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Influence of Health Care, Cost, and Culture on Breast Cancer Screening: Issues Facing Urban American Indian Women

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Authors: Risendal B., Roe D. , DeZapien J., Papenfuss M, Giuliano A
Publication Year: 1999
Last Updated: 2016-04-12 14:28:53
Journal: Preventive Medicine
Keywords: Female; Knowledge, Attitudes, Practice; Health Services Accessibility; Mammography; Mortality; Neoplasms, Breast/Prevention & Control; Women's Health Services, women health, female health, mammogram, cancer, predictors, breast examination, examination,

Short Abstract:

Background: Breast cancer is the second leading cause of cancer death among American Indian women. Southwestern American Indian women are more likely to have distant spread of the disease, and 5-year survival from breast cancer is poor in comparison to U.S. whites. Mortality from breat cancer could be reduced by more than 30% in American Indian women if current recommendations for screening were followed.

Abstract:

BACKGROUND: Breast cancer is the second leading cause of cancer death among American Indian women. Southwestern American Indian women are more likely to have distant spread of the disease, and 5-year survival from breast cancer is poor in comparison to U.S. whites. Mortality from breast cancer could be reduced by more than 30% in American Indian women if current recommendations for screening were followed.

METHODS: A random household cross-sectional survey was conducted among 519 adult American Indian women in Phoenix, Arizona. Logistic regression was used to identify predictors of recent clinical breast examination and mammogram among those women aged 40 years and older.

RESULTS: Just more than half (53.0%) of the women surveyed reported they had received a clinical breast examination in the last year, and 35.7% indicated they had received a mammogram in the last 2 years. Access to care, knowledge of the examinations, and health beliefs were positively associated with breast cancer screening in the multivariate analyses.

CONCLUSIONS: The cancer screening rates observed in urban American Indian women are far below current national estimates and Healthy People 2000 Objectives. This study confirms the limited access of urban Indians to preventive health services, and supports a role for cancer education in improving screening participation in this special population.

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Indian Health Service HIV/AIDS Prevention and Treatment Services for American Indians and Alaska Natives Governmental Accessibility Office 12-07

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Authors: Indian Health Service
Publication Year: 2007
Last Updated: 2016-04-12 13:05:50
Journal: I.H.S. Agency Report
Keywords: IHS, HHS, American Indians, Alaska Natives, UIHP, HIV, AIDS, Budget, GAO, Government Accountability Office, Report to Congress

Short Abstract:

The Indian Health Service (IHS), part of HHS, provides or arranges health care services, including HIV/AIDS treatment, to eligible American Indians and Alaska Natives. It provided or arranged services for a projected 1.5 million American Indians and Alaska Natives in fiscal year 2007, across 12 federally designated areas that cover all or part of 35 states. Services are provided through IHS-funded facilities, including those operated by IHS, those operated by tribes, and Urban Indian Health Program (UIHP) facilities or through contracts with outside providers. Our prior work found gaps in the health care services IHS provided for American Indians and Alaska Natives that, in some cases, hindered American Indians and Alaska Natives from obtaining needed services. In addition to IHS, American Indians and Alaska Natives with HIV/AIDS may also receive care through other sources depending on their access to private health insurance; their eligibility for other federal health care programs, such as Medicare and Medicaid; or their eligibility for services provided by entities because access to HIV/AIDS prevention services can affect the number of American Indians and Alaska Natives who have the disease and there may be variation in the availability of treatment services, you asked us to examine IHSs efforts related to HIV/AIDS. Specifically, we examined the extent to which IHS provides (1) HIV/AIDS prevention services and (2) HIV/AIDS treatment services. We also examined (3) what other HIV/AIDS-related initiatives IHS has undertaken.

Abstract:

The Indian Health Service (IHS), part of HHS, provides or arranges health care services, including HIV/AIDS treatment, to eligible American Indians and Alaska Natives.4 It provided or arranged services for a projected 1.5 million American Indians and Alaska Natives in fiscal year 2007, across 12 federally designated areas that cover all or part of 35 states. Services are provided through IHS-funded facilities, including those operated by IHS, those operated by tribes, and Urban Indian Health Program (UIHP) facilities or through contracts with outside providers.5 Our prior work found gaps in the health care services IHS provided for American Indians and Alaska Natives that, in some cases, hindered American Indians and Alaska Natives from obtaining needed services.6 In addition to IHS, American Indians and Alaska Natives with HIV/AIDS may also receive care through other sources depending on their access to private health insurance; their eligibility for other federal health care programs, such as Medicare and Medicaid; or their eligibility for services provided by entities because access to HIV/AIDS prevention services can affect the number of American Indians and Alaska Natives who have the disease and there may be variation in the availability of treatment services, you asked us to examine IHSs efforts related to HIV/AIDS. Specifically, we examined the extent to which IHS provides (1) HIV/AIDS prevention services and (2) HIV/AIDS treatment services. We also examined (3) what other HIV/AIDS-related initiatives IHS has undertaken.

