The Native American population has been historically discriminated against, with the consequences of systemic prejudice and low access to necessary healthcare services still being felt today. However, there is hope to minimize the implications of this prejudice and unequal access to resources. With the right approach, one can ensure a brighter future for this demographic and combat the systemic discrimination that has plagued them for far too long.
Background
Native Americans have experienced the negative consequences of prejudice and discrimination for centuries. Namely, the researchers highlight that the demographic has been through genocides, forced migrations, and segregation since the Europeans arrived on the continent (Findling et al., 2019). The consequences were associated with the desire to take on the territories that had already been in possession of Native Americans. Thus, historically, the demographic has been discriminated against.
The negative consequences were evident from a political, economic, and legal perspective. The political overview highlights an environment in which the demographic is rarely represented, which is why no specific legislation are being implemented with the aim of minimizing vulnerability. Economically, statistics highlight that Native Americans have an unemployment rate of 6,6% and a poverty rate of 25%, which is much higher compared to the white population (3,5% and 8,3%, respectively) (Asante-Muhammad & Ramirez, 2019). Legally, the group is overrepresented in crime statistics and prison populations. Thus, it is certain that centuries of violations and prejudice toward a demographic can negatively impact its current situation concerning economic stability, political representation, and legal assistance.
Historically, both institutionalized discrimination and individual one have been directed towards Native Americans. From an institutionalized perspective forced migration and the implementation of European values have been generated by the authorities, such as in the example of schools for forced assimilation (Rolnick, 2021). Nowadays, individual discrimination and resentment toward the group persist (Foxworth & Boulding, 2021). This has been documented in recent studies, which illustrate that 23% of Native Americans have experienced discrimination in clinical settings, and that close to 40% of the population have experienced or witnessed family members experience violence, with around 35% of the population having been harassed (Foxworth & Boulding, 2021; Findling et al., 2019). This underscores the challenges that Native Americans have had to contend with for a long time, having experienced a lengthy period of oppression and bias.
Geographic Dynamic
As the European settlers discovered the new territories and decided to migrate, Native Americans experienced challenges correlating with the dynamic. Namely, the Indian Removal Act was signed in 1830, allowing Europeans to forcefully take territories previously belonging to native tribes (Indian Removal Act: Primary Documents in American History, 2019). According to National Geographic Society (2022, para. 2) statistics, more than 46,000 Native Americans were pushed to quit their homes and migrate to “Indian Territory.” Moreover, over 4,000 people perished on the trek due to sickness, malnutrition, and exposure to harsh weather (National Geographic Society, 2022, para. 2). Such violations have impacted the demographic and have become a barrier that minimizes opportunities for economic, social, and health-related growth. For example, more than 42% of historical tribes currently have no official territory, and the tribes hold an average of 2.6% of their approximate heritage area (Treisman, 2021, para. 10). Thus, the historical background for the migration of Native Americans affects the group today and has generated challenges that are to be adequately addressed.
The demographic experienced cultural and physical assimilation due to the migration of Europeans who installed their premises as primary ones. Namely, Native Americans were viewed as in need of a transformation that correlates with the religious, social, and cultural values of European populations (Cromer et al., 2018). Nonetheless, the current division highlights the fact that the forceful assimilation generated a gap between the demographic and the rest of society. As such, according to statistics provided by Asante-Muhammad et al. (2022, para. 8). Native Americans’ national poverty level is 25.4%, the largest rate among other minorities in the US. Additionally, American Indians have an average lifespan that is 5.5 years lower than the overall population of the United States (Indian Health Service, 2019, para. 4). Lower life expectancy and a significant illness load may arise due to insufficient education, overwhelming poverty, discrimination in healthcare delivery, and cultural differences. Thus the immigration trends over time highlight the remaining negative consequences.
Health
Native Americans are vulnerable to experiencing negative health outcomes, especially compared to other demographics. Hence, the population is more likely to suffer from certain conditions, experience negative health effects, and be exposed to risks. Reports suggest that 15% of the group’s members have type 2 diabetes, almost 40% are obese, and close to 20% are regular smokers (Small-Rodriguez & Akee, 2021). However, while Native Americans are more likely to encounter such barriers, the existing prejudice and racism generate circumstances in which they cannot access high-quality, patient-centered medical care. The issue is not regulatory but rather socio-cultural and institutional (Liddell, 2020). Native Americans are much less likely to take advantage of said options due to the lack of trust and confidence in the solutions and a lack of culturally appropriate approaches.
