By any measure, health care for Native Americans lags behind other groups, despite a legal obligation on the part of the United States to provide health care to American Indians and Alaska Natives. Native American communities face significant inequity in health care and health status compared to other U.S. populations. Health outcomes for Native Americans are adversely impacted by wholly inadequate access to comprehensive health services.
American Indians and Alaska Natives born today have a life expectancy that is 4.4 years less than the United States’ all races population, and they continue to die at higher rates than other Americans in many categories of preventable illness, including chronic liver disease and cirrhosis, diabetes, and chronic lower respiratory diseases.
The Indian Health Service (IHS)—an agency within the U.S. Department of Health and Human Services—provides care to over 2.2 million Native Americans across the country. Although IHS fulfills treaty responsibilities to provide health care for members of more than 560 recognized tribes, Congress has consistently underfunded the agency, forcing hospital administrators to limit the services offered. As a result, tribal members have a different health care reality than many other U.S. citizens. For example, to match the level of care provided to federal prisoners, funding would have to nearly double, according to an analysis by the National Congress of American Indians. Funding would need to be even higher to match the benefits guaranteed by programs such as Medicaid.
Against this decades-long underfunding, there are overarching challenges in health care that further exacerbate access to care for American Indians. For example, a common challenge in many rural communities is the shortage of medical personnel; a problem that is even more severe in tribal communities, especially those in remote reservation locations. The IHS Scholarship Program provides qualified American Indian and Alaska Native health profession students an opportunity to establish an educational foundation for a career in health care and serve medically underserved Indian health programs throughout the country. Since IHS began providing scholarships in 1978, nearly 7,000 students have received awards. The Loan Repayment Program awards repayment of up to $40,000 for qualified health profession education loans to clinicians. These new providers are typically placed in Indian Health Program facilities with the greatest staffing needs. With shortages of clinicians that number in the thousands across American Indian and Alaska Native communities, markedly expanding these programs is essential to ensuring communities have needed providers.