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L59 Indian Health Service HIV-AIDS Prevention and Treatment Services for American Indians and Alaska Natives GAO 08-90.pdf

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Indian Health Care Reform Improvement Act (IHCIA) National Tribal Steering Committee – Summary of the Indian Health Care Improvement Reauthorization and Extension Action of 2009 by the Senate Committee on Indian Affairs October 2009 – Title V Provisions

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Authors: United States Senate, Senate Committee on Indian Affairs
Publication Year: 2009
Last Updated: 2016-04-12 12:14:41
Journal: NA
Keywords: Title V, title 5, aca, affordable care act, ACA, IHCIA, Indian Health Care Improvement Act, S.1200, reauthorization, 2009, HCR, Health Care Reform

Short Abstract:

Summary of Indian Health Care Improvement Reauthorization and Extension Action of 2009

Abstract:

Summary of Indian Health Care Improvement Reauthorization and Extension Action of 2009

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Indian Health Care Improvement Act (IHCIA) Letter from the National Council of Urban Indian Health to Senator Reid thanking for his work to reform national health care insurance 10-29-09

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Authors: Geoffrey Roth, National Council of Urban Indian Health
Publication Year: 2009
Last Updated: 2016-04-12 12:13:14
Journal: NCUIH
Keywords: IHCIA, Indian Health Care Improvement Act, aca, affordable care act. ACA, S.1790, NIHB, NCAI, NCUIH, National Indian Health Board, National Council of Urban Indian Health, National Congress of American Indians, NSC, National Steering Committee

Short Abstract:

The primary focus of the National Council of Urban Indian Health is advocating for the health and well-being of American Indians and Alaska Natives living in urban centers. We believe that health care reform is critical to ensuring all Indian people have access to affordable care and all medically necessary health care services. To that end we strongly encourage the Senate to follow Senator Dorgans lead and include S. 1790, the Indian Health Care Improvement Act, to the final Senate bill for national health care reform. We join the National Congress of American Indians (NCAI), the National Indian Health Board (NIHB), and the National Steering Council (NSC) in their request for your support of Senator Dorgans bill. Including IHCIA will ensure that national health care reform addresses the unique health care needs of Indian people. It has been 10 years since this important piece of legislation has been reauthorized. This is the best opportunity to pass this critical piece of legislation for Indian people and the only chance this Congress.

Abstract:

The primary focus of the National Council of Urban Indian Health is advocating for the health and well-being of American Indians and Alaska Natives living in urban centers. We believe that health care reform is critical to ensuring all Indian people have access to affordable care and all medically necessary health care services. To that end we strongly encourage the Senate to follow Senator Dorgans lead and include S. 1790, the Indian Health Care Improvement Act, to the final Senate bill for national health care reform. We join the National Congress of American Indians (NCAI), the National Indian Health Board (NIHB), and the National Steering Council (NSC) in their request for your support of Senator Dorgans bill. Including IHCIA will ensure that national health care reform addresses the unique health care needs of Indian people. It has been 10 years since this important piece of legislation has been reauthorized. This is the best opportunity to pass this critical piece of legislation for Indian people and the only chance this Congress.

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L751 --IHCIA--Letter from the National Council of Urban Indian Health to Senator Reid thanking for his work to reform national health care insurance 10-29-09.pdf

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Indian Health Care Improvement Act Fact Sheet Reauthorization of IHCIA Bringing Indian Health Services into the 21st Century

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Authors: National Council of Urban Indian Health
Publication Year: 2009
Last Updated: 2016-04-12 12:12:16
Journal: NCUIH
Keywords: IHCIA, Indian Health Care Improvement Act, ACA, affordable care act, aca, HCR, Health care Reform, Reauthorization, NCUIH, National Council of Urban Indian Health

Short Abstract:

The United States has a longstanding trust responsibility to provide health care services to American Indians and Alaska Natives. This responsibility is carried out by the Secretary of the United States Department of Health and Human Services through the IHS. Since its passage in 1976 the IHCIA has provided the programmatic and legal framework for carrying out the federal governments trust responsibility for Indian health. The IHCIA is the law under which health care is administered to American Indians and Alaska Natives.

