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HEALTH CARE NEEDS OF NATIVE AMERICANS.
Term Paper ID:28410
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Essay Subject:
Cites prevelant conditions--diabetes, cancer, suicide. Recommends & discusses specific reforms including access, quality & funding of health care.... More...
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7 Pages / 1575 Words
9 sources, 12 Citations,
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Paper Abstract:
Cites prevelant conditions--diabetes, cancer, suicide. Recommends & discusses specific reforms including access, quality & funding of health care.
Paper Introduction:
THE HEALTH CARE NEEDS OF NATIVE AMERICANS
Nature of the Group
An excellent description of the current health care status of Native Americans has been provided by Ray Began who, in 1998, was the President of the Association of American Indian Physicians. In this regard, it is noted by Began that in general this is a community where there are profound health care needs that are not being adequately addressed by the current health care system. As Began reports:
Native Americans receive the lowest health care dollars allocated by the Department of Health and Human Services (HHS) Indian Health Service. The per capita amount spent on health care for Native Americans is only $1,132 compared to the $3,261 spent
Text of the Paper:
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A good deal ofthis is attributed to the need for improved screening practices. Regarding specific health care needs, it is reported by Began thatDiabetes Mellitus is widespread in the Native American population wit thePima Indians having the world's highest rate of Diabetes with lower limbamputation as a secondary result of the disease. International Journal of Health Planning Management,5(3), 187-199. Meeting the needs of under-serviced communities:one university's externship experiment. References Barlow, A. A critical appraisal of the Navajohealth care system. Began, R. In addition, since such agencieshave been found to be better in defining tribal health care needs,conceptualizing tribal problems and implementing appropriate theoreticalmodels, this will also operate to improve supply or quality of care. In this regard, he notes thatseveral programs designed for Native Americans, such as new Diabetesprograms and projects, are allocated for the basic start-up programs theydo not cover on-going concerns Began states that funds need to be allocatedin very fiscal year budget if programs are to truly be effective. Probe, 29(5), 175-177. In this regard, it is notedby Began that in general this is a community where there are profoundhealth care needs that are not being adequately addressed by the currenthealth care system. Further, Novins,Fleming, Beals and Manson (2 ) report that alcohol with all of itsserious effects (e.g., more frequent need for health care services andincreased costs, increased visits to the emergency room, children born withfetal alcohol syndrome, lost productivity and employment, loss ofproductivity, profits, and competitiveness of Native American business,etc.) is a far greater problem among Native Americans than among many otherethnic groups. In this regard, he notes thatseveral programs designed for Native Americans, such as new Diabetesprograms and projects, are allocated for the basic start-up programs theydo not cover on-going concerns Began states that funds need to beallocated in very fiscal year budget if programs are to truly be effective. Further,such agencies are said to give a tribe a stronger feeling of self-determination. (1998). (p. No empirical evaluation of the plan wasconducted and thus there is no factual demonstration of its efficacy.Nonetheless, the existing research clearly indicates that the reformssuggested in the plan are at least likely to work to improve the healthcare provided to this population. Health Care, 2 (5), 517-525.----------------------- 9 Third, an increase in the tribal agencies and organizations thatprovide services will operate to increase access because the culturalconflicts and misunderstandings that can cause people to delay or refusetreatment will be drastically reduced. Also, Strickland (1999) notes that these agencies have also beenfound to be better in defining tribal health care needs, conceptualizingtribal problems and implementing appropriate theoretical models. health system In General. Effects of the Plan on Demand, Supply and Cost The developed plan should operate to improve access, the quality ofthe services, and costs as well. It is recommended that medical schools increasingly developprograms that are sensitive to societal needs and especially to those needsof under-served communities such as Native Americans. 5. Began (1998) feels that another way in which funds could be bettermanaged and so more monies made available for effective health care is fortheir allocation structure to be changed. Urban native American health issues.Cancer, 88(5 Suppl), 12 7-1213. First, by providing increased consultationand supervision to native outreach and other mental health workers, qualitywill be increased. & Pineault, R. Cancer, 78(7 Suppl), 1578-1581. The importance of qualitative research inaddressing cultural relevance: experiences from research with PacificNorthwest Indian women. THE HEALTH CARE NEEDS OF NATIVE AMERICANS Nature of the Group An excellent description of the current health care status of NativeAmericans has been provided by Ray Began who, in 1998, was the President ofthe Association of American Indian Physicians. Thus medical/treatment efforts must be supportedby educational programs that focus on prevention through decreasing stress(a well established contributor to illness) as it relates to risk factorssuch as geographic and socio-organizational accessibility, economicproblems and high unemployment. This is because Baris and Pineault (199 ) havenoted that such agencies can often do only so much as they tend to use abasically medical model. One point that must be made regarding reforming the health caresystem by increasing direct provision of health care services by Indiantribes, is that this reform really needs to work hand-in-hand with the useof educational programs. Fourth, an increase in medical school programs focusing on how bestto meet the needs of under-served populations such as Native Americanswill, in the long run, should also improve the quality of care given. Document available: www.aaip.com. Baris, E. 3. Kaur, J.S. The potential impact of cancer survivors on NativeAmerican cancer prevention and treatment. In the area of mental health, it is recommended that the systembegin to provide increased consultation and supervision to native outreachand other mental health workers; this because a review of the generalresearch on mental health services models conducted by Barlow and Walkup(1998) indicated that this reform is a more acceptable and potentiallymore effective use of scarce