Nelson M
School of Osteopathic Medicine in Arizona, AT Still University, Mesa, Arizona, USA.
Rural Remote Health. 2013 Apr-Jun;13(2):2302. Epub 2013 Apr 25.
Although the Indian Health Service (IHS) has adequately stifled acute infectious diseases that once devastated American Indian and Alaska Native (AIAN) communities, this system of health provision has become obsolete in the face of chronically debilitating illnesses. Presently, AIAN communities suffer disproportionally from chronic diseases that demand adequate, long-term health maintenance such as hepatitis, renal failure, and diabetes to name a few. A number of research endeavors have sought to define this problem in the literature, but few have proposed adequate mechanisms to alleviate the disparity. The objective of this study was to examine the efficacy of both the Indian Health Service (IHS) and the relative few tribal healthcare systems (PL 93-638) respectively in their sociopolitical contexts, to determine their utility among a financially lame IHS.
Domestic and international indigenous health systems were compared through analysis of the current literature on community and indigenous health. Informal interviews were carried out with indigenous practitioners, community members, and political figures to determine how AIAN communities were receiving PL 93-638 programs.
Although the IHS has adequately stifled the acute infectious diseases that once devastated AIAN communities, this system of health provision has become obsolete in the face of chronically debilitating illnesses. A number of research endeavors have sought to define this problem in the literature, but few have proposed adequate mechanisms to alleviate the disparity. International indigenous health systems are noted to have a greater component of community involvement in the successful administration of health services.
Reinstating notions of ownership in multiple paradigms, along with novel approaches to empowerment is requisite to creating viable solutions to the unique health circumstances in Native America. This article demonstrates the importance and need of more qualitative data to better characterize how PL 93-638 healthcare delivery is actually experienced by AIAN patients.
尽管印第安卫生服务局（IHS）已充分遏制了曾经肆虐美国印第安人和阿拉斯加原住民（AIAN）社区的急性传染病，但面对长期使人衰弱的疾病，这一卫生服务体系已过时。目前，AIAN社区在诸如肝炎、肾衰竭和糖尿病等需要充分长期健康维护的慢性病方面遭受的影响尤为严重。许多研究努力试图在文献中界定这一问题，但很少有人提出适当的机制来缓解这种差距。本研究的目的是分别考察印第安卫生服务局（IHS）和相对较少的部落医疗体系（第93 - 638号公法）在其社会政治背景下的效力，以确定它们在资金匮乏的IHS中的效用。
通过分析当前关于社区和原住民健康的文献，对国内和国际的原住民卫生系统进行比较。与原住民从业者、社区成员和政治人物进行了非正式访谈，以确定AIAN社区如何接受第93 - 638号公法项目。
尽管IHS已充分遏制了曾经肆虐AIAN社区的急性传染病，但面对长期使人衰弱的疾病，这一卫生服务体系已过时。许多研究努力试图在文献中界定这一问题，但很少有人提出适当的机制来缓解这种差距。国际原住民卫生系统在成功管理卫生服务方面社区参与的成分更大。
在多种范式中恢复所有权观念，以及采用新的赋权方法，对于为美国原住民独特的健康状况创造可行的解决方案是必要的。本文证明了需要更多定性数据来更好地描述AIAN患者实际体验第93 - 638号公法医疗服务的方式的重要性和必要性。
