Native Americans and reservation inequality
The Indian Self-Determination and Education Assistance Act (ISDEAA) resulted from culminating civil rights movements and calls for increased attention on Native American Affairs.
According to a 1997 study, "with the exception of cardiovascular diseases and cancer, the risk of death from most causes are higher among Native Americans than the total US population.
"[10] This increase is proposed to be based upon, as the same study states, "several potentially modifiable factors, including obesity, dietary composition, and physical inactivity.
[12] Multiple studies, including one presented in the American Journal of Epidemiology, describe the incidence of diabetes in the Pima Indians to be 19 times greater than a comparable white majority population.
The same source also argued that "data from American Indians and Alaska Natives need to be improved to allow better targeting of interventions to reduce health care disparities and monitoring the success of these activities.
[22] A 2009 study finds that there is a strong prevalence of cross-cultural miscommunication, mistrust, and lack of satisfaction among Native American patients when it comes to healthcare.
[23] A connection between mistrust from a community and health disparities is established in a 2014 study on "Cultural Identity and Patient Trust Among Older American Indians".
[25] The Association of American Medical Colleges (AAMC) supports that doctor-patient relationships and communication can be improved if members of their tribal communities themselves become healthcare providers.
[22] Native American doctors Siobhan Wescott and Beth Mittelstet argue that greater funding should be directed towards educating and encouraging indigenous people to become physicians in order to help remedy issues with staffing, reduce discrimination in care, lower Native American poverty rates, and increase patient advocacy among physicians.
[30] Several institutions such as UCSF, The University of Washington, and Massachusetts General Hospital have fellowships dedicated to filling full-time coverage positions.
[34] Several policy options have been proposed to help expand funding for Native American health initiatives that revolve around recognizing tribal sovereignty.
[35] Arizona already implemented this in 2012 by directing funds to the IHS and tribal facilities to cover care health costs for Native Americans.
Researchers have identified that issue has only come to light in the past few generations and much of it is linked to many individuals having a lack of healthy food options and an increased amount of time spent being sedentary.
Because the prevalence rates of obesity are higher in American Indians, studies have shown that the population will suffer from greater health complications later on in life as well.
The traditional Native American diet consisted wholly of lean meats, protein, fruits and vegetables and low in fat, non-processed sugars and sodium.
This lifestyle persevered until the 1830s through the 1840s, when under the Indian Removal Act, Native American tribes signed treaties with the U.S. government that relocated the entire population to live on secluded land which became known as a reservation.
In addition, in 1890, the government placed a ban on Native Americans which prevented them from leaving their lands to fish, hunt or gather in their usual territories.
The geographical isolation of many reservations create logistical and cost challenges, limiting people's ability to access affordable nutritious food because they live far from large grocery stores.
In addition, American Indians had significantly higher levels of food insecurity than the rest of the population, even after controlling for a wide range of demographic and socioeconomic characteristics.
Pilot school-based programs in the Southwestern United States suggest that Native American communities are actively receptive towards interventions within a school setting and that over time there is the potential of having a lower number of children meeting the BMI threshold of being obese.
People with diabetes can reduce their risk for complications if they are educated about their disease, learn, and practice the skills necessary to better control their blood glucose levels, and receive regular checkups from their healthcare team.
Navajos in favor wanted to pass a bill that could serve as a model for Indian country to improve the rates of diabetes and obesity among tribal members.
[54] Marijuana and prescription drug use for Native American teens are twice the national average and young people have been shown to start experimenting with alcohol at the age of 14.
These negative consequences include educational deficits, economic strain, poor marital outcomes, as well as slowed cognitive, social, and physical development in children of adolescent parents.
A Study completed by the United States Department of Agriculture found Native American young mothers on reservations show a tendency to begin prenatal care later than their peers.
[64] Advocates suggest the implementation of policies and programs that will delay sexual initiation and improve contraceptive use among Native teenagers as a possible solution to the rising rates of teen pregnancy.
[66] Some scholars suggest that historically, physical and sexual violence in Native American communities was rare in Pre-Colonial society, while others disagree.
[65] Additionally due to the overlapping jurisdiction of tribal, state, and federal authorities, enforcement of protection orders for victims remains largely unreliable.
[72] President Obama's White House administration vowed to veto any re-authorization of VAWA that failed to include the tribal protection clause.
[75] High suicide rates are often correlated with substance use disorder, alcoholism, depression, and poverty, widespread in many Native American reservations.
