Native Americans are also called American Indians, and they are the indigenous people of the United States of America. Over time, health disparities have existed among American Indian populations, and they keep on occurring across various age groups. Disparities in health indicate differences in well-being owing to sociodemographic variables such as gender and socioeconomic status (Sarche & Spicer, 2013). In this regard, this paper seeks to examine the health disparities of American Indians and the cultural barriers to healthcare that the group faces. This topic is significant as it educates healthcare providers about the notable health disparities that exist among minority groups, particularly American Indians and further shows how cultural practices influence the way American Indians perceive health care and its providers. In essence, understanding the health disparities within Native Americans can be helpful in developing culturally appropriate medical programs.
Cultural Population of American Indians
Presently, American Indians are considered the most culturally diverse individuals in the United States; they establish societies with clearly defined responsibilities, roles, religious rites and ceremonies, recreational and leisure styles, as well as economic and government systems. Research further indicates that social behavior which signifies group support, involvement, and consensus playe critical roles in defining the responsibilities as well as economic and government systems of the community members. At the same time, their political, economic, and social traditions reflect a dominant emphasis on group decision-making and engagement.
Essentially, the family is recognized to be the central pillar of the society of American Indians (Duran, 2014). Herein, the individuals live in extended families and kinship societies. Apart from a kinship system, Native Americans have formal and informal methods of organizing the community to ensure conformity. For instance, among the Crow Indians, there is the presence of "teasing cousins," who have the authority to make fun of other cousins to motivate them to adopt appropriate behavior. As a result, the person being teased adopts humility and proper etiquette. Thus, such relationship systems are meant to control the behavior of their people.
Native Americans also practice labor division based on gender to achieve order in the society. This ensures that tasks that are important to the well-being of people are accomplished. They usually have a system for assigning responsibilities to men and women that are based on the cultural values and beliefs of the tribe. Even though labor division is based on gender, women can perform male tasks and vice versa without being seen as deviant. Additionally, they have political, economic, and social freedom for both men and women. Thus, even though the genders are different, they are seen as equal. More specifically, male and female roles complement each other, and each role is seen as critical and necessary for the enrichment and survival of the community.
The family is vital in shaping the societal and cultural values of the American Indian children; they imitate and model the behaviors of significant individuals in their lives. Notably, the extended family is the foundation of tribal societies as many individuals including biological relatives are involved in child-rearing duties. Even though child raising is primarily the task of women, both genders work together to raise their children. It, therefore, needs no telling that children are valued in the community as they symbolize the renewal of life.
Traditionally, children were educated through the utilization of humor, stories, and theatre. They were taught to appreciate the community sincerely. At the same time, they were raised to adopt responsible behavior and comprehend that the community was only as robust as its members. However, currently, Native American children attend schools whose curricula are tailored to primitive learning needs and worldviews.
Native Americans conceive sacred sites or spirituality as consisting of all aspects of their ways of life. Religion is embodied into their being from the conception time, where some tribes perform various rites and rituals to certify the delivery of a healthy baby. In addition, religion is seen in their death ceremonies where the community takes great care to promote the return of the spirit of the deceased person to life (Duran, 2014). Native Americans who speak their native language have a likelihood of maintaining their religious customs, ceremonies, and traditions. Furthermore, they put more trust in their indigenous individuals for mental and physical health needs than in family therapists or Anglo medical doctors.
Health Disparities of Native Americans
According to Cobb, Espey, and King (2014), Native Americans experience an excessive burden from many infections and diseases that may be connected to risk behaviors such as the use of tobacco, physical inactivity, and poor diet. American Indians experience high mortality from tuberculosis, alcoholism, suicide, injuries, diabetes, and homicide. In fact, even the tribal leaders affirm that unintentional injuries, alcoholism, diabetes, and drug abuse are rapidly increasing in the community.
Markedly, alcoholism has been a problem for American Indians since its introduction to their way of life by early European settlers. Alcohol abuse in this community is at epidemic levels. Teenage drinking patterns, as well as peer and family influences on alcohol use, are common (Lamarine, 1988). Historically, American Indians made mild beers and other fermented beverages for ceremonial purposes. However, with time, European colonials introduced spirits and wine to Native Americans. At the same time, early traders used alcohol as a trade medium and, at times, provided free liquor during trade negotiations as it gave them an advantage. As a result, this contributed to heavy alcohol use among Native Americans, and the trend was passed down from generation-to-generation. Binge drinking, especially during the weekends and special occasions is particularly prevalent in the cultural population.
