The Indian Health Service and American Indian/Alaska Native Health Outcomes

Kruse, Gina; Lopez-Carmen, Victor A; Jensen, Anpotowin; Hardie, Lakotah; Sequist, Thomas D.

doi:10.1146/annurev-publhealth-052620-103633

Cited by 50 publications

(43 citation statements)

References 74 publications

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“…In particular, culturally tailored treatment regimens based in Indigenous systems of knowledge show promising evidence related to improved SUD outcomes (Brave Heart et al , 2011; Hartmann et al , 2019). However, health systems that service Indigenous groups can be poorly resourced (Kruse et al , 2022) and are sometimes located in areas that are geographically removed from the Indigenous populations they intend to serve (Indian Health Service, 2018). There is little catalogued information about the characteristics of culturally tailored programming; how these programs are distributed across tribal, rural and urban Indigenous groups; and what types of substances these interventions address.…”

Section: Introductionmentioning

confidence: 99%

Culturally tailored substance use interventions for Indigenous people of North America: a systematic review

Richer

Roddy

2022

JMHTEP

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Purpose The purpose of the current study is to conduct a systematic review of peer-reviewed work on culturally tailored interventions for alcohol and drug use in Indigenous adults in North America. Substance use has been reported as a health concern for many Indigenous communities. Indigenous groups experienced the highest drug overdose death rates in 2015, the largest percentage increase in the number of deaths over time from 1999 to 2015 compared to any other racial group. However, few Indigenous individuals report participating in treatment for alcohol or drug use, which may reflect the limited engagement that Indigenous groups have with treatment options that are accessible, effective and culturally integrative. Design/methodology/approach Electronic searches were conducted from 2000 to April 21, 2021, using PsycINFO, Cumulative Index to Nursing and Allied Health Literature, MEDLINE and PubMed. Two reviewers classified abstracts for study inclusion, resulting in 18 studies. Findings Most studies were conducted in the USA (89%). Interventions were largely implemented in Tribal/rural settings (61%), with a minority implemented in both Tribal and urban contexts (11%). Study samples ranged from 4 to 742 clients. Interventions were most often conducted in residential treatment settings (39%). Only one (6%) intervention focused on opioid use among Indigenous people. Most interventions addressed the use of both drugs and alcohol (72%), with only three (17%) interventions specifically intended to reduce alcohol use. Originality/value The results of this research lend insight into the characteristics of culturally integrative treatment options for Indigenous groups and highlight the need for increased investment in research related to culturally tailored treatment across the diverse landscape of Indigenous populations.

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Section: Introductionmentioning

confidence: 99%

Culturally tailored substance use interventions for Indigenous people of North America: a systematic review

Richer

Roddy

2022

JMHTEP

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“…The focus on neighborhood deprivation is particularly important given the historic nature of federal and state policies that have led to profound levels of racial residential segregation in the United States. For instance, in our cohort racial and ethnic minorities were more likely to live in the most deprived neighborhoods reflecting the longstanding effects of historic policies allowing for redlining, housing discrimination, disinvestment in communities, tribal lands, and Indian reservations 33–35. Therefore, policy efforts to target individual’s living in the most deprived neighborhoods may also aid in the goal of improving cancer care for racial and ethnic minorities.…”

Section: Discussionmentioning

confidence: 84%

“…For instance, in our cohort racial and ethnic minorities were more likely to live in the most deprived neighborhoods reflecting the longstanding effects of historic policies allowing for redlining, housing discrimination, disinvestment in communities, tribal lands, and Indian reservations. [33][34][35] Therefore, policy efforts to target individual's living in the most deprived neighborhoods may also aid in the goal of improving cancer care for racial and ethnic minorities. Prior assessments have demonstrated that individuals with higher socioeconomic disadvantage would travel to a more specialized center for cancer care if financial barriers for travel were removed.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Deprivation, Hospital Quality, and Mortality After Cancer Surgery