Abstract:

The United States has a longstanding trust responsibility to provide health care services to American Indians and Alaska Natives. This responsibility is carried out by the Secretary of the United States Department of Health and Human Services through the IHS. Since its passage in 1976 the IHCIA has provided the programmatic and legal framework for carrying out the federal governments trust responsibility for Indian health. The IHCIA is the law under which health care is administered to American Indians and Alaska Natives.

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L174 Indian Health Care Improvement Act Fact Sheet Reauthorization of IHCIA Bringing Indian Health Services into the 21st Century.pdf

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Indian Health Care Improvement Act (IHCIA) Background and Timeline

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Authors: National Council of Urban Indian Health
Publication Year: 2009
Last Updated: 2016-04-12 12:11:14
Journal: NCUIH
Keywords: IHCIA, NCUIH, ACA, aca, affordable care act, Background, Timeline, Indian Health Care Improvement Act, National Council of Urban Indian Health, health disparities

Short Abstract:

Originally created in 1976 as an acknowledgement of low-health status ranking disparities in comparison to the general population, the Indian Health Care Improvement Act has been reauthorized three times with the mandate to implement the Federal responsibility for the care and education of the Indian people by improving the services and facilities of Federal Indian health programs and encouraging maximum participation of Indians in such Programs.

Abstract:

Originally created in 1976 as an acknowledgement of low-health status ranking disparities in comparison to the general population, the Indian Health Care Improvement Act has been reauthorized three times with the mandate to implement the Federal responsibility for the care and education of the Indian people by improving the services and facilities of Federal Indian health programs and encouraging maximum participation of Indians in such Programs.

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L56 Indian Health Care Improvement Act IHCIA Background and Timeline.pdf

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Indian Health Care Improvement Act (IHCIA) Proposed Provision of Restitution 1

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Authors: NCUIH
Publication Year: 2009
Last Updated: 2016-04-12 12:10:42
Journal: NCUIH
Keywords: Provision for Restitution, NCUIH, HIT, UIHP, IHCIA, National Steering Committee, aca, affordable care act, ACA, National Council of Urban Indian Health, Health Information Technology, Urban Indian Health Programs

Short Abstract:

Provisions for Restoration: Although the urban Indian health programs have lost a number of provisions over the years, the National Council of Urban Indian Health is only advocating for the return of 3 provisions and the creation of one new provision authorizing the appropriation of funds for HIT for Urban Indian Organizations. These provisions would all be included in Title V of the Indian Health Care Improvement Act and would not impact Tribal appropriations as all appropriations for Urban Indian Organizations must come through authorizing language in Title V. Outlined below are the provisions that NCUIH respectfully asks that National Steering Committee recommend for re-inclusion in the Indian Health Care Improvement Act.

Abstract:

Provisions for Restoration: Although the urban Indian health programs have lost a number of provisions over the years, the National Council of Urban Indian Health is only advocating for the return of 3 provisions and the creation of one new provision authorizing the appropriation of funds for HIT for Urban Indian Organizations. These provisions would all be included in Title V of the Indian Health Care Improvement Act and would not impact Tribal appropriations as all appropriations for Urban Indian Organizations must come through authorizing language in Title V. Outlined below are the provisions that NCUIH respectfully asks that National Steering Committee recommend for re-inclusion in the Indian Health Care Improvement Act.

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L16 Indian Health Care Improvement Act _IHCIA_ Proposed Provision of Restitution 1.pdf

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Indian Health Care Improvement Act (IHCIA) Letter from the National Council of Urban Indian Health to Congresswoman Pelosi thanking for the work done developing H.R. 3962 Affordable Health Care for America Act 10-29-09

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Authors: National Council of Urban Indian Health
Publication Year: 2009
Last Updated: 2016-04-12 12:07:59
Journal: NCUIH
Keywords: IHCIA, Indian health Care Improvement Act, ACA, affordable care act, aca, HCR, Health care reform, Thank You letter, Nancy Pelosi, NCUIH, National Council of Urban Indian Health, H.R.3962, H.R.2708

Short Abstract:

Thank you for the work you and others have done on developing H.R. 3962. We appreciate your efforts to address the problems facing our nations health care system and move forward on the passage of real health care reform legislation that will provide Americans with quality, affordable health coverage and care.

The primary focus of the National Council of Urban Indian Health is advocating for the health and well-being of American Indians and Alaska Natives living in urban centers. We believe that health care reform is critical to ensuring all Indian people have access to affordable care and all medically necessary health care services. To that end we are delighted that the House has included H.R. 2708, the Indian Health Care Improvement Act, in H.R. 3962. We join the National Congress of American Indians (NCAI), the National Indian Health Board (NIHB), and the National Steering Council (NSC) in their request for your continued support of Representative Pallones bill in H.R. 2708. Including IHCIA will ensure that national health care reform addresses the unique health care needs of Indian people. It has been 10 years since this important piece of legislation has been reauthorized. This is the best opportunity to pass this critical piece of legislation for Indian people and the only chance this Congress.

