Despite the high quality of American health care, the life expectancy of American Indians can be as much as 30 years shorter than the lifespan of an average American.
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In front of an audience of 25 health professionals and members of the Yale community in the Sterling Hall of Medicine on Friday, professor Margaret Moss, director of the Nursing Management, Policy and Leadership Specialty at the Yale School of Nursing, described the history of federal Indian policy and the current state of American Indian health. The lecture, part of the Beaumont Medical Club lecture series, addressed the issues of historical trauma, sovereignty, dual citizenship and small population numbers that continue to cause discrepancy between American Indians and the rest of the country.
“People don’t even know [American Indian health care] exists, let alone the dire straits it’s in,” said Moss, who is an enrolled member of the Three Affiliated Tribes of North Dakota.
Moss said that of the four million people that self-identify as being American Indian, over 900,000 individuals live below the poverty line, fewer than 10 percent receive a bachelor’s degree, and all face a greater risk of suicide. American Indians, she added, also face a seven times greater risk of alcohol death and a three times greater risk of diabetes.
One of the major problems, Moss said, is a lack of federal funding. She said American Indian health care receives less funding than many other federal health care programs, such as Medicare.
“Indian Health Service gets half the dollars per capita of the federal prisons,” she said. “It has been enacted, but not funded.”
The large number of American Indian tribes that remain unrecognized by the federal government also pose challenges for those trying to obtain health care for American Indians, Moss said. Unless tribes are recognized by the federal government, they do not receive funding for health care or education. Currently, there are 565 federally recognized tribes and over 100 unrecognized tribes in the United States, she said.
The issue stems back to the 1940s and 1950s, during the Termination Era of federal policy, Moss said, in which the Supreme Court ruled that tribes maintain sovereignty only at the discretion of Congress.
In order to receive health care from the Indian Health Services, a person has to prove that they are at least one quarter American Indian. Moss said American Indians are the only minority to have an entire legal code, U.S. Code Title 25, which defines precisely who qualifies to be a member.
“[They] literally have papers,” Moss said, adding that American Indians have to show them in order to receive treatment.
Moss concluded by saying that American Indians are like “canaries in the mines for health” and that by researching and solving problems in American Indian health care, people can prevent issues within the greater American population.
Audience members interviewed said Moss’s lecture revealed a side of minority health care that is often forgotten.
Robert Lyons, chief of infectious disease and epidemiology at St. Francis Hospital in Hartford, said after the talk thathe thought Moss’s lecture was at once interesting and discouraging.
“She’s right,” said Lyons, who is also an associate clinical professor at Yale. “We tend to forget about health care on Indian reservations and it seems to have a big history of inadequacy.”
Vice President of Research at the Haskins Laboratories Doug Whalen GRD ’82 said the lecture was gripping and expanded his existing knowledge of American Indian health care problems.
Moss is the first and only American Indian to hold both a juris doctorate and a nursing doctorate.