The reported population of American Indians and Alaska Natives has grown rapidly over the past 20 years. These changes raise questions for the Indian Health Service and other agencies responsible for serving the American Indian population. How big is the population? What are its health care and insurance needs? This volume presents an up-to-date summary of what is known about the demography of American Indian and Alaska Native populationâ€"their age and geographic distributions, household structure, employment, and disability and disease patterns. This information is critical for health care planners who must determine the eligible population for Indian health services and the costs of providing them. The volume will also be of interest to researchers and policymakers concerned about the future characteristics and needs of the American Indian population.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Presents the justification and advantages of providing mental health services in primary care. Provides advice on how to implement and scale-up primary care for mental health, and describes how a range of health systems have successfully undertaken this transformation. Part 1 provides the context for understanding primary care for mental health within the broader health care system. Part 2 explains how to successfully integrate mental health into primary care and highlights 10 common principles which are central to this effort. It also presents 12 detailed case examples to illustrate how a range of health systems have undertaken this transformation. Annex 1 provides information about the skills and competencies that are required to effectively assess, diagnose, treat, support and refer people with mental disorders.
The report reveals that the Native American health care system created by the federal government has used only limited and incremental responses to the health care challenges faced by Native Americans.
The average life expectancy of a male born on the Pine Ridge reservation in South Dakota today is 40 years oldóthe lowest life expectancy of all peoples not only in the U.S. but also in the entire Western Hemisphere. Written by and for nurses, this is the first text to focus exclusively on American Indian health and nursing. It addresses the profound disparities in policy, health care law, and health outcomes that affect American Indians, and describes how these disparities, bound into the cultural, environmental, historical, and geopolitical fabric of American Indian society, are responsible for the marked lack of wellbeing of American Indians. American Indian nurse authors, natives of nine unique American Indian cultures, address the four domains of healthóphysical, mental, spiritual, and emotional--within each region to underscore the many stunning disparities of opportunity for health and wellbeing within the American Indian culture as opposed to those of "Anglo" culture. In an era of cultural competency, these expert nurse authors bring awareness about what is perhaps the least understood minority population in the U.S. The text covers the history of American Indians with a focus on the drastic changes that occurred following European contact. Included are relevant journal articles, historical reports, interviews with tribal health officials, and case studies. The book addresses issues surrounding American Indian nursing and nursing education, and health care within nine unique American Indian cultural populations. Also discussed are the health care needs of American Indians living in urban areas. Additionally, the book examines the future of American Indian Nursing in regard to the Affordable Care Act. Key Features: Focuses exclusively on American Indian health and nursing, the first book to do so Written by predominately American Indian nurses Covers four domains of health: physical, mental, spiritual and emotional Highlights nine specific cultural areas of Indian country, each with its own unique history and context Includes chapter objectives, end-of-chapter review questions, and case studies
This unique book examines the physical, psychological, social, and environmental factors that support or undermine healthy development in American Indian children, including economics, biology, and public policies. The reasons for mental health issues among American Indian and Alaska Native children have not been well understood by investigators outside of tribal communities. Developing appropriate methodological approaches and evidence-based programs for helping these youths is an urgent priority in developmental science. This work must be done in ways that are cognizant of how the negative consequences of colonization contribute to American Indian and Alaska Native tribal members' underutilization of mental health services, higher therapy dropout rates, and poor response to culturally insensitive treatment programs. This book examines the forces affecting psychological development and mental health in American Indian children today. Experts from leading universities discuss factors such as family conditions, economic status, and academic achievement, as well as political, social, national, and global influences, including racism. Specific attention is paid to topics such as the role of community in youth mental health issues, depression in American Indian parents, substance abuse and alcohol dependency, and the unique socioeconomic characteristics of this ethnic group.
American Indians and Alaska Natives have consistently experienced disparities in access to healthcare services, funding, and resources; quality and quantity of services; treatment outcomes; and health education and prevention services. Availability, accessibility, and acceptability of behavioral health services are major barriers to recovery for American Indians and Alaska Natives. Common factors that infuence engagement and participation in services include availability of transportation and child care, treatment infrastructure, level of social support, perceived provider effectiveness, cultural responsiveness of services, treatment settings, geographic locations, and tribal affliations.
