Tribal Health Frequently Asked Questions
Question:
How many federally-recognized tribes are
there?
Answer:
There are over 569 federally recognized tribes in 35 states, with
a total membership of approximately 2.5 million. More
statistics related to
the American
Indian & Alaska Native Populations are available from
the CDC Office of Minority Health.
Question:
How are health services to American Indians and Alaska Natives paid for and provided?
Answer:
Payment for American Indian health services, like those of many other groups, are covered by Veteran's Administration (VA) for those who have served in the military, Medicare and Medicaid for those that are eligible by age or income, and private insurance for those who have that available through their employment. In addition, Indian Health Service (IHS) is charged with meeting the U.S. Government's treaty obligation to American Indians and Alaskan Natives to provide health care.
For information about the federal government's role in providing health care services to American Indians, please see the Kaiser Family Foundation's
Legal and Historical Roots of Health Care for American Indians and Alaska Natives in the U.S.
Question:
What services does the Indian Health Service
provide?
Answer:
The Indian Health Service’s mandate is to provide health
care services to members of all federally-recognized tribes. The
unique relationship between sovereign Native American tribes and
the U.S. federal government was established through a series of
treaties, court decisions, and executive orders over the past 200
years. The Indian Self-Determination and Education Assistance Act
of 1975 allows tribes to elect to assume responsibility and administration
of their health care services or to remain within the IHS system.
Specifically, the IHS:
- Assists Indian tribes in developing their health programs through
activities such as health management training, technical assistance,
and human resource development.
- Facilitates and assists Indian tribes in coordinating health planning, in
obtaining and using health resources available through Federal, State, and
local programs, and in operating comprehensive health care services and health
programs.
- Provides comprehensive health care services, including hospital and ambulatory
medical care, preventive and rehabilitative services, and development of community
sanitation facilities.
- Serves as the principal Federal advocate in the health field for Indians
to ensure comprehensive health services for American Indian and Alaska Native
people.
For more information about the IHS mission, please see the Indian
Health Service Fact Sheet.
Question:
How does Indian Health Service (IHS) funding per capita compare with other federal health spending per capita?
Answer: According to Facts on Indian Health Disparities, IHS funding provides only 59% of the necessary federal funding for providing personal health care services to American Indians and Alaska Natives using the system.
The U.S. Commission on Civil Rights' publication, Quiet Crisis: Federal Funding and Unmet Needs in Indian Country, reports that the federal government budgeted nearly twice as much per capita for health care to federal prisoners compared to the IHS budget for AI/AN health care.
Question:
I am interested in working as a health care
provider in a tribal community. Where can I find information about
job opportunities and loan repayment programs?
Answer:
Detailed information about loan repayment programs and job openings
in Indian Health Services sites is available at the IHS Jobs
and Scholarships web page: http://www.ihs.gov/JobsCareerDevelop/Jobs_index.asp
Question:
What grants are tribes eligible to apply
for?
Answer:
There is often confusion because some grants do not list tribes
as eligible entities. However, most tribes are eligible for any
federal grants with a rural focus, including all grants administered
by the Federal Office
of Rural Health Policy.
Question:
Besides the Indian Health Service, what
federal agencies support Native American health care initiatives?
Answer:
Almost 50% of Native Americans do not live on reservations and
often have greater difficulty accessing Indian Health Service
resources. However, a number of other programs housed within
HHS and elsewhere in the federal government support Native Americans.
The CDC’s
Office of Minority Health supports
tribal public health initiatives. Both the Federal
Office of Rural Health Policy and the
Office of Minority Health have
programs that benefit tribal health care services. The National
Institute
of Health’s National Center
on Minority Health and Health Disparities is a principal
supporter of health disparities research, including work on disparities
in American Indian and Alaska Native populations.
Question:
What disparities are present in the health
status of Native Americans?
Answer:
Broad health disparities exist in Native American populations.
For example, compared to the general U.S. population American
Indians and Alaska Natives have higher death rates due to the following
conditions, taken from the IHS publication, Facts
on Indian Health Disparities:
- Tuberculosis– 600%
- Alcoholism– 510%
- Motor Vehicle Crashes– 229%
- Diabetes– 189%
- Unintentional Injuries– 152%
- Suicide– 62%
- Homicide– 61%
Broad disparities are also present in the oral health status
of Native American populations. 69% of Native American children
ages 6-8 suffer from tooth decay, compared with 26% of white
children from the same
age group. (Source: Healthy
People 2010, Chap 21 Oral Health) There is an acute shortage
of dental care providers, with many Indian Health Service
positions currently vacant. (Source: IHS
Workforce Issue Brief)
73% of all non-metro American Indians and Alaska
Natives live in Health Professional Shortage Areas (HPSAs).
(Source: Minorities
in Rural America, South Carolina Rural Health Research Center)
Significant health disparities exist in the
prevalence of mental illness, strokes, heart disease, and domestic
violence. For more information on health disparities visit
the IHS Health & Heritage site.
Question: What
are some factors that contribute to disparities in Native American
Health status?
Answer:
The CDC cites geographic isolation, cultural barriers, inadequate sewage
disposal, and economic
conditions as barriers that contribute to poorer health outcomes. For more
information, see the American
Indian & Alaska Native Populations web page from the CDC Office of
Minority Health.
Question: How
does the average economic status of Native Americans compare
to the general U.S. population?
Answer:
The American Indian and Alaska Native poverty rate is 26% - twice the national
rate and greater than that of any other ethnic group. [Source: Health
Disparities Experienced by American Indians and Alaska Natives]. Socioeconomic conditions
vary from tribe-to-tribe and in different regions of the country.
Credits
Last revised 11/06/2007
