Meeting Healthcare Needs: Health Equity for Low Income Native American Communities

Sydnie Pino

San Ildefonso and Taos Pueblo


Sydnie Pino- Final Presentation.mp4

Supporting Research

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Sharing One Skin: Okanagan Community

Armstrong, Jeanette. “Sharing One Skin: The Okanagan Community,” in Jerry Mander and Edward Goldsmith (eds), The Case Against the Global Economy. San Francisco, CA: Sierra Club Books, 1996. pp. 460-470. Accessed: January 16, 2021


Sharing One Skin: Okanagan Community written by Jeannette Armstrong is an article that primarily focuses on the importance of community and how it contributes to one’s identity and views. Explaining the cultural aspects and views of the Okanagan, Armstrong dives into a deeper meaning of her identity and how her community reflects upon her. Upon doing so, Armstrong develops an observation and comparison in which she discusses and compares the views and ways of her people to the views and ways of society at large. Explaining the views of her people, Armstrong explores various ideas, that include the body as a whole and the perceptions of things around us, some of which is conducted and expressed through the “Four Capacities of Self” (Armstrong). The four capacities include the physical self, the emotional self, the thinking-intellectual self, and the spiritual self. To the Okanagan, “the four selves have equal importance in the way we function within and experience all things...they join us to the rest of creation in a healthy way” (Armstrong 463). The four selves define who the Okanagan really are and the basic guidelines in which they follow for a healthy and happy life. In addition to The Four Capacities of Self, Armstrong also explores the ideas of community and family in which she explains everyone is part of a community and family and without those important factors of life, “we are truly not human,”. Furthermore, Armstrong also brings forth the ideas of Earth and the importance of taking care of it as “we are keepers of Earth” (Armstrong 467). At large, Armstrong discusses the differences between people and their ways of life. Though many have their own views and customs, it is a matter of how we present ourselves and remember our teachings to live a happy and healthy life in this world full of change. In the end, it is our identity and communities that shape who we are and how we live.

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Native American Identity

Horse, Perry G. “Native American Identity.” New Directions for Student Services, no. 109, © Wiley Periodicals, Inc, 2005. Pp. 61-68. Accessed: 13 January, 2021



In the article "Disparities Among Native American Communities in the United States," the Infectious Disease Society of America (IDSA) discusses various inequities that result in poor healthcare for under served communities such as the Native American population. Reflecting upon the Covid-19 pandemic, the ISDA dives into a deeper understanding and addresses the ways in which Covid-19 has disclosed health inequities in the United States. Speaking on behalf of the Native American population in the United States, the IDSA brings awareness to the issues of health inequity that is not only affecting many during this pandemic, but has affected many for years. Providing background of the ongoing issue, the ISDA discusses how previous experiences with health inequities have affected the overall health and well-being of Native American communities, putting them at higher risk of illness and fatality from Covid-19 as opposed to those of privilege Furthermore, the IDSA goes on to discuss how factors of public health infrastructure, insurance, race/ethnicity, age, and poor healthcare are affecting the overall health of Native Americans in the United States. In hopes of addressing the issue and making a change, the ISDA provided various suggestions and ways in which the government and healthcare systems can meet the healthcare needs of Native American communities especially in the midst of a global pandemic.

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Disparities Among Native American Communities in the United States

IDSA. “Disparities Among Native American Communities in the United States.” Idsociety.org, Infectious Disease Society of America, 7 July 2020, www.idsociety.org/. Accessed 14 January, 2021


In the article "Disparities Among Native American Communities in the United States," the Infectious Disease Society of America (IDSA) discusses various inequities that result in poor healthcare for under served communities such as the Native American population. Reflecting upon the Covid-19 pandemic, the ISDA dives into a deeper understanding and addresses the ways in which Covid-19 has disclosed health inequities in the United States. Speaking on behalf of the Native American population in the United States, the IDSA brings awareness to the issues of health inequity that is not only affecting many during this pandemic, but has affected many for years. Providing background of the ongoing issue, the ISDA discusses how previous experiences with health inequities have affected the overall health and well-being of Native American communities, putting them at higher risk of illness and fatality from Covid-19 as opposed to those of privilege Furthermore, the IDSA goes on to discuss how factors of public health infrastructure, insurance, race/ethnicity, age, and poor healthcare are affecting the overall health of Native Americans in the United States. In hopes of addressing the issue and making a change, the ISDA provided various suggestions and ways in which the government and healthcare systems can meet the healthcare needs of Native American communities especially in the midst of a global pandemic.

