The ACP says the federal government needs to improve health care for Indigenous communities

Indigenous peoples continue to face significant barriers and disparities in health care, in part because the federal government does not provide adequate health support and services for these communities, according to a new position paper from the American College of Physicians (ACP). ACP argues that policymakers have a duty to fulfill the federal trust’s duty to provide equitable health care and other services to indigenous peoples in the United States, including adequate financial resources to support their care. The full text of the document is published in Annals of Internal Medicine.

In recent years, indigenous peoples have faced high rates of chronic disease, deaths from unintentional and intentional injuries, and infant mortality. These differences arise in part from the historical trauma of decades of racism, discrimination, and violence; subsequent poor social determinants of health; degradation of traditions, culture and society of the indigenous population; and inadequate access and chronic underfunding health care services for the indigenous population.

The ACP offers several recommendations for state policymakers at the federal level to promote Indigenous health and well-being in ways that reflect the need for self-determination and cooperation in meeting federal commitments. In particular, ACP believes that:

• Increased funding for Indigenous health services is needed, especially given the identified disparities and inequities in federal funding.
• Community driven state policydeveloped under the leadership of Indigenous leaders, necessary to address the injustices, inequalities and inequities faced by Indigenous individuals and communities.
• Improved support is needed to prioritize health and wellness promotion, chronic disease prevention, and other public health interventions to address high-incidence diseases in Indigenous communities; and that policymakers must join with Indigenous leaders to address the full range of underlying social health determinants associated with disproportionately high levels of poverty in Indigenous communities.
• A multidisciplinary approach, developed by Indigenous people in collaboration with other experts in the field, is needed to implement culturally appropriate interventions to address the underlying factors that exacerbate physical, mental and behavioral health problems and contribute to catastrophic suicide rates in Indigenous communities.
• Community-led collaboration between relevant governments, agencies and Indigenous leaders is needed to develop plans to reduce the high levels of violence among Indigenous people. ACP also supports actions to increase Indigenous representation in medical school student bodies and medical staff.