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Wash. report lays out plan for Indian health care
Tuesday, September 9, 2003

A new report from a coalition of tribal and state officials in Washington paints a picture of the health status of American Indians and Alaska Natives.

The report's findings probably won't come as a surprise to anyone in Indian Country. From poverty to diabetes to substance abuse, Native Americans are affected at higher rates than the general population, according to statistics.

But while the "2003 American Indian Health Care Delivery Plan," a collaboration of the American Indian Health Commission and the Washington Department of Health, notes the problems, it also highlights the successes. By working together, officials believe tribes and states can improve the health status of Native people.

"In this time of shrinking federal dollars for the Indian Health Service and state budget shortfalls, it is very important that we have a joint commitment to improve health care for our people," said Marilyn Scott, head of the AIHC and chairwoman of the Upper Skagit Tribe.

Completed in July and released yesterday, the report combines tribal, state and federal sources on a wide variety of health and environmental indicators. Everything from IHS funding to tobacco use is discussed, with data emphasizing the disparities affecting Native Americans, who make up about 2 percent of Washington's population.

Among the major findings:
Death rates for Native due to stroke, chronic liver disease, and diabetes are higher than for the total population.
Violence, suicide, and injury death rates among Natives are higher than for the state as a whole.
The Native population has higher rates of several infectious diseases.
Pregnant Native women delay prenatal care longer, are younger, and are more likely to smoke, resulting in poorer birth outcomes.
Native children have poorer oral health.
Natives have a higher rate of obesity, and the obesity rate for youth is increasing.
Tobacco use among Natives is high and likely increasing.
Alcohol and substance abuse is a significant problem among men, women, and youth, and death rates due to causes related to alcoholism are substantially higher.

Limited access to health care, lack of health insurance and inadequate federal funding are some of the reasons for the disparities, according to the report. In 2002, only 79 percent of Native Americans were insured, the lowest rate of all racial and ethnic groups in the state.

Since the Portland area of IHS lacks a hospital, many Native Americans living on or near reservations rely on service purchased through IHS contract health service (CHS) funds, which tribes say fail to cover needs. Urban Indian programs don't receive CHS funds and must look to other federal, state and outside sources.

One way tribal and state officials are working together to improve these conditions is through Medicaid Administrative Match funding. Washington was the first state to contract with tribes for the federal program, which allows tribes to be reimbursed for providing services o patients enrolled in Medicaid and Medicare. According to the report, the reimbursements are a significant source of revenue for tribes, and they prevent basic services from being cut because IHS funding fails to keep up with inflation.

Individual tribes work with the state to tailor specific needs. The Port Gamble S'Klallam Tribe, recognized as a leader by IHS, combines federal funding with state contracts to offer a broad range of services to more than 1,000 tribal members and Native Americans.

Get the Report:
2003 American Indian Health Care Delivery Plan (September 2003)

Relevant Links:
American Indian Health Commission - http://www.aihc-wa.org
Washington Department of Health - http://www.doh.wa.gov

Related Stories:
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Health studies show Indian Country disparities (08/01)
Diabetes rates explode in Indian Country (05/07)
CDC atlas documents disparity in stroke deaths (02/21)
Tribes told to explore health funding options (02/05)
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