World Health Day and Health Care in Tribal Communities
World Health Day is celebrated on April 7 every year to mark the anniversary of the founding of WHO (World Health Organization) in 1948. Annually, a theme highlights a priority area of public health and provides opportunities for every community to engage in activities that can lead to better health.
In PWNA’s service area, the main source of health care is Indian Health Service (I.H.S.), and in a previous blog on Healthcare for Native Americans, we discussed the treaty obligations of the U.S. and how the I.H.S. remains grossly underfunded. A 2016 I.H.S. fact sheet indicates their per capita health care expenditure rests at $3,688 for Native Americans, whereas the health expenditure for the U.S. population is $9,523. In addition, there are just 500 Indian health facilities serving the 567 federally recognized tribes with 2.2 million American Indian and Alaska Native members. (Update: As of 2020, there are 574 federally recognized tribes.)
As a nation, America recognizes the importance of accessible, quality health care, and for those of us residing in urban areas, a plethora of urgent care clinics, specialty physicians and full-service hospitals exist. In Rapid City, South Dakota, a town of 70,000 people, urgent care centers are sprouting up in every corner and, within a two-mile radius, I have a choice of two different urgent care centers. The National Institute for Health Care Reform reports nearly 9,000 of these centers exist across the U.S., yet very few are within reach of tribal communities.
For the remote and geographically-isolated populations PWNA serves, our Program Partners and others working directly with tribal members are the link connecting important information and resources to individuals challenged with scarce access to health facilities. So many residents, particularly the homebound, rely on the Community Health Representative (CHR) or laypersons to observe any potential health issues and to do so during the shortest of visits. For instance, they may rely on the person delivering their daily meals, or even the driver picking them up for an appointment. Early detection and intervention is critical for disease prevention, and is especially critical in our rural communities.
PWNA’s most frequently requested service, Healthy Living, supports preventative healthcare and other care providers working within tribal communities. Healthy Living helps these Program Partners engage and motivate community members to learn more about preventing diseases and making healthy choices. Through this service we support on average about 500 partners on about 50 reservations, who are offering health classes, conducting home visits and assisting people with appointments.
One by one, tribal communities are fighting health disparities with whatever resources they have available. For instance, on the San Carlos Reservation the CHR program and the Elderly Feeding Center act as PWNA’s health partners. Staff from both agencies work together to help residents like Matthew, an 81-year-old Elder living in the community of Bylas, Arizona. Partially blind and living alone, Matthew struggles with high blood pressure and needs frequent visits for vital sign checks and medication. Although previous referrals for Matthew to have a full-time caregiver were declined, his deteriorating eye condition only increases his need for care.
Rosalie, a CHR assisting Matthew along with her colleague Susie, has served as a CHR for 42 years, almost as long as the program has existed.
“I know the whole Bylas community and they know me. I talk to them in Apache and it’s good that I speak to them that way because some don’t speak English,” Rosalie says.
Veronica delivers Matthew’s meals from the Senior Center (supported by PWNA’s Food service), and says, “I love knowing that I’ve contributed to the Elders in some form.”
In recognition of World Health Day, PWNA honors those dedicated individuals like Rosalie, Susie and Veronica, and the many programs throughout Indian country that work hard to combat the alarming health disparities in our nation’s tribal communities.