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American Indians’ and Alaska Natives’ Healthcare


The healthcare challenges that American Indian and Alaska Natives face on a regular basis present significant limitations for nursing practice. The increased occurrence of chronic health conditions as compared to their white counterparts have been attributed to poor health literacy, low levels of educational attainment and income, as well as limited access to affordable care. The current exploration focuses on discussing the key issues that the cultural group encounters in health care and identifies recommendations for future practice and implications for nursing care. It was found that the increase of cultural literacy and the involvement of AI/AN nurses were necessary to boost patients’ health education as well as facilitate better access to health care.

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American Indian and Alaska Natives (AI/AN) cultural group represent the Indigenous people, the ancestors of whom were inhabiting the territories of the United States and Alaska long before the discovery of the Americas. Despite playing a fundamental historical role and holding valuable cultural traits, from art to cultural practices, the health care needs of the group remain unaddressed. According to the report for DCD by Adakai et al. (2018), the population has a lower life expectancy, experience a poorer quality of life, as well have a higher likelihood of developing adverse chronic health conditions.

The adverse health implications of AI/AN were found to be dependent on the behaviors and lifestyle choices. For example, the population showed to have a higher prevalence of consuming sugar-sweetened beverages compares to whites (33% against 26.8%), high blood pressure (32.9% versus 28.6%), diabetes (21.4% against 8.0%), as well as being overweight or obese (76.7% against 63.2%) (Adakai et al., 2018).

Such disparities in health care have been linked to the overall poor health status of the AI/AN as well as physical inactivity contributing to the increase of weight and subsequent health conditions. The limited capacity of having personal providers of care as well as limited access to services shows that the health of the population is considered not as important as compared to whites, contributing to further disparities and complications.


The purpose of the exploration is to underline the health care issues that need to be addressed in the context of the American Indian and Alaska Native cultural groups. Topics such as the lower level of income and educational attainment and a higher level of unemployment are likely contributors to the decreasing quality of life of the group as compared to their white counterparts. The inability of AI/AN accessing health care services that would be instrumental in addressing their needs is indicative of the disadvantages that the cultural group faces on an everyday basis. It is also important to note that Indian Health Service (IHS) facilities have been historically located in remote areas on reservations to provide care to AI/AN groups.

However, as the population became younger and more diverse both racially and culturally, the increased numbers of residents from the group limited the continuous access to HIS. Additional barriers preventing AI/AN from getting the desired level of care include longer wait times, the need to spend more time traveling to HIS facilities, limited access to transportation, and the lack of linguistically and culturally competent providers. The list of issues that the cultural group encounters in terms of care access requires increased attention in the healthcare field.

Research Method

To evaluate the issue of healthcare disparities within the AI/AN population, a systematic literature review is a method chosen for the purpose of the study. The method uses systematic tools for collecting secondary information and critically appraise research studies. As a result of the review, it is possible to synthesize findings from both qualitative and quantitative perspectives. Studies chosen for the potential review will be collected with the help of MEDLINE, CINAHL, and Cochrane Library databases.

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Literature Review

According to Bauer and Pleascia (2014), chronic illnesses and injuries represent the most significant threats to health for the AI/AN population. For the cultural group, the rates of mortality associated with excessive tobacco use represent one of the main concerns compared to other groups (Bauer & Pleascia, 2014). Improving the quality of care of the population implies the expansion of research from multiple medical settings in order to have a better understanding of the existing disparities.

To address the healthcare challenges of the AI/AN, Adakai et al. (2018) proposed incorporating surveillance measures at local, state, and national levels to increase the awareness of the issues that the cultural group faces. It is also essential to overcome the challenges of varying cultural differences, roadblocks preventing access to care, as well as the limitations associated with limited health literacy within the AI/AN population.

Ensuring a greater awareness of healthcare disparities is possible through enhancing the training of personnel as well as including more professionals of AI/AN backgrounds into the process of caring for the population. According to the findings of Marcinko (2016), American Indians and Alaska Natives are more likely to have hospital stays and experience certain health conditions such as diabetes and coronary heart disease.

Because of this, it is vital to incorporate more AI/AN nurses and doctors into healthcare settings because they can be more effective in facilitating positive health outcomes by reflecting on their personal experiences. When practitioners are familiar with the cultural practices and values, the peculiarities of lifestyles, and the spiritual beliefs of their patients, they are more likely to foster positive doctor-patient relationships that facilitate recovery.

Implications for Nursing Practice

The problem of the AI/AN cultural group being adversely affected by disparities in health care requires the increased attention in the healthcare sphere. Cultural competence and fostering the principles of justice and equality represent essential implications for nursing practice. Finding ways in which the management of healthcare organizations can engage more professionals of AI/AN background is imperative because they can offer unique perspectives on the process of care. Furthermore, it is recommended to educate healthcare personnel on the principles of cultural competence because they are necessary to understand the unique needs of the AI/AN group.


The cultural group of American Indian and Alaska Natives has shown to experience disparities in health care, which resulted in the increased occurrence of severe or chronic health conditions. The representatives of the group are more likely to suffer from obesity and overweight, diabetes, and chronic heart disease; however, the methods targeted at addressing these issues remain ineffective. Preliminary findings showed that it was necessary to increase the competence of practitioners in dealing with diverse patients as well as engage AI/AN nurses into the field. It is recommended to conduct a systematic literature review on the chosen topic and explore best practices that can benefit the well-being of the population.


Adakai, M., Sandoval-Rosario, M., Xu, F., Aseret-Manygoats, T., Allison, M., Greenlund, K., & Barbour, K. (2018). Health disparities among American Indians/Alaska Natives – Arizona, 2017. Weekly, 67(47), 131401318.

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Bauer, U. E., & Plescia, M. (2014). Addressing disparities in the health of American Indian and Alaska Native people: the importance of improved public health data. American Journal of Public Health, 104(Suppl 3), 255-257.

Marcinko, T. (2016). More Native American doctors needed to reduce health disparities in their communities. Web.

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