Native Village
Youth and Education news
Volume 3, November 2011

American Indians fall through health-care cracks
Condensed by Native Village
The death rates for American Indians and Alaska Natives are much larger than the national average:
 600% higher.
510% higher.
Motor vehicle crashes:
229% higher.
18% higher.
Unintentional injuries: 
152% higher.
61% higher.
62% higher.
Statistics and Map of IHS Regions and Clinics:  Indian Health Services 

Indiana: Lou Ann Bush and Argentina Hayes have much in common: both are American Indian; both live in Indiana;  both have diabetes, and both say they're not receiving the health care promised to them.

Bush is from the Sault Ste. Marie Tribe of Chippewa. Every three months --if she can afford it -- Lou Ann drives more than 400 miles to her tribe's homeland to see her doctor.

Most often she calls Ask-A-Nurse. Usually, the nurses with whom she speaks know nothing about her medical history.

Hayes is a Chiricahua Apache. She doesn't have medical insurance, so she doesn't see a doctor for medication.  Instead, she gulps three spoonfuls of coconut oil to bring down her sugar level.

Bush and Hayes are among thousands Indiana's Native Americans who lack easy access to Indian Health Service. IHS is a nationwide network of clinics and hospitals run by the federal government. Their purpose is to provide free health care for American Indians. IHS clinic caregivers are either fellow American Indians or trained to effectively communicate with American Indians,

The 2010 census shows that about 18,000  American Indians live in Indiana. Thousands are from federally recognized tribes. Yet, this "Land of the Indians" is one of the few Midwestern state without an IHS clinic. The reason: no federally-based tribes live in Indiana -- a requirement for placing an IHS clinic in a state.

This issue concerns American Indians who move to Indiana from a reservation or state with Indian Health Service clinics. Most assumed there would be a clinic wherever they lived.

Doug Poe is from the American Indian Center of Indiana. One of the first questions American Indian newcomers ask him is:  Where can I get my medications or go to the doctor?

His answer: "You can't."

Even for Native people with insurance, there is a question of adequacy. Health care is more than a physician's diagnostic skills. It is also about communicating and making patients feel comfortable -- building trust. And trust is complicated by history.

"It's called historical trauma because of what has happened to us in the past, "Bush said. She doesn't trust doctors enough to give them her personal and medical information.

Elders who spent their entire lives on reservations feel the same, says Sally Tuttle, an Indiana resident from the Choctaw Nation of Oklahoma.

"You just don't walk in and say, 'Hey, take off your clothes. I'm going to examine you,' " she said. "The old ways are still working for them."

Nationwide, more than half of American Indians and Alaska Natives rely on IHS.  Centuries-old treaties required the U.S. to provide education and health benefits in exchange for their land. Indiana belongs to the IHS' Bemidji Area which serves MN, WI, MI, and IL. For some, the closest facility is an urban clinic in Chicago that provides limited services.

This angers many. The lack of IHS clinics is just another broken promise made to American Indian governments.

"Why should I have to stay in my home territory to receive what the treaties said that my ancestors, my kids and myself are entitled to?" Tuttle asked. "If you're in Indiana, and you're a member of a federally recognized tribe, doesn't that mean you should be able to get services?"

Both Poe and Tuttle have made it personal goals to bring Indian Health Service to Indiana.  One effort was  encouraging American Indians to complete a survey by Indiana's State Department of Health.

Some information Indiana's survey hopes to answer rregards Indian Health Service:
Do Native Americans in their community have access to health services?
Do health services even exist in their community?
 Have they been denied health care?
How far so they have to travel to visit an IHS clinic?
 Are they satisfied with the services?
Do they have insurance to meet your needs?
Are there gaps in your coverage?
 Is it affordable?

Such information is now unavailable. Without it, the state's American Indians health-care needs is only a guess.

Bush filled out the survey and hopes it will make a difference. She said having an nearby Indian Health Service clinic would make a big difference in her life.

The same goes for Hayes, who also has a thyroid problem. She occasionally receives thyroid medicine from her son or friends. But she's supposed to take that medication daily. When she misses, her eyes swell.

"It's only a matter of time," Hayes said, "before that happens again."

Tuttle said it shouldn't be that way. "The first people in this country, or even in this territory are are out in the cold."

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