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Native American's Reliant on Hospital Feel Abandoned by U.S During Pandemic

Walker, Mark. “Native Americans Reliant on Hospital Feel Abandoned by U.S. During Pandemic.” The New York Times, The New York Times, 3 Jan. 2021, https://www.nytimes.com/2021/01/03/us/politics/indian-health-service-hospital.html. Accessed 20, January, 2021


As the current global pandemic is on the rise, many Native American communities like the Pueblos of Acoma and Laguna, located in New Mexico are facing great hardship and barriers in health care systems. In the article Native American’s Reliant on Hospital Feel Abandoned by U.S. During Pandemic, Mark Walker of the New York times brings national awareness to the destructive heallth crisis that the Pueblos of Acoma and Laguna are currently facing during this pandemic. For many years, the Pueblos of Acoma and Laguna have been reliant upon the Acoma Canoncito -Laguna Hospital for all their health care needs. It wasn’t until the Indian Health services decided to close down this hospital due to a lack of funding, that the Pueblos of Acoma and Laguna were no longer receiving adequate medical attention in their own communities. The controversy that sparked the issue was when “one of the two pueblos whos federal funding helped support the health service’s Acoma Canoncito-Laguna Hospital in Acoma Pueblo, N.M., decided to take its share of the hospital’s budget and start its own independently run clinic” (Walker p.1). This action led to the closing of the Hospital overall by the Indian Health Services and has brought forth great controversy and anger of tribal members and council as the Indian Health Services failed to notify congress about the closing of the hospital. Now with limited access to healthcare in their own communities, Tribal members of Acoma, Laguna, and surrounding areas are forced to take an hour trip to local towns such as Grants and Albuquerque for emergency situations and adequate health care needs.

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American Indian Health Policy: Historical Trends and contemporary issues

Warne, Donald, and Linda Bane Frizzell. “American Indian Health Policy: Historical Trends and Contemporary Issues.” American Journal of Public Health, American Public Health Association, June 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4035886/. Accessed: 22 February, 2021

Healthcare for Native American and Alaska Native tribes has been such a struggle for many years dating as far back as settler periods and times of early disease outbreak. Though many Native American and Alaska Native tribes are continuing to face struggles with healthcare, It is the government’s responsibility to meet the healthcare needs of these populations and uphold the promises and standards which have been historically set in place regarding Native and Indigenous healthcare. In the article American Indian Health Policy: Historical Trends and Contemporary Issues, Donald Warne, MD, MPH and Linda Bane Frizzell PhD reflect upon the United State’s roles and responsibilities to provide various services to Native American and Alaska Native tribes as a result of various historical policies/promises that have been enacted. This promise is known as the Federal Indian Trust Policy which according to Warne and Frizzell is “a legal obligation under which the government “has charged itself with moral obligations of the highest responsibility and trust” toward Indian Tribes”, (P. 1). Reflecting upon these policies and promises, Warne and Frizzell provide a breakdown and describe the ways in which policy significantly impacts the healthcare needs and services for Native and Alaska Native individuals and communities. Some of these important policies include the Indian Self-Determination and Education Assistance Act, Transfer Act, Snyder Act, and Indian HealthCare Improvement Act (IHCIA). In addition, Warne and Frizzell look at the funding of Indian Health Services (IHS) and explore the ways in which lack of funding affects healthcare and health disparities.

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How Indian Relocation Created a Public Health Crisis

Poon, Linda. “How ‘Indian Relocation’ Created a Public Health Crisis.” Bloomberg.com, Bloomberg, 2 Dec. 2019, 7:57 AM MST, www.bloomberg.com/news/articles/2019-12-02/what-s-behind-native-american-health-disparities. Accessed: 25, February 2021.


In the article How “Indian Relocation” Created a Public Health Crisis, publisher Linda Poon speaks with Melissa Walls, a Ojibwe tribal member about the topic of historical traumas and their impacts on American Indian and Alaska Native healthcare. Melissa Walls is currently head of the new Great Lakes hub of Johns Hopkins University’s Center for American Indian Health in Duluth, Minnesota, and has conducted various research and studies focusing on American Indian Health. Upon studying this topic issue, Walls discovered inequities within her own family and understood the ways in which her family were being victimized by health inequity. Sharing some of her studies and findings with Linda Poon, Walls shared information and insight about how historical traumas of the past have affected healthcare of American Indians and Alaska Natives today. Events such as the Indian Relocation Act from the 1950’s to 1960’s made efforts to relocate individuals and their families away from their reservations and into urban areas. The impacts of this act have left generations of trauma and many illnesses for American Indian and Alaska Native tribes as opposed to other races and ethnic groups. As stated by Walls “we see it play out in terms of mental health, substance abuse, suicide, and other chronic diseases”, (Paragraph 12). Historical traumas as such have left great impacts on many generations and are continuing to bring forth and result in health inequities.

