Indian Health Service Innovations Have Helped Reduce Health Disparities Affecting American Indian And Alaska Native People
ABSTRACT The Indian Health Service (IHS), a federal health system, cares for 2 million of the country's 5.2 million American Indian and Alaska Native people. This system has increasingly focused on innovative uses of health information technology and telemedicine, as well as comprehensive, locally tailored prevention and disease management programs, to promote health equity in a population facing multiple health disparities. Important recent achievements include a reduction in the life-expectancy gap between American Indian and Alaska Native people and whites (from eight years to five years) and improved measures of diabetes control (including 20 percent and 10 percent reductions in the levels of low-density lipoprotein cholesterol and hemoglobin A1c, respectively). However, disparities persist between American Indian and Alaska Native people and the overall US population. Continued innovation and increased funding are required to further improve health and achieve equity.
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ABSTRACT: The integration of public health practices with federal health care for American Indians and Alaska Natives (AI/ANs) largely derives from three major factors: the sovereign nature of AI/AN tribes, the sociocultural characteristics exhibited by the tribes, and that AI/ANs are distinct populations residing in defined geographic areas. The earliest services consisted of smallpox vaccination to a few AI/AN groups, a purely public health endeavor. Later, emphasis on public health was codified in the Snyder Act of 1921, which provided for, among other things, conservation of the health of AI/AN persons. Attention to the community was greatly expanded with the 1955 transfer of the Indian Health Service from the US Department of the Interior to the Public Health Service and has continued with the assumption of program operations by many tribes themselves. We trace developments in integration of community and public health practices in the provision of federal health care services for AI/AN persons and discuss recent trends. (Am J Public Health. Published online ahead of print April 22, 2014: e1-e8. doi:10.2105/AJPH.2013.301767).American Journal of Public Health 04/2014; DOI:10.2105/AJPH.2013.301767 · 4.23 Impact Factor
American Indian culture and research journal 01/2014; 38(1):157-190.
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ABSTRACT: Rare in Indian Country just 60 years ago, type 2 diabetes mellitus is now woven into the fabric of losses in tribal communities across North America. Westernized lifestyles, with coincident obesity and physical inactivity, are powerful risk factors for this relatively new “disease of civilization.” The web of causation is thicker and wider than obesity and physical activity alone, intertwined by historical, economic, environmental, and sociological roots.The purpose of this article is to describe a number of dynamic, tribally driven efforts that draw on traditional ecological knowledge to address the problem of diabetes in American Indian and Alaska Native communities.American Indian culture and research journal 01/2014; 38:1:157-190.