Perceived medical discrimination in American Indian health care

Health disparities have been well documented in American Indian populations and are partially explained by persistent under-utilization of preventive and medical services. Medical mistrust and perceived racism may play important roles in these disparities, particularly when medical recommendations conflict with cultural beliefs, traditional knowledge, and personal or family experience of discriminatory treatment in medical care. A growing body of research documents that American Indians perceive medical discrimination, and that discrimination impacts health seeking behaviors and subsequent health. The presenter will highlight the following points respective to American Indian populations: (1) gaps in current scientific evidence regarding medical discrimination; (2) American Indian cultural attributes and historical experiences that influence medical mistrust and perceived discrimination; and (3) pathways through which medical discrimination affects medical utilization patterns and health status. The presenter will expand upon the “Indigenist” Stress-Coping Model (Walters & Simoni, 2002) to provide a theoretical basis to further investigate these complex relationships. Finally, the presenter will argue that current efforts to address American Indian health disparities, through research and intervention, are limited and require an expanded focus on the social determinants of health. Strategies to support this focus, including the training and development of Native researchers and education of Tribal leaders and Native organizations, will be shared.