An American Debt Unpaid: Stories of Native Health - Alliance for a ...

Native people go withoutneeded health careIndian people and Alaska Natives do not receive all the healthcare they need. One fifth had no usual source of care in2003-2004. 32 They are the most likely of all reported groups togo without timely prenatal services. 33 And, from 1999 to 2003,they went without needed health care due to cost almost twiceas frequently as did white people. 34No Usual Source of Health Care: Adults 18–64 by Race, 2003–200410% 15% 20% 25% 30%AFRICAN AMERICANASIAN AMERICANAMERIC. INDIANS/ALASKA NATIVESLATINOSWHITESSource: Kaiser Family Foundation, “Key Facts: Race, Ethnicity &Medical Care,” January 2007. Figure 26, p. 22.Little research or data is available on Hawaiians’ access to the healthcare system, either in Hawaii or the continental U.S. Yet some datais available: Hawaiian women on O’ahu are less likely than others tosee a doctor and more likely to have an emergency room visit. 35 Theyare less likely than white women to receive needed mental health orsubstance abuse treatment. 36 And Hawaiian women in Hawaii aremore likely than others to go without early prenatal care. 37UNINSURED RATES 2005–2007WHITESAFRICAN AMERICANASIAN AMERICANSAMERIC. INDIANS/ALASKA NATIVESLATINOSHAWAIIANS & OTHERPACIFIC ISLANDERS17.9%19.2%20.8%30.9%14.6%10.6%19.6%16.5%32.1%32.8%20.5%10% 15% 20% 25% 30%Source: U.S. Census Bureau, “Income, Poverty, and HealthInsurance Coverage in the United States: 2007,” August 2008,Table 7, p. 23.Though Native people have very high uninsured rates, this isnot the only—or, in some cases, the primary—barrier to care forthem. 38 A number of other obstacles exist, ranging from a pooror stressed health care infrastructure, to mistrust of the healthcare system, to lack of culturally competent care. The followingsections address these obstacles.“The doctors, nurses, and staff I’ve workedwith in the Indian Health Service are someof the best and most dedicated anywhere, butthey are working with so little. If the IHS werefully funded, I think it would be one of thebest health care systems in the world. But afteryears of underfunding, the infrastructure iscrumbling. We see the entire health care systemcollapsing beneath us.Recently, the Santa Fe Indian Hospital, where Iwork, didn’t have enough money to pay some ofits contractors. As a result, we ran out of milk.We had sick children admitted to the hospital,and their parents had to go out and buy food forthem. The hospital also has had trouble with theheating system, and we had elders with pneumoniabundling up under four or five blanketsto stay warm. Our patients have been very kindand understanding – they know we’re doing thebest we can. But I think you have to ask, ‘Is thissupposed to be what health care in the UnitedStates of America looks like?’Our patients often wait a minimum of threehours, but more typically five or six hours, tobe seen. Many people just wind up leaving, eventhough there are few other options. One man– who was quite ill with undiagnosed hyperthyroidism– left the Santa Fe hospital to trythe emergency room at the University of NewMexico in Albuquerque, where he waited thirteenhours and was never seen. He came back toSanta Fe the next day and waited four hours.”Dr. John FogartySanta Fe, New MexicoNORTHWEST FEDERATION OF COMMUNITY ORGANIZATIONS 15