Health Facts and Cold Realities in Indian Country

While a weekend snowstorm raged in Washington, D.C., a small group of health care advocates gathered in a conference room at the Hyatt Regency Hotel and were treated to a history lesson as well as a glimpse into the cold realities of Indian Country.

The topic: American Indian Health Policy. And unlike the weather that everyone talks about, a trio of speakers addressed a subject they insist is largely overlooked.

"One of the challenges we have in Indian health is anonymity," said Dr. Donald Warne, executive director of the Aberdeen Area Tribal Chairmen's Health Board, in Rapid City, South Dakota.

"We're quite often a forgotten population when we look at health care issues whether it's health care reform or just funding for American Indian health programs," said Warne, an Oglala Lakota.

The Aberdeen health board assists tribal members from 18 tribes in South Dakota, North Dakota, Nebraska and Iowa. And the number of people in Saturday's audience barely matched the number of tribes in that four-state region.

The audience members were among the 800 people attending a three-day conference at the nation´s capital on health reform sponsored by Families, USA, a grass roots organization.  The workshop on Native health issues was held on the final day, but the small numbers in the audience did not deter Warne or the others who spoke.

Jennifer Cooper, legislative director of the National Indian Health Board, and Cara Thunder, health director of the American Indian Community House in New York City, also provided what amounted to a primer and legislative update on health policies and legislation that affect Native Americans.

They reminded workshop attendees that the outcome of any health care reform package – a debate that will resume once more on nearby Capitol Hill – will affect all Americans including the ones who were here originally.

And their stories stemmed from both a personal and professional perspective.

Thunder, a Menominee from Wisconsin, has been at her job for only three months directing health programs for New York's urban Indians, but her limited experience does not concern her.

"I'm really a newbie,"she said, "but I'm not new to being Indian as far as health disparities associated with that."

Those health disparities can seem staggering.

According to statistics from the Indian Health Services, cited by Warne, the death rates in 2002-2003 from preventable diseases among American Indians were significantly higher than among non-Natives: From diabetes 208% higher, alcoholism 526% higher, accidents 150% higher and suicides 60 % higher. Meanwhile, there was nearly a 10-year difference in life expectancy between Native Americans and non-Indians.

A former professor at Arizona State University, Warne then asked the question he poses to his students: do Americans have a fundamental right to health care, beyond emergency medical services in a life-threatening situation or labor? No, he answered, with one exception.

"Something most people don't realize is that American Indians are the only population born with the legal right to health care," he said. "And that's based on treaties where tribes exchanged land and natural resources for several social services including housing, education and health care."

He looked at his audience.

"We didn’t lose those resources in a war," he said with a smile. "We exchanged them through treaties for these social services. So the tribal leaders in my region like to say we have the largest pre-paid health plan in history."