The fact that the demographic does not utilize the right to access healthcare services becomes more severe, considering the prominence of certain conditions correlating with the population. Namely, Native Americans are more likely to have illnesses correlating with substance abuse, injuries, diabetes, and liver disease (Skewes et al., 2020). The challenge, however, is not to generate opportunities for health insurance. Instead, the main problem is creating circumstances in which Native Americans take advantage of the services instead of avoiding facilities and doctors. This can be achieved through diversity and patient-centered approaches that consider the cultural traits of each individual within the demographic.
Practices to Employ
Applying a culturally-inclusive method would minimize the potential gap between the two parties and facilitate a more understanding and mutually beneficial environment. As such, cultural considerations are vital when it comes to minimizing health barriers. For example, researchers highlight the importance of cultural competency when addressing substance use among Native American communities (Skewes et al., 2020). As a result, the healthcare provider is to avoid being dismissive in case the patient exemplifies certain concerns, questions, or misunderstandings occurs.
Regarding beginning and end-of-life decisions, the health care practitioner is to remember the importance of patient-centered care principles. Researchers highlight the significance of compassion and aiming for goals that are set together with the patient (Glover & Kluger, 2019). When a healthcare provider works with a member of the aforementioned demographic, similar values should be at the core of communication and decision-making. If dietary guidelines are necessary to be implemented, the practitioner has to remember the economic and socio-cultural aspects and recommend products that are both accessible and familiar to the patient. Concerning gender, the health provider should not differentiate between male and female Native Americans. Nonetheless, acknowledging that gender affects decision-making and is a potential barrier to access to care is vital for creating equal opportunities for all community members.
Conclusion
To conclude, Native Americans have been historically oppressed, and the consequences of this violence continue to be felt in the community today. A culturally-conscious approach must be employed in order to create circumstances where Native Americans can access the care they so desperately need. This can be accomplished by implementing communication measures and community-led interventions tailored to the unique culture and needs of Native Americans.
References
Asante-Muhammad, D., & Ramirez, K. (2019). The economic reality of Native Americans and the need for immediate repair ” NCRC. Web.
Cromer, L. D. M., Gray, M. E., Vasquez, L., & Freyd, J. J. (2018). The relationship of acculturation to historical loss awareness, institutional betrayal, and the intergenerational transmission of trauma in the American Indian experience. Journal of Cross-Cultural Psychology, 49(1), 99–114. Web.
Findling, M. G., Casey, L. S., Fryberg, S. A., Hafner, S., Blendon, R. J., Benson, J. M., Sayde, J. M., & Miller, C. (2019). Discrimination in the United States: Experiences of Native Americans. Health Services Research, 54(S2), 1431–1441. Web.
Foxworth, R., & Boulding, C. (2021). Discrimination and resentment: Examining American attitudes about Native Americans. The Journal of Race, Ethnicity, and Politics, 7(1), 9–36. Web.
Glover, T. L., & Kluger, B. M. (2019). Palliative medicine and end-of-life care. Handbook of Clinical Neurology, 545–561. Web.
Indian Health Service. (2019). Disparities. Newsroom. Web.
Indian Removal Act: Primary Documents in American History. (2019). Web.
National Geographic Society. (2022). May 28, 1830 CE: Indian Removal Act. Web.
Rolnick, A. C. (2021). Assimilation, Removal, Discipline, and Confinement: Native Girls and Government Intervention. Columbia Journal of Race and Law, 11(3), 811-860.
Small-Rodriguez, D., & Akee, R. (2021). Identifying disparities in health outcomes and mortality for American Indian and Alaska native populations using tribally disaggregated vital statistics and health survey data. American Journal of Public Health, 111(S2). Web.
Skewes, M. C., Gonzalez, V. M., Gameon, J. A., FireMoon, P., Salois, E., Rasmus, S. M., Lewis, J. P., Gardner, S. A., Ricker, A., & Reum, M. (2020). Health Disparities Research with American Indian Communities: The importance of trust and transparency. American Journal of Community Psychology, 66(3-4), 302–313. Web.
Treisman, R. (2021). How loss of historical lands makes Native Americans more vulnerable to climate change. NPR. Web.