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

www.nwfco.orgprovide its patients formal language services, such as interpretationand translation, even though many Indian people and Alaska Nativeshave a primary language other than English. 98 And there also exists“a general lack of cultural competency and understanding of NativeHawaiians in the providing of health care services, teaching andeducation, and in conducting research.” 99Nonetheless, there are many examples of progress. Hawaiians havemade important advances in developing culturally relevant healthpromotion strategies. And, in Alaska, in the 1990’s the SouthcentralFoundation (SCF), an Alaska Native-owned health care systemdelivers primary care with integrated care teams that fully incorporatetribal doctors or traditional healers as well as chiropractors, massagetherapists, and acupuncturists.” 100 The Southcentral Foundation andother Native-run health programs show that it is possible to integrateculture into health care and health promotion for Native people. Butthey do not yet account for all, or even most, care received by Nativepeople.Delivery of care by Native providers could address many of theshortfalls in cultural competence, continuity, and trust. 101 Yet, therecontinues to be a lack of Native practitioners, who represent less thanone percent of medical school graduates 102 and are underrepresentedamong registered nurses. 103THE HUMAN FACEOF HEALTH INEQUITIESHealth inequities are about more than data and statistics. They affectreal people, harming their health and shortening their lives.The next part of this publication presents the stories of Native peopleand their struggles to get health care they need, be treated withrespect by practitioners, and improve the health of their communities.20 AN AMERICAN DEBT UNPAID stories of native health 2009