Taylor T L
Department of Health Administration, College of Public Health, University of Oklahoma, Oklahoma City 73190.
Public Health Rep. 1988 Jan-Feb;103(1):88-95.
The use of primary health care services by urban American Indians and their health problems were compared with national and regional data compiled by the Indian Health Service, Bureau of the Census, Office of Technology Assessment, and the National Center for Health Statistics. A survey of medical records was conducted at urban Indian health clinics, one located in Oklahoma City, OK, and the other in Wichita, KS. Health records of 500 patients from each clinic were reviewed. Information was gathered concerning reasons for visit, diagnoses, and number of physician visits. In addition, predisposing variables and enabling variables from each patient's registration form were reviewed. According to the data collected in the survey, the clientele of these urban Indian clinics have annual incomes well below the average income of the general population and the overall American Indian population in these cities. Their lack of health insurance and low education levels were also evident. Use of primary health services was below that of the general population, and lower, but relatively close, to use levels of American Indians residing in rural Oklahoma and Kansas. Information on health problems indicated high levels of diabetes mellitus and hypertension among the middle-age groups, and high levels of use by young women for prenatal care and contraception. The absence of systematically collected and comprehensive health and health care use information about urban American Indians, who now comprise more than half the U.S. American Indian population, and the limitations in the available information leave important questions unanswered. There are indications that large segments of urban Indian populations have difficulty obtaining primary and preventive health care services due to their general socioeconomic condition and the absence of the Indian Health Service in many urban areas.
将美国城市印第安人的初级卫生保健服务使用情况及其健康问题，与印第安卫生服务局、人口普查局、技术评估办公室和国家卫生统计中心汇编的国家和地区数据进行了比较。在城市印第安人健康诊所进行了一项病历调查，一家位于俄克拉荷马城，另一家位于堪萨斯州威奇托。对每家诊所的500名患者的健康记录进行了审查。收集了有关就诊原因、诊断和就诊次数的信息。此外，还审查了每位患者登记表中的易患变量和促成变量。根据调查收集的数据，这些城市印第安诊所的客户年收入远低于这些城市普通人群和美国印第安人群体的平均收入。他们缺乏医疗保险和低教育水平也很明显。初级卫生服务的使用低于普通人群，并且低于但相对接近居住在俄克拉荷马州和堪萨斯州农村的美国印第安人的使用水平。关于健康问题的信息表明，中年人群中糖尿病和高血压的发病率很高，年轻女性对产前护理和避孕的使用率很高。目前占美国印第安人口一半以上的城市美国印第安人缺乏系统收集的全面健康和卫生保健使用信息，现有信息的局限性使得一些重要问题无法得到解答。有迹象表明，由于总体社会经济状况以及许多城市地区没有印第安卫生服务局，城市印第安人口的很大一部分在获得初级和预防性卫生保健服务方面存在困难。