et al. 2022

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Objective: To evaluate if receipt of complex cancer surgery at high-quality hospitals is associated with a reduction in disparities between individuals living in the most and least deprived neighborhoods. Background: The association between social risk factors and worse surgical outcomes for patients undergoing high-risk cancer operations is well documented. To what extent neighborhood socioeconomic deprivation as an isolated social risk factor known to be associated with worse outcomes can be mitigated by hospital quality is less known. Methods: Using 100% Medicare fee-for-service claims, we analyzed data on 212,962 Medicare beneficiaries more than age 65 undergoing liver resection, rectal resection, lung resection, esophagectomy, and pancreaticoduodenectomy for cancer between 2014 and 2018. Clinical risk-adjusted 30-day postoperative mortality rates were used to stratify hospitals into quintiles of quality. Beneficiaries were stratified into quintiles based on census tract Area Deprivation Index. The association of hospital quality and neighborhood deprivation with 30-day mortality was assessed using logistic regression. Results: There were 212,962 patients in the cohort including 109,419 (51.4%) men with a mean (SD) age of 73.8 (5.9) years old. At low-quality hospitals, patients living in the most deprived areas had significantly higher risk-adjusted mortality than those from the least deprived areas for all procedures; esophagectomy: 22.3% versus 20.7%; P < 0.003, liver resection 19.3% versus 16.4%; P < 0.001, pancreatic resection 15.9% versus 12.9%; P < 0.001, lung resection 8.3% versus 7.8%; P < 0.001, rectal resection 8.8% versus 8.1%; P < 0.001. Surgery at a high-quality hospitals was associated with no significant differences in mortality between individuals living in the most compared with least deprived neighborhoods for esophagectomy, rectal resection, liver resection, and pancreatectomy. For example, the adjusted odds of mortality between individuals living in the most deprived compared with least deprived neighborhoods following esophagectomy at low-quality hospitals (odds ratio = 1.22, 95% CI: 1.14-1.31, P < 0.001) was higher than at highquality hospitals (odds ratio = 0.98, 95% CI: 0.94-1.02, P = 0.03). Conclusion and Relevance: Receipt of complex cancer surgery at a high-quality hospital was associated with no significant differences in mortality between individuals living in the most deprived neighborhoods compared with least deprived. Initiatives to increase access referrals to high-quality hospitals for patients from high deprivation levels may improve outcomes and contribute to mitigating disparities.

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“…In 1921, the US Congress passed the Snyder Act to authorize funding for the “relief of distress and conservation of health” in Indian communities ( 38 , p. 18). After several reorganization attempts, the 1954 Transfer Act assigned to the US Public Health Service the responsibility for AI health services, and the IHS was created ( 26 , 38 ) to provide health care services on or near AI reservations. Today, the IHS provides mainly primary care and some referral care in a system of hospitals, clinics, and health stations located on or near AI/AN reservations.…”

Section: Historical and Political Contexts Of Ai/ansmentioning

confidence: 99%

Advancing Diabetes Prevention and Control in American Indians and Alaska Natives

Lucero

Roubideaux

2022

Annu. Rev. Public Health

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As with many Indigenous populations globally, American Indians and Alaska Natives (AI/ANs) experience high rates of type 2 diabetes. Prevention efforts, ongoing medical care, patient self-management education, and support to prevent and reduce the risk of long-term complications must be developed to limit the impact of diabetes on individuals, families, and communities. Diabetes prevention and control require both individual- and community-level efforts as well as policies that attempt to mitigate contributing adverse socioeconomic factors. Congressional funding since 1998 continues to address the epidemic of diabetes in AI/AN groups with the Special Diabetes Program for Indians (SDPI), which has resulted in significant outcomes and key lessons that can inform new efforts to prevent diabetes in other populations and communities. The purpose of this review is to understand the context behind the epidemic of diabetes in AI/ANs, review the impact of the SDPI on prevention and control of diabetes as well as the translation of these strategies into clinical practice and their influence on health practice, and identify lessons learned for future efforts to address this ongoing challenge for AI/AN and other communities suffering from type 2 diabetes.

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The Indian Health Service and American Indian/Alaska Native Health Outcomes

Cited by 50 publications

References 74 publications

Culturally tailored substance use interventions for Indigenous people of North America: a systematic review

Culturally tailored substance use interventions for Indigenous people of North America: a systematic review

Neighborhood Deprivation, Hospital Quality, and Mortality After Cancer Surgery

Advancing Diabetes Prevention and Control in American Indians and Alaska Natives

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