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Curtis Harris, MPA

Harlem Health Promotion Center, Columbia University

It must be emphasized that American Indians and Alaska Natives are not "just another ethnic minority." Many of our ancestors lost their lives to establish the legal, legislative, executive and constitutional basis for the unique federal government–to–tribal government relationship. The trend to reduce the size of the federal government cannot result in the reduction or dilution of historic trust and treaty obligations.

Michael H. Trujillo, MD, MPH

Director, Indian Health Service

I am San Carlos Apache. I am indigenous. For many, the word "indigenous" conjures images of wholesomeness and healthfulness. For others, "indigenous" summons less positive apparitions, perhaps a pungent earthiness not easily embraced. For me, "indigenous" calls on me to broaden my self-definition.

I come from a culture that defines itself by its primacy in history. Yet I am more than a member of a specific clan or tribe, as vital as those affiliations are to me. Being indigenous connects me to a wide global community. Collectively, our voices are growing stronger and louder. We are demanding attention to the many pressing public health concerns that threaten our communities.

Recent historic events have served to further the health needs of indigenous people. In 2001, Michael Bird, a Santo Domingo/San Juan Pueblo, was elected the first indigenous president of the American Public Health Association (APHA). His leadership and close working relationships within APHA and throughout the public health community brought indigenous voices closer to the decisionmakers in the center of the circle (see Bird’s editorial, "Health and Indigenous People: Recommendations for the Next Generation," page 1391).

In June 2002, in connection with the International Indigenous Peoples Caucus, a report was issued by the Committee on Indigenous Health that called upon the United Nations to address the special health needs of indigenous people. The report documented the continuing discrimination against indigenous people in national health policies, as well as the extremely limited access of indigenous people to quality health care. It also noted the irrefutable links between loss of land and travesties such as the destruction of tradition; inequitable economic structures; environmental degradation; and poor health outcomes for indigenous people. It is impossible to overstate the importance of this report or the effect that the formal recognition of indigenous people by the United Nations has had on the global indigenous community.

As awareness of the grave health conditions of indigenous people in the United States and throughout the world grows, public health agencies must be able to respond with effective and culturally appropriate programs. Health inequities are marked. Deaths for American Indians and Alaska Natives from 1998, compared with all other races combined in the United States, are 533% higher for tuberculosis, 249% higher for diabetes, and 71% higher for pneumonia and influenza (http://www.ihs.gov/PublicInfo/Publications/trends98/trends98.asp).

Sound research on the health issues facing indigenous people is an essential part of the solution. To effectively address the severe health inequities faced by indigenous people, a global commitment to resources and program support is requisite. While the sizeable health needs of varied indigenous communities present an enormous challenge, our longevity as a people is unsurpassed. It is our collective responsibility to ensure that future generations of indigenous people will inherit what was promised to them in treaty obligations, in order that they may live full and healthy lives.

Related articles in AJPH:

Health and Indigenous People: Recommendations for the Next Generation

Michael E. Bird
AJPH 2002 92: 1391-1392. [Extract] [Full Text]  

This article has been cited by other articles:

				M. SARCHE and P. SPICER Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects Ann. N.Y. Acad. Sci., June 1, 2008; 1136(1): 126 - 136. [Abstract] [Full Text] [PDF]

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