two factors, such as financial inequality and ineffective efforts aimed at healthy lifestyle promotion. For example, according to the data for the Arizona population in 2017, AIANs were more likely to consume a lot of alcoholic drinks and sweet beverages compared to other ethnic groups (Adakai et al., 2018). As is stated by Jernigan, Huyser, Valdes, and Simonds (2016), the population is affected by both undernutrition and obesity. One of the biggest challenges is territorial isolation resulting in poor access to food. As of 2016, almost 60% of the U.S. population and only 25% of AIANs needed to travel less than one mile to reach the closest supermarket (Jernigan et al., 2016). With that in mind, the group may need specific programs increasing people’s access to fresh and healthy food.
Barriers to Health
Nowadays, barriers to health impacting the chosen population are widely recognized. The factors that prevent AIANs from accessing healthcare services and taking care of their health include discrimination, bureaucracy, and transportation (Wille, Kemp, Greenfield, & Walls, 2017). Socioeconomic and sociopolitical factors contributing to these limitations include AIANs’ low-income levels compared to the majority population, geographic/social isolation, healthcare underfunding, and similar issues (Wille et al., 2017). As for education, AIANs aged 25 or older are two times less likely to have a master’s degree than non-Hispanic Whites, which impacts wage rates and people’s opportunity to afford healthcare (OMH, 2018). Speaking about culture, the chosen group has a variety of healing traditions, but not all of them align with the current medical knowledge (Moorehead, Gone, & December 2015). Despite their cultural value, these traditions need to be used in combination with evidence-based medicine to avoid creating additional barriers to well-being.
Practiced Health Promotion Activities
Just like any other ethnic group, the discussed population practices a number of health promotion activities, ranging from tribe-specific rituals to health education. To begin with, the selection of practices may depend upon geographical locations. Speaking about isolated and rural territories, it is necessary to mention that any tribe tends to have some unique health practices, including approaches to cooking, exercising, and seasonal rituals (CDC, 2019). In addition to some culture-specific health promotion methods, the group in consideration recognizes the achievements of medicine and implements practices that the majority of people in the United States would regard as traditional. They include patient-centered health education, events aimed at raising mental and physical health awareness, and similar methods (CDC, 2019). Thus, compared to the national average, the discussed group seems to be using a wider range of approaches to health promotion.
Levels of Health Promotion Prevention
Based on the previously identified health disparities existing for the group, care plans for AIANs should focus on the prevention of chronic and dangerous conditions. The American Indian Health Program (AIHP) is an approach to minority care implemented in Arizona (Arizona Health Care Cost Containment System, n.d.). This plan includes measures related to different levels of disease prevention; for instance, primary prevention is represented by immunization programs (AHCCCS, n.d.). As for secondary disease prevention, the served population has access to cancer and heart disease screenings, which indicates the recognition of disparities (AHCCCS, n.d.). Concerning tertiary prevention, AIHP covers the treatment of numerous conditions, including some types of cancer to improve patients’ quality of life (AHCCCS, n.d.). This plan meets the needs of the discussed minority group since the included initiatives and services are informed by health disparities for AIANs. Also, this approach to disease prevention includes patient education, which maximizes its effectiveness and helps to address knowledge disparities.
Culturally Competent Health Promotion
To create an effective care plan to serve the population in question, a range of cultural practices should be considered. The degree to which different AIANs implement traditional practices may vary, and such plans should be flexible. This group is extremely dissimilar in terms of spiritual practices, but Native American religions present a factor to be taken into account (Guttmannova et al., 2017). In the context of care, it involves making sure that AIAN patients or their relatives are free to implement spiritual practices and do not face discrimination. The Sunrise model of care proposed by Leininger can help to support health promotion initiatives targeted at AIANs. This model stresses the need for assessments to identify the key cultural components to be addressed in care plans (Cai, 2016). Also, given AIANs’ cultural diversity, this model can be helpful since it allows minimizing the impact of stereotypes on care practices (Cai, 2016). Therefore, the mentioned cultural model can help to strike the right balance between underestimating some unique cultural traits and stereotyping.
Conclusion
To sum it up, AIANs are among ethnic minority groups that face barriers to health-related to dissimilar factors. The key areas impacting their access to timely and high-quality services are wage levels, education, and geographic isolation. Nutritional challenges are also among the concerns contributing to the population’s current health status. To improve the situation, culturally competent approaches to health promotion should be designed and implemented.
References
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