Healthcare Inequality Amongst Native Americans: The Newest Form of Genocide?

America has a prevalent issue of health inequalities through lack of a universal healthcare system and it is literally killing more people in our nation annually than all homicides combined. Amongst those most highly effected by this catastrophe are the people indigenous to this land. Although the Declaration declares, “We hold these truths to be self-evident, that all men are created equal”(1) it is obvious that all men are not created equal. This “land of the free” treats it’s citizens disproportionately and this has a tremendous consequence for the health of many people. The World Health Organization focuses on the global effect of health inequities and defines them as, “avoidable inequalities in health between groups of people.” (2) Today, there are many reasons why our citizens and specifically, Native Americans, are dying from a lack of healthcare, finances, and medical support. In this blog post we will discuss how health inequities impact all Americans, how health inequities specifically harm Native Americans, and why this matters to health educators working for a healthier nation.

To understand this issue more closely, let's first take a look at how the healthcare system is negatively affecting all Americans. Approximately 20,000-45,000 deaths a year are due to lack of health insurance.(3) In addition, Harvard Medical School and Cambridge Health Alliance conducted a study in 2009 that was published in the American Journal of Public Health explaining that there is a 40% increase of death among the uninsured populations.(4) The United States is the only developed country that doesn’t have universal healthcare, meaning that all the other 32 countries are practicing universal healthcare.(5) It is obvious that the healthcare policies in America are drastically different than the other developed countries and this difference is killing American citizens daily.

In addition, there is a mixture of economic and social factors that affect an individual’s ability to access healthcare in today’s political system. The complexity that results in not having access to healthcare is two-fold because on one hand it limits people’s ability to take preventative measures as well and handicapping their resources to get the medical attention that they need once a health issue has arised. Author and medical doctor Andrew Wilper speaks out on this as he states, “The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health… We doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.”(6) The healthcare inequality in our nation today is harming millions by limiting their access to live a happy, healthy life simply due to financial and social challenges that unfairly marginalize specific members of our population.

One of the populations most negatively impacted by the healthcare inequalities are the American Indians. These health inequalities began over 500 years ago with the first marks of colonialism as the Europeans arrived in the Americas. These colonists brought diseases with them that soon started waves of epidemics among the Native American tribes and then those diseases were often used against them to justify mass genocide. For example, when the colonists wanted to take the land in Massachusetts federal officials declared the Sioux Indians were dying rapidly on their own due to tuberculosis, so there was justification in helping to end the life of the tribe.(7) This issue is further perpetuated by the fact that for centuries there has been very limited health data available to support the Native American populations. Just recently in 1955 the Indian Health Service (IHS) was established and has been able to improve health conditions although still more research needs to be done and more resources need to be made available to these tribes.(8)

Furthermore, a study conducted by the American Public Health Association shows that the Native Americans have suffered disproportionately throughout history by society's most prevalent hazards such as smallpox, tuberculosis, alcoholism, infant mortality and other chronic afflictions.(9) With the lasting health inequities that exist today, it is almost as though our government is holding the same views of the colonists from centuries ago. In an explanation of why indigenous people were more susceptible to small pox in 1764, Thomas Hutchinson gave the following rational: “Our ancestors supposed an immediate interposition of providence in the great mortality among the Indians to make room for the settlement of the English. I am not inclined to credulity, but should not we go into the contrary extreme if we were to take no notice of the extinction of this people in all parts of the continent.” This statement above defines the foundation upon which this country is built.(10)

The healthcare inequities that plague the most vulnerable in our nation today are responsible for the death of millions that could be avoided with more medical resources, financial support, and health education. The Native Americans have been the victim of this failing health care system for over five centuries. This unnecessary bloodshed could be mitigated if we adopted a holistic approach through a universal healthcare system like every single other developed country in the world. This is the single most important healthcare policy that our nation could make for the betterment of all our people. Obamacare was one step in this direction, but due to the current administration even those small steps of improvement are being threatened. Perhaps there is a reason why America is abandoning the poor, sick, elderly, young, disabled, and people of color by allowing them to suffer without healthcare access or insurance. Is it a lack of wealth and power that makes one sick? Or is it the sickness that impedes the wealth and power? Or is it the wealth and power that is needed to be able to afford health insurance in order to prevent sickness? As health educators we must seek answers to these questions if we are ever going to help the people that need us most.

We must also wonder if there is a relationship between the foundation upon which this country is built and those who are still leading our nation today. Why would America let it's people die? Are all people created equal? Are all people who live in America, valued as citizens of this land? What will it take to obtain equality and equity in our healthcare system? These are additional questions for the health educator to ponder and these are the people that we must be prepared to serve. The stakes are high and this is a life or death matter. We must not allow 20,000-45,000 more people to die this year due to health inequities and a lack of health insurance. We must work towards a policy of universal healthcare for a healthier nation. Sign this petition if you agree: Universal Health Care Petition

How will you do your part? Why do you think this is happening? Can we cure this systemic cycle?

Let us know by sharing your comments here: My Comment to Share

(1) Declaration of Independence: A Transcription. (n.d.). Retrieved May 10, 2017, from https://www.archives.gov/founding-docs/declaration-transcript

(2) Key concepts. (n.d.). Retrieved May 10, 2017, from http://www.who.int/social_determinants/thecommission/finalreport/key_concepts/en/

(3)F. (n.d.). Facts on Deaths Due to Lack of Health Insurance in US. Retrieved May 10, 2017, from https://obamacarefacts.com/facts-on-deaths-due-to-lack-of-health-insurance-in-us/

(4): Alvin Powell, Harvard Staff Writer |, |, B. M., Liz Mineo, Harvard Staff Writer |, David Cecere, Cambridge Health Alliance |, Colleen Walsh, Harvard Staff Writer |, |, D. B., . . . David Cecere, Cambrdige Health Alliance |. (2017, May 06). New study finds 45,000 deaths annually linked to lack of health coverage. Retrieved May 10, 2017, from http://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/

(5) P. (2016, March 25). List of Countries with Universal Healthcare. Retrieved May 10, 2017, from https://truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/

(6) Wilper, A. (2009, December). Health Insurance and Mortality in US Adults. Retrieved from http://www.pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf

(7) Jones, David S. "The Persistence Of American Indian Health Disparities". N.p., 2017. Print.

(8) "About IHS | Indian Health Service (IHS)". Ihs.gov. N.p., 2017. Web. 12 May 2017.

(9) Jones, David S. "The Persistence Of American Indian Health Disparities". N.p., 2017. Print.

(10)Hutchinson Thomas, The History of the Colony of Massachusetts-Bay, 1628–1691 (Boston: Thomas & John Fleet, 1764), 35n