National Association of Social Workers

American Indian Social Workers Optimistic

Obama Vows 'More to Address Disparities in Health Care Delivery'

American Indians disproportionately suffer from a lack of access to quality health care.

By Matthew Malamud, News Staff

Credit: John Michael Yanson

Situated along the banks of the Rio Grande in New Mexico, halfway between Albuquerque and Santa Fe, is the reservation of the Santo Domingo Pueblo people. Archeologists estimate that the Pueblo people have been living off the same land and in the same adobe structures anywhere from 10,000 to 30,000 years.

They've survived European conquests, wars and the encroachment of Western society, holding fast to their traditional culture and centuries-old way of life.

Like so many other American Indian and Alaskan Native peoples, though, the Santo Domingo Pueblo disproportionately suffer from a lack of access to quality health care, the provision of which legally and constitutionally rests upon the United States government.

"The U.S. has promised much in the way of health care to the American Indian people," says Michael Bird, a social worker and member of the Santo Domingo Pueblo, referring to various treaties, legislation and executive orders. Bird, a past president of the American Public Health Association, calls them empty promises. "Just look at how they fund the Indian Health Service."

The IHS, an agency within the U.S. Department of Health and Human Services that serves as the principal federal health care provider and health advocate for approximately 1.9 million of the nation's estimated 3.3 million American Indians, is notorious for being severely underfunded and understaffed; even its new director, Yvette Roubideaux, M.D., a member of the Rosebud Sioux Tribe of South Dakota, admits as much.

"It is clear that we face enormous challenges as we consider how to change and improve Indian Health Service and how to address the health issues of the population we serve," Roubideaux said at her June 29, 2009, swearing-in ceremony.

Those health issues are myriad. In fact, American Indians as a group fare worse than all other minorities in terms of health disparities. For example, according to the IHS, American Indians born today have a life expectancy that is 4.6 years less than the rest of the U.S. population (72.3 years to 76.9 years, respectively).

Also, they die at higher rates than other Americans from tuberculosis (750 percent higher), alcoholism (550 percent higher), diabetes (190 percent higher), unintentional injuries (150 percent higher), homicide (100 percent higher) and suicide (70 percent higher).

But things are changing, or so American Indians have been promised once again.

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From January 2010 NASW News. © 2010 National Association of Social Workers. All Rights Reserved. NASW News articles may be copied for personal use, but proper notice of copyright and credit to the NASW News must appear on all copies made. This permission does not apply to reproduction for advertising, promotion, resale, or other commercial purposes.