resources. Robbins, A. & Manson, S.M. Evaluation and SummarySummary Based on a search of the literature on the health care needs ofNative Americans, it was noted that the population suffersdisproportionately from certain conditions and that there were problemswith access and quality and funding. & Walkup, J.T. Further, there are indications that educationgiven to one family member can help him or her to recognize the symptoms inanother thereby increasing the chances that the other person will receivetimely services. First, Robbins(1997) points out that one move that would lower costs would be to providetribal agencies and organizations with extensive training on resource andpersonnel management. Based on the research noting thisproblems and suggesting solutions, a system of health care for thepopulation was formulated, this system consisting of an inter-relatednetwork of certain basic reforms in the existing system. (1998). American Journal of MedicalQuality, 15(4), 148-156. Novins, D.K., Fleming, C.M., Beals, J. Began (1998) feels that another way in which funds could be bettermanaged and so more monies made available for effective health care is fortheir allocation structure to be changed. Itconsists primarily of a document search and subsequent analysis of therelevant articles and publications. System of Health Care That Addresses Needs One solution to the health care problems of Native Americans is tomake targeted and specific reforms in the existing health care system,reforms that specifically address and meet, at least in part, thoseparticular health care needs of the Native American population. 4. As Began reports: Native Americans receive the lowest health care dollars allocated by the Department of Health and Human Services (HHS) Indian Health Service. Also, End Stage RenalDisease is much higher in Native Americans with Diabetes than in otherethnic groups with Diabetes. (1995). (2 ). Also,by creating in at least some students, a greater awareness of theirobligations to serve the medical needs of all of society and not just apart of it, it is likely that this reform will also produce a greaternumber of health care personnel desiring to work with under-servedpopulations thereby increasing service to greater numbers of people in thepopulation. Recommendedreforms included: increasing consultation and supervision of mental healthpersonnel, increasing the number of educational programs focusing onprevention that are provided to Native Americans, increasing the directprovision of health care services by Indian tribes, changing the structureand management of funds, and advocating that medical schools develop moreprograms that are sensitive to the needs of under-served communities.Evaluation The plan developed in this project was based on a comprehensivesearch of the literature on the health care needs of Native Americans. It is recommended that there by an increase in agencies andorganizations involved in the direct provision of services by Indiantribes; this recommendation is formulated based on Novins, Felming, Bealsand Manson's (2 ) observances that when Native American Tributes areinvolved in the actual provision of services, problems such as resistanceto following treatment, feelings of being a "second class" citizen in theeyes of service providers, and a host of other caregiver-caretakerinteractions that interfere with effective treatment can be markedlydecreased. Department of Health and Human Services, handling the changingrelationships with the Indian Health Service as tribes move towards greaterindependence, reductions and restructurings of Medicaid, Medicare, welfare,and any existing tensions between Native and non-Native staff. Challenges To native american health care evenmore profound than those facing the U.S. (May 21, 1998). (1997). Based onresearch conducted to examine the health care problems of the population,the following reforms are suggested: 1. 1). In addition, Burhansstipanov (2 ) reports that while cancer,especially breast cancer, is high in the Native American Population,treatment procedures and consequent survival rates are poor. (199 ). Second, educational programs of the type recommendedwith reduce costs because of their preventative role. Further, it will increased students' degree of preparedness inworking with the under-served. (2 ).Commentary: quality of alcohol, drug, and mental health services forAmerican Indian children and adolescents. It is recommended that new funding approaches be used to pay forthe cost of these reforms. In the area of prevention of diseases common in the community, itis recommended that the system develop educational programs that focus onbehaviors (e.g., nutrition) that can operate to prevent the disease; thisis recommended because Kaur (1996) observed that the high incidence ofcancer among Native Americans can be substantially decreased wheneducational efforts focus on increasing awareness of cancer risks andsymptoms, fatalism, and lack of access to screening services. 2. Child and Adolescent Psychiatric Clinics ofNorth America, 7(3), 555-577. Burhansstipanov, L. The per capita amount spent on health care for Native Americans is only $1,132 compared to the $3,261 spent per capita on non-native Americans. Developing mental health servicesfor Native American children. Unmet health care needs of nativeamericans. However, given the lack of evaluativeresearch on the plan, it should be considered to be preliminary in natureand understood that its effectiveness needs to be determined by futureresearch. (1999). Odlum, O. Documentavailable: www.arobbins@nlm.nih.gov Strickland, C.J. Finally, the recommendations for changing elements of fundingstructure and management should, if they are successful, provide NativeAmericans will more for actual service provision which could, in turn, canbe used to improve both quality and access. According to Odlum(1995), this kind of reform, although it may take years before its effectsare realized, will create in students far greater awareness of theirobligations to serve the medical needs of all of society and not just apart of it. This can be done in several ways. Also, suicide is said by Began (1998) to be the second leading causeof death among Native American adolescents; this while there are no morethan 59 psychologists in the Indian Health Service. Robbins reports that in terms of management needs,Native American health systems could be helped to respond more fully andmore cost effectively to such problems as: procuring funding, difficulty inrecruitment and retention of professional staff due to remove locations,ongoing difficulties being able to depend upon contracts between tribes andthe U.S. Kaur alsosuggests that cancer survivors in native communities be used as resourcesto educate others, raise cancer awareness, and most importantly prove thatcancer is not always fatal. Bettermanagement in each of these agencies, according to Robbins could wellprovide increased funds for actual service provision.
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