New policy paper supports Indigenous people in their advocacy to improve the health and welfare of their communities
Oct. 21, 2022 (ACP) – The American College of Physicians released a new policy paper that stands with the Indigenous people of the United States and urges national policymakers to fulfill their responsibility to provide equitable health care and other services to Indigenous populations, including sufficient financial resources to support their care.
“Public policy must be supported with proper funding for those Indigenous populations whose health care challenges are unsurprising, given historical societal discrimination towards Indigenous peoples and governments' policies of violence, forced relocation and erasure of cultures and traditions,” said Dr. Ryan D. Mire, president of ACP. “With the proper health care funding, the government will be fulfilling its duty of providing the same proper medical care, services and access as it provides for others.”
The policy paper is a reflection of the ACP commitment to support diversity, equity and inclusion as key priorities, said Josh Serchen, ACP associate for health policy. “The College felt it was important to not only acknowledge the realities and challenges faced by Indigenous communities, but also recognize and uplift the resilience and other strengths demonstrated by these communities to serve as models for addressing many of the health care challenges facing our nation,” he explained.
In the policy paper, ACP makes several recommendations to policymakers:
- Increased funding is needed for health services for Indigenous people, especially because of the identified disparities and inequities in federal funding.
- Community-driven public policy developed under the leadership of Indigenous leaders is necessary to remedy the injustices, disparities and inequities experienced by Indigenous individuals and communities.
- Improved support is needed to prioritize health and wellness promotion, chronic disease prevention and other public health interventions addressing morbidities with high incidence in Indigenous communities. Policymakers must work with Indigenous leaders to address the full range of underlying social drivers of health associated with disproportionately high rates of poverty experienced by Indigenous communities.
- A multidisciplinary approach, developed by Indigenous populations in collaboration with other experts in the field, is necessary to implement culturally appropriate interventions to address the underlying drivers that exacerbate physical, mental and behavioral health issues and contribute to high rates of suicide in Indigenous communities.
- Community-driven collaboration is needed among relevant governments, agencies and Indigenous leaders to develop plans to mitigate the high rates of violence experienced in Indigenous populations. ACP also supports actions to increase Indigenous representation in medical schools and the medical workforce.
“Ultimately, ACP is calling for targeted federal government attention and resources to be directed toward health programs serving Indigenous people, as well as toward addressing health and social challenges directly impacting Indigenous communities,” Serchen said. “Indigenous people face disproportionately high rates of mortality, incidences of chronic diseases, poor overall physical and mental health, high rates of food insecurity and high rates of poverty. Many of these disparities stem from upstream historical trauma, societal discrimination toward Indigenous peoples and government policies of violence, forced relocation with loss of ancestral homes and erasure of cultures and traditions.”
These disparities are made worse because the federal government provides fewer per-capita health care resources for Indigenous populations compared with other federal programs such as Medicare, Medicaid and Veterans Affairs, Serchen said. “Despite these challenges, Indigenous communities have displayed resilience and other protective factors that have allowed them to persevere. Further, Indigenous-administered health systems, such as in Alaska, can serve as an innovative and effective model for delivering quality care, particularly in rural and remote settings.”
ACP hopes the nation's leaders will heed this guidance. “ACP is looking forward to using our policy to support the advocacy that Indigenous people are doing to improve the health and welfare of their communities,” said Mire. He cautioned, however, that “conversations around health care and public health interventions for Indigenous people must be respectful and responsive to their unique challenges, culture, traditions and values.”
The policy paper, “Supporting the Health and Well-Being of Indigenous Communities: A Position Paper From the American College of Physicians,” is available on the Annals of Internal Medicine website.