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Health and Social Justice in Egypt: Toward a Health Equity Perspective


World Social Science Report 2016: Challenging Inequalities: Pathways to a Just World. UNESCO Publishing, 2016. Pp. 140-142. Accessed: 14 March, 2021


For many countries around the world, complications surrounding health and healthcare systems have continued to arise, leaving drastic impacts and great struggle for many. Like many countries, Egypt faces various healthcare challenges that put it’s country and people at significant risk for health related illness and mortality. Healthcare in Egypt is divided up upon two sectors which include both private and public healthcare. Private healthcare in Egypt is of high standards and is staffed with highly qualified healthcare professionals, whereas, public healthcare in Egypt is of low standard and below average. Being that the healthcare system of Egypt is divided based upon these two sectors, gaps in healthcare systems arise, leaving room for various disadvantages and inequities. In the section titled Health and social justice in Egypt: towards a health equity perspective from the book World Social Science Report, the injustices of healthcare systems of Egypt are thoroughly highlighted and addressed. The section provides great detail of the gaps in these healthcare systems and describes how these gaps and inequities have come about and how they have tried to be addressed. Having two sectors in healthcare, Egypt has been faced with a healthcare crisis for quite some time that has left many faced with health disparities and a lack of adequate healthcare. The cause of these injustices results from political and social issues. As stated by Soha Bayoumi, “The deterioration of the health system in Egypt, and its accompanying health inequities, is the outcome of a complex web of authoritarian politics, crony capitalism and corruption…, (P. 141)”. In hopes of trying to address the issue of these healthcare inequities, many medical doctors have tried to advocate and voice their concerns relating better wages, work conditions, and improvements of healthcare, and even distribution of finances toward healthcare settings. In addition, “Among various other efforts, doctors staged two-long strikes, in 2012 and 2014, which lasted for nearly three months each.,” (Bayoumi). Though many efforts have been made to address the issue, most attempts have drastically failed, leaving great downfall in the healthcare systems of Egypt.

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Health Disparities in Liver Disease in Sub-Saharan Africa

Spearman, C. Wendy, and Mark W. Sonderup. “Health Disparities in Liver Disease in Sub‐Saharan Africa.” Wiley Online Library, John Wiley & Sons, Ltd, 26 June 2015, onlinelibrary.wiley.com/doi/full/10.1111/liv.12884 . Accessed: 18 March, 2021

iHealth disparities are found everywhere within healthcare systems. It is a global issue that stretches clear across the world. Not only are health disparities found and present in healthcare systems in the United states, but are also found in other countries such as Sub-Saharan Africa. In the article titled Health disparities in liver disease in sub-Saharan Africa, Wendy Spearmen and Mark Sonderup focus and reflect upon liver disease and its impact on Sub-Saharan Africa as a result of inadequate healthcare and health disparities. In Sub-Saharan Africa, there is great struggle when it comes to liver disease and liver disease treatment/prevention as “HBV, HCV, and alcohol accounts for 69% of cirrhosis mortality in SSA,” (Spearman, Sonderup). The burden of this disease results from “...a combination of limited medical and public awareness of an often preventable cause of morbidity and mortality coupled with the high cost of diagnosis and management of liver diseases ,” (Spearman, Sonderup). In hopes of treating and addressing liver disease in Sub-Saharan Africa, many attempts and suggestions have been made. These attempts and suggestions include prevention and management of viral hepatitis, research protocols, clinical trials, and compassionate programmes, and ensuring sustainable access to affordable medications. Of these suggestions and attempts, sustaining access to affordable medications has been most successful as it has “...led to the reduced price of ART 100-fold in the past 15 years, thereby contributing to significantly reducing HIV incidence rate in SSA and potentially increasing access to antivirals for HBV,” (Spearman, Sonderup). While there have been success in these efforts, there have also been failures. With working toward the prevention and management of hepatitis, a WHO analysis found that HBV vaccines could prevent Hepatitis related deaths, however, as mentioned by Spearman and Sonderup, “Unfortunately, an open call for GAVI support failed as the HBV vaccine costs only 0.17 US dollars and falls below their 0.20 US dollars funding threshold policy,”