Page 54 - Cultural Competence in Health Education

32 Cultural Competence in Health Education and Health Promotion

outlook, there are some common trends in American Indian and Alaska Native health
disparities (U.S. Census Bureau, 2006).
The American Indian and Alaska Native population has long experienced lower
overall health status when compared with other populations, as evidenced by the sta-
tistics provided in this chapter. The reasons for this persistent and pervasive disparity
are not entirely clear but are related to inadequate education, higher poverty rates, dis-
crimination, and cultural differences.
On the health status measures of life expectancy at birth and the infant mortality
rate, American Indian and Alaska Native populations are also disproportionately
affected when compared with other U.S. populations. American Indian and Alaska
Native people born today have a life expectancy 2.4 years less than the expectancy for
all other races. Similarly, American Indian and Alaska Native infants die at a rate of
8.5 per every 1,000 live births, as compared to 5.8 per 1,000 for all U.S. races (2000 to
2002 rates) (Indian Health Service, 2007).
American Indians and Alaska Natives also die at higher rates than other U.S. racial
and ethnic groups, from a variety of causes including tuberculosis (600 percent higher),
alcoholism (510 percent higher), motor vehicle crashes (229 percent higher), diabetes
(189 percent higher), homicide (61 percent higher), and suicide (62 percent higher),
according to the Indian Health Service (2007).
It is important to note that American Indians and Alaska Natives frequently contend
with issues that prevent them from receiving quality medical care. The American Indian
and Alaska Native population is different in several key ways from the U.S. all - races
population, and these differences affect that population ’ s access to quality health care
services at costs similar to costs for other U.S. populations. The American Indian and
Alaska Native population is younger, due to having a higher mortality rate than other
Americans do, and approximately 55 percent of this population receives health services
from the Indian Health Service. The population is also predominantly rural, and a rural,
younger population would suggest that personal health services could be provided at a
lower cost than expected. The vast differences in health status between American Indian
and Alaska Native people and non - Hispanic whites, reflecting American Indians ’ and

Alaska Natives ’ disproportionate incidence of acute and chronic medical conditions,
will require a continued commitment to funding ways to bring the health status of
American Indians and Alaska Natives into parity with the health status measures for
all Americans (Indian Health Service, 2007).
Hispanics
Although health disparities are narrowing for most U.S. minorities when their health is
compared with that of non - Hispanics whites, Latinos may well be falling further behind,
according to a study published by the Agency for Healthcare Research and Quality
(2006). According to this report, which tracked disparities related to quality of health
care and access using data from 2002 and 2003 that examined disparities in forty - six
health care measures along with six categories of access to care, 59 percent of disparity
measures were widening for Latinos, and 41 percent were decreasing. Treatment for

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