ACP says federal government needs to improve health support for indigenous communities

Indigenous populations continue to suffer significant barriers and disparities in health care, due in part to the federal government failing to provide adequate health support and services for these communities, says the American College of Physicians (ACP) in a new position paper. ACP says that policymakers have an obligation to fulfill the federal trust responsibility to provide equitable health care and other services to Indigenous populations in the U.S., including sufficient financial resources to support their care. The full position paper is published in Annals of Internal Medicine.

In recent years, Indigenous populations have experienced high rates of chronic diseases, death due to unintentional and intentional injuries, and infant mortality. These disparities have arisen in-part from the historical trauma associated with decades of racism, discrimination, and violence; subsequent poor social drivers of health; the degradation of Indigenous traditions, culture, and society; and inadequate access to and chronic insufficient funding of health care services for Indigenous populations.

ACP offers several recommendations for public policymakers at the federal level to strengthen the health and well-being of Indigenous populations in a manner that reflects the need for self-determination and collaboration while ensuring federal obligations are met. Specifically, ACP believes:

• Increased funding is needed for health services for Indigenous people, particularly given 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; and that policy makers must team 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 catastrophic 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 school student bodies and the medical workforce.