American Indian Policy: Were We've Been and Were We're Going

American Indian/Alaska Native (AIAN) health policy hasn't kept pace with the demographic and social changes of the last 50 years, and the result is that people are suffering needlessly. Contrary to popular portrayals of American Indians as a vanishing people, the latest U.S. census shows that the AI/AN population has reached a high point of more than 4 million people. Indian health problems are both structural and behavioral, and some level of accountability must also rest with tribal governments and individuals. In response, there has been a strong Indian wellness movement, which for several decades has been addressing alcohol and other drug problems, mental health, diet, and sedentary lifestyle issues with some success. However, the impact and sustainability of these health efforts cannot be fully realized without targeted health policy both on a local and national level. Health policy is an integral structural component that shapes resources and efforts aimed at AI/AN health issues; further complicated by the relationships tribes have with federal and state governments, federal trust responsibilities, entitlements, self-governance and interactions between Medicare, Medicaid and the Indian Health Service. This presentation will focus on American Indian policy and highlight how such policy is an important factor in AI/AN health disparities.