Research Researchers propose novel solution to Indian Health Service underfunding

[C C]

https://www.eurekalert.org/news-releases/1102285

INTRO: or many years, the Indian Health Service (IHS) has been underfunded, leading to health and life expectancy disparities among Indigenous people, according to University of Oklahoma researchers. In a newly published article in Health Affairs, OU researchers propose a novel trust fund solution to increase and sustain the funding level, with the ultimate goal of improving health care access and outcomes.

“IHS underfunding has been a challenge for tribal nations and the United States, and it is highly relevant to Oklahoma, which was partly founded on Indian Territory. The health of Indigenous populations in the U.S. has suffered greatly because of chronic underfunding of IHS. Indigenous people have a life expectancy of 67.9 years – a decade less than the average U.S. life expectancy,” said lead author Junying (June) Zhao, Ph.D., Ph.D., MPH, an assistant professor at the OU Hudson College of Public Health.

“The difference in federal health care investment compared to other health programs is stark,” she added. “In fiscal year 2021, per capita federal spending for the IHS was $4,140. In comparison, the Bureau of Prisons spent $8,302; Medicaid, $8,908; the VA, $12,223; and Medicare, $15,094. For the IHS, this has meant staff shortages, outdated facilities and care that is declined or deferred.”

To raise funding, Zhao and her research team propose the creation of an IHS Trust Fund, modeled after the federal Vaccine Injury Compensation Trust Fund. In the late 1980s, Congress made a one-time appropriation to the Vaccine Injury Compensation Fund, which has since collected excise taxes on vaccine sales and invested its balances. As of January 2023, the fund held over $4 billion, which is used to pay for injury claims. An IHS Trust Fund would operate similarly to generate ongoing financial resources for unmet Indigenous health care needs.

From fiscal years 2009 to 2020, the IHS was underfunded by about $60 million annually, Zhao said. To generate a $60 million annual return, about $600 million would be needed for the baseline principal, assuming a modest 10% return rate on investments. Accounting for inflation, that number would be close to $1 billion today, she said.

In addition to a one-time congressional appropriation to launch an IHS Trust Fund, Zhao and her team suggest that Congress should grant IHS the ability to accept gifts. Although government programs typically cannot accept gifts, Zhao believes that some entities and individuals have shown the ability and desire to contribute. There is a precedent for IHS accepting gifts: About 20 years ago, the IHS manual included a policy for donations... (MORE - details, no ads)

[Zinjanthropos]

Not saying the indigenous do this but what kind of life expectancy would there be if everybody just trusted their deity to keep them well? Belief, prayer and devotion over science and medicine. Even if hospitals only staffed faith healers, shamans and medicine men? If those are your ways then don’t count on living to an old age. So if you do or don’t accept new age medicine then how should health funds be dispersed? How much?

Anyways, here’s what AI has to say re indigenous acceptance of Western medicine:

Acceptance of Western medicine by Indigenous peoples is not a simple historical event but a complex and ongoing process shaped by centuries of colonialism, systemic abuse, and differing worldviews. Resistance to Western medicine was and continues to be significant for many reasons, including a deep-seated and well-founded mistrust of a system that historically caused harm, often while actively suppressing Indigenous healing traditions.

The relationship can be broadly summarized through several key historical phases:

Initial resistance and contrasting worldviews (16th–19th centuries)
Upon contact, Indigenous peoples often had more advanced medical knowledge for treating local ailments and healing practices that addressed spiritual and community health, which contrasted sharply with early European remedies.

Disease epidemics: Early contact brought devastating European epidemics like smallpox to which Indigenous people had no immunity, wiping out large portions of populations. Western medicine was powerless to stop these diseases, and the trauma of these events further solidified a distrust of colonizers.

Forced assimilation: The U.S. and Canadian governments pursued policies of forced assimilation in the 19th and 20th centuries, which included suppressing Indigenous ceremonies and healing knowledge. This was a direct effort to replace Indigenous culture with European ways, reinforcing the idea that Western medicine was superior.
Indian hospitals and forced treatment (Early 20th century)
In the early 20th century, the Canadian government opened segregated "Indian hospitals" to treat Indigenous people, primarily for tuberculosis.

Systemic neglect: These hospitals were often underfunded and understaffed, and they physically and emotionally separated Indigenous patients from their families and communities.

Erosion of trust: Patients were subjected to harsh and invasive treatments, further cementing a deep and lasting mistrust of the Western medical system.

A shift toward integration (Late 20th century–present)
Since the late 20th century, there has been a growing movement toward recognizing Indigenous healing traditions alongside Western biomedical approaches.

Indigenous-led initiatives: Communities have increasingly advocated for self-determination in healthcare, leading to partnerships that integrate Indigenous healing with Western medicine.

Treaty rights: In Canada, First Nations resistance in the 1960s and 70s forced the government to acknowledge its treaty responsibilities for providing health care.

Continuing barriers: Despite some progress, systemic racism, cultural barriers, and lack of culturally sensitive care remain significant issues. Studies show that Indigenous patients still experience discrimination and may delay seeking care as a result.

The ongoing journey toward cultural safety
The acceptance of Western medicine is not a story of "how long before" but rather one of constant adaptation, resilience, and advocacy. Today, many Indigenous health practitioners navigate "two-eyed seeing," applying both Indigenous and Western medical knowledge to provide optimal care. For many Indigenous people, health is a holistic concept that includes physical, mental, emotional, and spiritual well-being, and it is a connection that Western medicine has often failed to consider.

[Syne]

Not saying the indigenous do this but what kind of life expectancy would there be if everybody just trusted their deity to keep them well?

There's also the higher prevalence of alcoholism, especially on reservations.

Native Americans have a higher prevalence of alcohol use disorder and alcohol-related deaths compared to other racial groups, though the majority of Native Americans do not have a drinking problem. According to a 2018 survey, 7.1% of Native Americans had an alcohol use disorder and 21.2% of those aged 12 and older reported binge drinking in the past month, compared to 21.2% for American Indians and Alaska Natives as a whole. Alcohol-related deaths are notably higher, with rates that are 3.6 times greater than non-Hispanic whites, notes this NIH article.
- Google AI