Special_Populations

Special Populations: American Indians with Cancer By: Rebecca Lynn Harjo University of Phoenix There are different circumstances of location, culture, beliefs, and history that produce unique patterns of cancer occurrences among American Indian and Alaska Natives (A.I. /A.N.) here in the United States. Many American Indians and Alaska Natives live on tribal reservations and in remote urban areas. American Indian health care is mostly funded by tribally operated programs such as Indian Health Service (I.H.S). Urban American Indians as well as rural American Indians experience living in poverty, with lower levels of education, and poor homes compared to the general public of other Americans. There are well documented differences that happen within Urban American Indians, Alaska Natives, and all of the American Indian population as one in terms of access to health care. American Indians and Alaska Natives deal with greater health disparities as compared to the general public. American Indians and Alaska Natives suffer greatly with health disparities due to tobacco use, domestic violence, and lack of prenatal care, suicides, death from diabetes mellitus, and alcohol abuse that eventually leads to liver disease. Due to the higher mortality rate within American Indians/Alaska Natives, this special population as a whole is younger as a group compared to the general population. American Indians continue to be the poorest group in the United States. Cancer is the second leading cause of death among AI/AN. This paper will explain why this group of special populations was chosen. This are of interest was formed due to the health disparities among American Indians and Alaska Natives. There are many barriers that occur when American Indians and Alaska Natives receive treatment. What all this comes down to is most of the AI/AN cannot afford the much needed health insurance for their family members. The benefits that are meant for American Indians and Alaska Natives are not enough to actually meet the needs of proper medical care. According to an Indian Health Service spokesperson, “When you compare the average American health plan benefits with those the IHS provides, the IHS can only provide from 54% to 59% of these same benefits.  Also mentioned in the report were cultural differences and discrimination in delivery of health care services (4)”. With all the different diseases that arise among AI/AN, a higher mortality rate pushes this special populations to be referred to as a young group. This issue makes it a barrier for getting the proper resources through Indian Health Service. A greater barrier is the lack of specialty care for AI/AN that leads to more disparities. Transportation is always an issue that faces American Indians and Alaska Natives. This is because they live in areas that are remote and far from hospitals which in turn makes it even more difficult to have access to health care. Doing outreach in the Native communities about cancer would be beneficial to this specific special population. The outreach that I would provide will meet the needs of American Indians for screenings, cancer education, and care. The outreach that will be done will meet the respect for Native American tradition and culture. A great benefit that will be brought to the Indian community is by educating American Indians about cancer. In turn, this will lower the cancer rate among Native Americans. Teaching American Indians the importance of cancer screening will teach them that cancer is often preventable. What most American Indians do not know is cancer is also survivable. Having access to screenings and care are important factors in preventing cancer. Case management could be used among this special population because there are a lot of barriers that American Indians face in a clinical setting. While working with a diverse population, health care providers at times view a patient’s tradition and background as a barrier. A great barrier to Indian Health is the lack of the correct machines for cancer screenings. For example: Indian Health Services (I.H.S.) only has 14 mammography machines in all of its clinics nationwide (Burhansstipanov, 2000). In order for Indian Health to increase early cancer detection, then Indian Health Services must make screenings more accessible. Another barrier is how individual relationships influence access to care. Having the support of family and friends can strongly increases the final outcome of one’s health. The last barrier I am discussing is transportation. Many Native Americans live in urban areas where the roads are in poor shape making it hard to travel on. Some limitations that occur are the identities of American Indians not documented correctly. Finding out the real percentage of American Indians diagnosed with cancer will not be exact and the numbers are more than likely underestimated. Some cases are based off of small numbers that are incorrect. Finally, the causes of death among American Indians and Alaska Natives are usually labeled wrong because the cause of death is misclassified. With these limitations, this causes the plans for educating and preventing cancer among American Indians and Alaska Natives vary. This is turns explains the lack and shortage of programs that should be available to this special population. There is likely to be multicultural issues that will be faced while working with this special population (American Indians/Alaska Natives). Case workers must work cautiously with all the different tribal members who need someone to advocate for them. Keeping an open mind is important in making sure that you are culturally sensitive to their beliefs and traditions. Nonverbal communication is more common than most think. Speaking directly to an elder is considered rude and obnoxious. When speaking to an elder, you must make eye contact but only at the beginning of the conversation and never speak unless told to. Having consideration for his or her past history is vital when speaking to them about their past. Post traumatic stress disorder may be common as well as depression. This comes from this history of American Indian population. Understanding the importance of family and extended family is going to help when dealing with this special population. Obtaining honest empathy for their cultural oppression is also going to help when working with American Indians. References Burhansstipanov, L. (2000). Urban Native American Health Issues. Cancer 88(5), 1207-1213. Hermes, M. (1997) Going Back and Forth: Reflections on Research Methods at a Tribal School. 9 (23). Retrieved December 7, 2012 from ProQuest Research Library database.