Senate Democrats

The Indian Health Care Improvement Act Will Make Significant Progress to the Health Care Crisis for Native Americans

The Senate is scheduled to begin debate on S.1200, the Indian Health Care Improvement Act Amendments of 2007, on January 22, 2008.  The bill will reauthorize and make amendments to the Indian Health Care Improvement Act (IHCIA), which was originally passed in 1976 and last reauthorized in 1992.  IHCIA reauthorization has been proposed by the last five Congresses.  The 109th Congress favorably reported legislation out of the Indian Affairs and Finance Committees, but it did not pass the Senate because S.4122 failed to pass by unanimous consent before adjournment.

The IHICAcreated the first comprehensive framework for the delivery of health care services for Native peoples – American Indians and Alaska Natives.  Since 1992 though, while mainstream health care has undergone a number of improvements and modernizations, health care services for Native peoples have lagged far behind.  The failure of prior Congresses to address the health care needs of Native peoples has resulted in a crisis that needs immediate attention.

This fact sheet will focus on the need for improvements to the Indian Health Care Improvement Act by highlighting a series of disturbing health care statistics among Native peoples.  The fact sheet will also highlight the key provisions in the IHICA reauthorization that would work to address the glaring health care needs of Native peoples.

The Chronic Shortage of Quality Health Care in American Indian Communities Contributes to Poor Health and Preventive Health

According to the Indian Heath Service, the federal agency whose purpose is to deliver and provide health services to American Indians, Alaska Natives, and urban Indians, Native Americans:

1.      Have a life expectancy that is 2.4 years less than the rest of all the other races in the United States (74.5 years to 76.9 years; 1999-2001 rates);

2.      Experience 10 deaths for every 1,000 live births for infants; as compared to 7 per 1,000 for the general population (2001-2003 rates).  The Georgetown University Center for Child and Human Development and the National Center for Cultural Competence report that for Native Americans the incidence of sudden infant death syndrome is more than three times the rate of white infants.

3.      Are 60 percent more likely to commit suicide.  The United States Commission on Civil Rights has also found that suicide is the second leading cause of death for Native Americans 15 to 24 years old and the third leading cause of death for Native American children 5 to 14 years old;

4.      Are 150 percent more likely to die from accidents.  The United States Commission on Civil Rights has also found that unintentional injuries are the leading cause of death for Native Americans under the age of 44 and the third leading cause of death overall;

5.      Are 200 percent more likely to die from diabetes.  The United States Commission on Civil Rights has found that Native Americans have the highest prevalence of Type 2 diabetes in the world.  Since 1996, the Indian Health Service has documented a 54 percent increase in the prevalence of diagnosed diabetes among Native American youth 15 to 19 years of age;

6.      Are 500 percent more likely to die from tuberculosis.  The American Lung Association reported that in 1998 the incidence rate of tuberculosis among Native Americans was 12.6 cases per 100,000 persons, which is more than five times the rate for non-Hispanic whites; and

7.      Are 550 percent more likely to die from alcoholism.  The United States Commission on Civil Rights has also found that Native Americans use and abuse alcohol and other drugs at younger ages, and at higher rates, than other ethnic groups. 

The Indian Health Care Improvement Act will make significant progress in responding to the health care crisis in Indian Country:

  • Authorize additional tools for tribal communities to address suicide among Indian youth;
  • Address the lack of access to health care services, due to limited hours of operation of existing facilities and other factors, by establishing grants for demonstration projects that include a convenient care services program as an alternative means of health care delivery;
  • Respond to the $1 billion backlog in needed health care facilities, such as alcohol and substance abuse treatment centers, and $1 billion in unmet need for sanitation facilities in tribal communities;
  • Make permanent a number of successful federal programs providing services to Native Americans in long-term health care, diabetes prevention, and other key areas;
  • Expand scholarship and loan programs that encourage more American Indian people to enter health care professions.
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