Tobacco use is also prevalent among Native Americans, especially in males. Many tribes value tobacco as a sacred gift and utilize it during ceremonies and as traditional medicine. However, most of its heavy and persistent users suffer health issues such as respiratory problems and heart attack. American Indians are also likely to be obese or overweight due to the lack of physical activity during their leisure time; the primary risk factor for obesity is a sedentary lifestyle.
Additionally, Native Americans consume less fruits and vegetables than the recommended intake by health nutritionists. This dietary pattern highly contributes to the onset of obesity and other illnesses. Essentially, the Native Americans traditionally categorize foods into weak as well as healthy foods. Foods considered to be healthy such as fried bread, meat, potatoes, and corn are believed to boost good health. Also, a common belief is that the elderly people should drink goat milk. Since the people are more inclined to consume proteins and carbohydrates - which they regard as healthy foods - they have over the years reduced their consumption of fruits and vegetables.
Native Americans hold the belief that their healing traditions and practices function in the context of four constructs: community, spirituality, environment, and the self. Some Native Americans are using both traditional and western medicine to assist with a variety of diseases and illnesses that they are suffering. The most prominent diseases to hit American Indians are HIV and diabetes. Although traditional medicine cannot heal HIV, it has the capability of bringing balance back to an individual's soul which aids that person to deal with the illness better. Moreover, native Americans use traditional medicine to help with diabetes.
Notably, American Indians continue to experience high mortality rates and health disparities than the rest of the population of the United States. For instance, Indian Health Service (IHS) claims that the death rate of American Indian adults is more than that of the general population by approximately 0.4% (Sarche & Spicer, 2008). These deaths are attributed to liver cirrhosis, diabetes, tuberculosis, accidents, among other factors. American Indian children in the development spectrum also go through physical health-related discrepancies (Sarche & Spicer, 2008). There is insufficient prenatal care, thereby leading to post-neonatal deaths among Native American infants; the rate of post-neonatal mortality is two times higher among Native American Indians as compared to white infants.
More physical health disparities can be seen in Native American children starting from early childhood and progressing throughout development. These may include childhood obesity and dental caries. According to national research, children of Native Americans are three times as likely to be overweight, and 0.79% of the children had caries experience, while 0.68% had dental decay that was not treated (Sarche & Spicer, 2008). Disparities in mental health can also be seen in rising cases of depression, alcoholism, and posttraumatic stress disorder. Worse still, suicide deaths in American Indian population are 0.72% higher than those in the whole population.
Cultural Barriers to Healthcare
Many traditional American Indians do not believe in Western medicine for treating all kinds of diseases. Healing is identified as sacred work; it cannot be considered successful without taking into account the spiritual aspect of the person. Many modern Indians use Western medicine in the treatment of "white man's disease" (for example cancer and diabetes) and use traditional drugs to prescribe pain and sickness of the spirit (Bassett, Tsosie, & Nannauck, 2012). This indicates that Native Americans do not fully trust contemporary medicine because of their spiritual beliefs. As a result, many sick people in the cultural population avoid going to health facilities as they believe in traditional medicine, thereby making this the biggest cultural barrier to healthcare.
In conclusion, health disparities continue to exist among minority groups, particularly among Native Americans. Native Americans practice many traditions that influence how they perceive healthcare and modern medicine. The population has high mortality rates due to suicide, cancer, diabetes, pneumonia, and liver cirrhosis. More specifically, high-risk health behaviors such as alcohol and tobacco use, poor nutrition, and lack of exercise have contributed to many health problems among this cultural population.
Bassett, D., Tsosie, U., & Nannauck, S. (2012). "Our culture is medicine": Perspectives of native healers on posttrauma recovery among American Indian and Alaska native patients. The Permanente Journal, 16(1), 19-27.
Cobb, N., Espey, D., & King, J. (2014). Health behaviors and risk factors among American Indians and Alaska natives, 2000-2010. PubMed Central, 104(3), 481-489. https://dx.doi.org/10.2105%2FAJPH.2014.301879
Duran, B. (2014). American Indian belief systems and traditional practices. University of Oklahoma, 2-6.
Lamarine, R. J. (1988). Alcohol abuse among native Americans. Journal of Community Health, 13(3), 143-155.
Sarche, M., & Spicer, P. (2008). Poverty and health disparities for American Indian and Alaska native children: Current knowledge and future prospects. PubMed Central, 1136, 126-136. doi: 10.1196/annals.1425.017.
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