WASHINGTON, October 10, 2022 – 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 published today in the Annals of Internal Medicine, Supporting the Health and Well-being of Indigenous Communities: A Position Paper from the American College of Physicians. The paper 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.
“Public policy must be supported with proper funding for those Indigenous populations whose health care challenges are unsurprising, given historical societal discrimination towards Indigenous peoples and governments’ policies of violence, forced relocation and erasure of cultures and traditions,” said Ryan D. Mire, MD, MACP, President, ACP. “With the proper health-care funding, the government will be fulfilling its duty of providing the same proper medical care, services and access as it provides for others.”
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.
“ACP is looking forward to using our policy to support the advocacy that Indigenous people are doing to improve the health and welfare of their communities. Conversations around health care and public health interventions for Indigenous people must be respectful and responsive to their unique challenges, culture, traditions, and values,” concluded Dr. Mire.
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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 160,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook and Instagram.
ACP Media Contact: Andrew Hachadorian, (215) 351-2514, AHachadorian@acponline.org