Nationally designated heritage months attempt to honor contributions to society and to recognize injustices suffered among a specific group of people. It is only fitting, since November is American Indian and Alaska Native Heritage Month, to reflect on the health care and health outcomes of the “first Americans” that were nearly obliterated during the forging of this country and then promised quality health care through treaties with the federal government.
The Indian Health Service (IHS) operates within the Department of Health and Human Services as the federal agency responsible for administering health services to American Indians and Alaska Natives. Approximately 1.9 million people are under the care of the IHS, which has been charged with the goal of raising constituent health status to “the highest possible level.”
An article in the October issue of Health Affairs focuses on the success that innovations in health care have had in reducing health disparities of those under the care of the IHS, such as reducing the life expectancy gap between American Indian/Alaska Native people and whites by three years. Before we raise a banner proclaiming a mission accomplished, however, it is important to understand the health status of American Indians. American Indians face the highest prevalence among minority groups for obesity, current smoking, cardiovascular disease, and diabetes. Though improvements are notable, parity will never be realized unless policies are implemented to provide the IHS with adequate funding and solutions for removing cultural and structural barriers to access.