American Indians fall through
The death rates for American Indians
and Alaska Natives are much larger than the national average:
Map of IHS Regions and
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
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
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,
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
"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
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
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
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?"
"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
complete a survey
Indiana's State Department of Health.
Indiana's survey hopes
to answer rregards Indian Health
Do Native Americans in
their community have
access to health
Do health services even
exist in their
Have they been denied health
How far so they have to
travel to visit an IHS
Are they satisfied with the
Do they have insurance
to meet your needs?
Are there gaps in your
Is it affordable?
Such information is now unavailable.
Without it, the state's American
Indians health-care needs
only a guess.
Bush filled out
the survey and hopes it
will make a difference. She said having an
Indian Health Service clinic
would make a big difference in her
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
"It's only a matter of time," Hayes
said, "before that happens again."
Tuttle said it shouldn't be that
"The first people in this country,
or even in this territory are are out in the cold."
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