Minority health, Indians
Ethnic minorities in the US often suffer from differences in health outcomes, poorer access to health resources, and lower quality health services (Dickman, Himmelstein & Woolhandler, 2017, Holm, Vogeltanz-Holm, Poltavski & McDonald, 2010). , While formally reducing and eliminating health imbalances is one of the primary government goals, significant health imbalances persist in real life. Health inequalities have consistently been associated with increasing economic inequality in the US, with “any chronic disease, from stroke to heart disease to arthritis, following a predictable pattern of increasing prevalence with declining income” (Dickman, Himmelstein & Woolhandler), 2017 , P.1431). They have also been associated with complex social, biological, cultural and psychological interaction factors that are unique and often poorly understood by ethnic groups (Holm, Vogeltanz-Holm, Poltavski & McDonald, 2010). The current state of health of the Indians is lower than the national average in the United States. According to Thomas Sequist, Harvard Medical School’s Department of Healthcare Policy, “the population of Native Americans and Native Americans (AIAN) in the US, which includes about 5 million people, has worse health outcomes than other Americans” (Sequist, 2017). S.1379). For example, based on the data provided by Sequist, life expectancy in this subpopulation is 4+ years lower than that characterizing the US total population. In addition, the mortality rates of the Indians are almost 50% higher than that of the white population. Research has also shown that Indians die to a much greater extent than most of the country’s other ethnic subpopulations of CVD (cardiovascular disease), alcohol-related disorders, tuberculosis, motor vehicle accidents, accidental injuries, diabetes, suicide. and manslaughter (Holm et al., 2017). In addition, there have been reports of a higher rate of multiple diseases, such as asthma, some cancers, diabetes and rheumatic diseases, particularly among Indian populations in the United States. Sequist (2017) also notes that Indians consume more tobacco, obesity, physical inactivity, and fewer fruits and vegetables than whites. He also provides the following findings: Indians are more likely to report a “fair or poor” health status than whites (20% vs. 9%) and increased exposure to diabetes, hypertension, asthma, drug use disorders, and mental illness “(Sequist, 2017, p. 1379). Sequist (2017) also notes that Indians are more likely to say that they do not have a personal doctor compared to whites (28.3% vs. 18.7%). In addition, Indians living in remote or isolated communities have difficulty receiving medical care for conditions such as kidney transplantation and acute myocardial infarction (Sequist, 2017).
Health promotion in conventional medicine has been linked to the prevention of disease. Lundy & Janes (2009) explain that, as health is traditionally understood to be the absence of disease, “the definition of health promotion would necessarily include the idea of disease prevention” (p. 304). In this regard, traditional health promotion practices take place at three basic levels: primary, secondary and tertiary. Given that the definition of health promotion depends on the definition of health, it turns out that the understanding of Indians of health promotion is different. Especially for this American subpopulation, health is associated with the state of “harmonic balance”. Therefore, Native American medicine aims to restore the person to the state of equilibrium in every sphere of their life, and to first associate all imbalances with the mind (Healthandhealingny.org, 2017). Health promotion strategies thus take into account the foundations of health perceived by this population. For example, a five-year CDC intervention in 2008 was “Using Traditional Food and Sustainable Environmental Approaches to Promote Health and Prevent Diabetes in Native American and Alaskan Native Americans”. The health promotion initiative was informed by the leaders of tribes and earlier identified needs for improving access to traditional foods (CDC.gov, 2016).
The intervention described above, also known as the “Traditional Foods Project” (2008-2014), aims to prevent the occurrence of heart disease, stroke, diabetes and the risk factors associated with these diseases among the Native Americans at the primary level , Some examples include increasing the availability of traditional foods, reviving healthy traditional ways through stories, and improving access to physical activity. At secondary level, the program aimed to reduce the impact of chronic diseases on Indians by offering activities to prevent complications in diabetics and physical activity programs to reduce the impact of chronic diseases. At the tertiary level, the program envisaged involving people with diabetes in diabetes management programs.
Although the program described above focused primarily on the primary and secondary prevention of chronic diseases among Native Americans, it met the needs of the population and was a good choice for government funding. In particular, the program uses the American Indian approach to health as a balance and this focus of culture on natural medicine and spirituality as the cornerstone of prevention (through promoting traditional healthy food practices ). To a lesser extent, the conventional approach to the prevention and treatment of chronic diseases has been used. It met the needs of the population by tackling one of the most serious health problems in the group: obesity and related problems.
Overall, Indian health is lower in the United States than among white or most other minority ethnic groups at national level. However, health promotion in this group should take into account the understanding of Indian health and their commitment to holistic medical practices. At the level of prevention, health promotion initiatives should incorporate traditional Native American values and practices and apply them in accordance with traditional practices to meet the needs of this ethnic minority.