invisible-tribes
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Title Page
Report Title: Invisible Tribes: Urban Indians and Their Health in a Changing World
Prepared by: Urban Indian Health Commission
Supported by: Robert Wood Johnson Foundation
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Urban Indian Health Commission Overview
Purpose: Examine health care issues for urban American Indians and Alaska Natives.
Key People:
Commissioners:
Michael Bird, M.P.H., M.S.W.
Linda Burhansstipanov, Dr.P.H., M.S.P.H., C.H.E.S.
Jarrett Clinton, M.D., M.P.H.
Others include Jeffrey A. Henderson, Jennie R. Joe, Theresa Maresca, etc.
Acknowledgments: Special thanks to the Robert Wood Johnson Foundation and local urban Indian health organizations for contributions and support.
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Table of Contents
Executive Summary
A Population in Crisis
Urban Indian Access to Health Care
Challenges in Data Collection
Depression Among Urban Indians
Type 2 Diabetes Among Urban Indians
Cardiovascular Disease Among Urban Indians
Models of Success
Conclusion
Appendix A: A History of Broken Promises
Appendix B: Acronym List
Appendix C: Tables
Appendix D: Commission Information
Works Cited
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(Blank Page)
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Executive Summary
Urbanization of American Indians: Over 1 million moved to metropolitan areas in the past 30 years.
Health Crisis: High health risks and invisibility of urban Indians in America's healthcare system.
Federal Policies: Challenges arise from federal health care policies favoring reservation living.
Disparities: Urban Indians face significant healthcare access barriers, particularly in mental health and chronic diseases.
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Executive Summary Continued
Health Statistics: Urban Indians are more likely to suffer from co-morbidities (depression, diabetes, cardiovascular diseases).
Poor Access: Only 1% of federal health budget goes to Urban Indian Health Organizations (UIHOs).
Need for Action: The report urges necessary steps towards better funding, culturally competent care, and policy changes to improve urban Indian health.
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Executive Summary - Specific Findings
Prevalence Data:
Depression: Some studies indicate 30% of American Indians suffer from depression.
Diabetes: Higher prevalence (15%) among American Indians compared to the general population.
Cardiovascular Disease: A leading cause of death; risk factors include diabetes, obesity, and hypertension.
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Executive Summary - Conclusions and Recommendations
Urgent Need: To recognize urban Indians in health care policies to reduce disparities.
Recommendations: Include urban Indian health in national programs, expand best practices, increase access to insurance, and culturally competent care.
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A Population in Crisis
Misconceptions: Many believe American Indians predominantly reside on rural reservations; in reality, 70% live in urban areas.
Health Disparities: Higher rates of poverty, unemployment, and chronic illnesses among urban American Indians.
Key Statistics:
Higher infant mortality rates and death rates associated with diabetes, accidents, and alcohol-related causes.
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A Population in Crisis Continued
Accessibility Issues: Urban Indians face barriers like poverty and distrust of government services.
Invisible Communities: Urban Indians are often overlooked in demographics and health studies.
Urgency of Attention: There’s a call to improve the health status of urban Indians through policy reform.
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Urban Indian Access to Health Care
UIHOs: 34 existing organizations funded under Title V of IHCIA, serving approximately 100,000 urban Indians.
Trust and Cultural Needs: Urban Indians prefer health services from culturally relevant and operated organizations instead of government clinics.
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Access to Health Care Continued
Geographic Barriers: Many urban Indians lack access to IHS clinical services.
Funding Challenges: Urban Indian health organizations face inadequate funding and rely on diverse funding sources.
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Urban Indian Access to Health Care Continued
Challenges in Treatment: High mobility of urban Indian populations complicates continuity of care for chronic health issues.
Need for Local Solutions: UIHOs are developing initiatives to adapt to the challenges of urban mobility.
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Urban Indian Access to Health Care Continued
Additional Health Resources: Community health centers are also utilized but struggle to meet unique cultural needs of urban Indians.
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Challenges in Data Collection
Data Gaps: Lack of formal health surveillance systems for urban Indians hinders understanding of health trends.
Misclassification: Urban Indians are frequently misidentified in health databases.
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Challenges in Data Collection Continued
Poor Quality Data: Difficulty in obtaining accurate health statistics due to limited studies on urban Indian populations.
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Depression Among Urban Indians
Importance: Depression is a significant issue among urban Indians, frequently coexisting with other chronic illnesses.
Cultural Competence: Health professionals need awareness of cultural issues in treating urban Indians suffering from mental health issues.
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Depression Among Urban Indians Continued
Historical Trauma: Factors contributing to depression include the legacy of historical discrimination faced by American Indians.
Lack of Resources: Urban Indian health organizations often lack adequate mental health resources and funding to address these issues effectively.
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Type 2 Diabetes Among Urban Indians
Rising Rates: Type 2 diabetes prevalence among urban Indians significantly exceeds national averages.
Health Impacts: High risk of complications including heart disease and premature death associated with diabetes in urban Indian communities.
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Type 2 Diabetes Among Urban Indians Continued
Statistics: Urban Indian youth are at an alarming risk for developing type 2 diabetes earlier than their peers in other racial groups.
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Type 2 Diabetes Among Urban Indians Continued
Mortality Implications: Diabetes-related mortality rates among urban Indians are disproportionately high.
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Cardiovascular Disease Among Urban Indians
Primary Cause of Death: CVD is the leading cause of death in urban Indian populations.
Risk Factors: Obesity, lack of exercise, and diabetes contribute significantly to CVD rates among urban Indians.
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Cardiovascular Disease Among Urban Indians Continued
Preventive Challenges: UIHOs face difficulties in offering comprehensive care due to limited funding and infrastructure.
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Models of Success
Effective Programs: Highlight of successful health programs and initiatives addressing urban Indian health, emphasizing cultural sensitivity and community involvement.
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Models of Success Continued
Diverse Examples: Various urban Indian health organizations implementing effective health strategies and community efforts.
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Conclusion
Health Crisis Summary: Urgent action is required to address the health disparities faced by urban American Indians and Alaska Natives.
Recommendations: Suggests enhancement in data collection, policies, and programs focused on urban Indian health.
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Appendix A: A History of Broken Promises
Historical Context: Exploration of federal relations with American Indians impacting urban health circumstances.
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Appendix B: Acronym List
Key Acronyms: Major terms and organizations used throughout the report.
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Appendix C: Tables
Relevant Data Tables: Analysis of health data reflecting the conditions faced by urban Indians.
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Appendix D: Commission Information
Commission Overview: Information about the Urban Indian Health Commission and its members.
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Works Cited
Comprehensive Reference: List of sources and studies referenced throughout the report.