Self-Determination to Better Health Outcomes: A Study of Diabetes in the Native American Community

Abstract

Increased self-determination in health care by the Native American community may help combat preventable diseases like diabetes. The racial stereotyping of Native Americans in medical clinics has been found to directly correlate to health disparities such as poor care and poor medical outcomes (Solomon et al.). However, since 1975, the ISDEAA, or Indian Self-Determination and Education Assistance Act, provides three major avenues by which Native Americans may receive health care: directly from the federal government through the Indian Health Service, through a Title I contract to administer part of their own health care programs, or through a Title V compact to take over all of their own health care (Marley, “Ambiguous Jurisdiction” 433). Longitudinal research into the diabetes prevalence rates across time for each of the 574 federally recognized tribes should be juxtaposed against the timeline of when each individual tribe evolved from Indian Health Service dependent to Title I, and then finally to Title V. I had sought to prove that diabetes prevalence rates for Native Americans show a lagging decline as self-determination of health care increases. Further collection of specific, tribal, micro-level data is necessary to prove or disprove this point. Ultimately, this conceptual paper is a proposal for further data collection by the United States Department of Health and Human Services, which is in charge of the Indian Health Service.