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Federal health care delivery among Native American populations: a historical perspective

Hayes, Zachary (2018) Federal health care delivery among Native American populations: a historical perspective. Master Essay, University of Pittsburgh.

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In recent years, federal and Tribal Organizations tasked with providing health care and other services to Native Americans have faced increasing public scrutiny over their ability to address rampant health disparities. Unfortunately, these critiques and subsequent efforts to amend shortcomings are nothing new; for over a century, many native populations of the United States have faced storied challenges in securing a level of health and well-being commensurate with the progress in public health practices on the greater national landscape. Today, many marked disparities persist in Tribal populations for a compendium of clinical and socio-economic indicators. Research into comparative health care delivery practices among Native American and other public or private organizations of similar size and geographic locations, though relatively scant, can provide insights into the nature of these challenges and how they may be addressed.

This paper is designed to provide an assessment of administrative practices in the Indian Health Service (IHS), and barriers to health care quality and access faced by American Indian/Alaskan Native (AI/AN) Tribal populations in the United States. It begins with a brief chronological outline of the historic relationship of federal and state governments with Native American Tribes, detailing major developments affecting targeted health care delivery. Next, a look into the current state of healthcare and public health services among Tribes details the specific health disparities present in many Native Americans living on federally-recognized reservations. Lastly, a summary of findings from a semi-formal literature review of research conducted over the last two decades outlines current obstacles to healthcare delivery faced by Tribal and affiliated public organizations. The review concludes with an assessment of recommended strategies to address these obstacles.

Public health relevance: By examining not only the present discrepancies in health care access, quality and outcomes among a geographically and culturally diverse group, but also the historical context which precipitated these challenges throughout much of the nation’s history, it is possible to elucidate root causes of major issues of social inequity, the administration and financing of public programs, and quality improvement in health care.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Hayes, ZacharyZGH4@pitt.edu0000-0002-2516-9318
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairHershey, Tina Batratbh16@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberMaseru, Noble A-Wnam137@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 12 April 2018
Date Type: Completion
Number of Pages: 38
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Health Policy & Management
Degree: MHA - Master of Health Administration
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 05 Oct 2018 21:18
Last Modified: 05 Oct 2018 21:18


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