Abstract
The circumstances of death in the United States have changed compared to the previous century because of successful public health programs. More Americans including ethnic minorities now suffer more from chronic lifestyle diseases. As a consequence, some minorities endure prolonged periods of debility, limited resources and culturally-inappropriate medical care. Although several studies have investigated health disparities among minorities with terminal illness, very few have addressed the end-of-life (EOL) issues of American Indians. Palliative care for American Indians may qualify as a public health agenda based on four criteria: (1) high burden of death and suffering, (2) major impact on individuals and society, (3) possibility for intervention and (4) involvement of socio-ecological determinants of health. As a public health issue, palliative care for American Indians requires multisectoral collaboration, community cooperation, involvement of public agencies, health care providers and the public health sector.
Published Version
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