Abstract:

Thank you for the work you and others have done on developing H.R. 3962. We appreciate your efforts to address the problems facing our nations health care system and move forward on the passage of real health care reform legislation that will provide Americans with quality, affordable health coverage and care.

The primary focus of the National Council of Urban Indian Health is advocating for the health and well-being of American Indians and Alaska Natives living in urban centers. We believe that health care reform is critical to ensuring all Indian people have access to affordable care and all medically necessary health care services. To that end we are delighted that the House has included H.R. 2708, the Indian Health Care Improvement Act, in H.R. 3962. We join the National Congress of American Indians (NCAI), the National Indian Health Board (NIHB), and the National Steering Council (NSC) in their request for your continued support of Representative Pallones bill in H.R. 2708. Including IHCIA will ensure that national health care reform addresses the unique health care needs of Indian people. It has been 10 years since this important piece of legislation has been reauthorized. This is the best opportunity to pass this critical piece of legislation for Indian people and the only chance this Congress.

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L750 --IHCIA--Letter from National Council of Urban Indian Health to Congresswoman Pelosi thanking for the work done developing H.R.pdf

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Health Problems and Use of Services at Two Urban American Indian clinics

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Authors: Taylor TL
Publication Year: 1988
Last Updated: 2016-04-06 20:14:57
Journal: Public Health Reports
Keywords: Adult; Age Factors, Aged, Ambulatory Care Facilities, Utilization, Cross-Sectional Studies, Educational Status, Health Services Needs and Demand, Health Services Research, Health Status, Health Surveys, Income, Insurance, Health, Male, Medical Records, Middle Age, Sex Factors, Urban Health

Short Abstract:

The use of primary health care services by urban American Indians and their health problems were compared with national and regional data compiled by the Indian Health Service, Bureau of the Census, Office of Technology Assessment, and the National Center for Health Statistics.  A survey of medical records was conducted at urban Indian health clinics, one located in Oklahoma City, OK, and the other in Wichita, KS.  Health records of 500 patients from each clinic were reviewed.

Abstract:

The use of primary health care services by urban American Indians and their health problems were compared with national and regional data compiled by the Indian Health Service, Bureau of the Census, Office of Technology Assessment, and the National Center for Health Statistics. A survey of medical records was conducted at urban Indian health clinics, one located in Oklahoma City, OK, and the other in Wichita, KS. Health records of 500 patients from each clinic were reviewed. Information was gathered concerning reasons for visit, diagnoses, and number of physician visits. In addition, predisposing variables and enabling variables from each patient's registration form were reviewed. According to the data collected in the survey, the clientele of these urban Indian clinics have annual incomes well below the average income of the general population and the overall American Indian population in these cities. Their lack of health insurance and low education levels were also evident. Use of primary health services was below that of the general population, and lower, but relatively close, to use levels of American Indians residing in rural Oklahoma and Kansas. Information on health problems indicated high levels of diabetes mellitus and hypertension among the middle-age groups, and high levels of use by young women for prenatal care and contraception. The absence of systematically collected and comprehensive health and health care use information about urban American Indians, who now comprise more than half the U.S. American Indian population, and the limitations in the available information leave important questions unanswered.

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Top Priorities of Centers of Medicaid and Medicare Services

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Authors: National Council of Urban Indian Health
Publication Year: 2009
Last Updated: 2016-04-06 13:46:29
Journal: NCUIH
Keywords: CMS, Transition, First 100 Days, Medicaid, Medicare, fmap, federal medical assistance program, Urban Indians, UIHP, Policy Recommendations, Development, Center for Medicaid and Medicare Services

Short Abstract:

The National Council of Urban Indian Health developed a comprehensive transition plan for the first 100 days of the Obama Administration addressing problems and issues confronting American Indians and Alaska Natives living in Urban Centers. NCUIH fully supports the goals and plans of Indian Country, but wants to ensure that the specific needs of the urban communities are addressed during this critical time. For the sake of clarity NCUIH has identified its top three concerns for the Centers for Medicare and Medicaid Services Transition Team:

Abstract:

The National Council of Urban Indian Health developed a comprehensive transition plan for the first 100 days of the Obama Administration addressing problems and issues confronting American Indians and Alaska Natives living in Urban Centers. NCUIH fully supports the goals and plans of Indian Country, but wants to ensure that the specific needs of the urban communities are addressed during this critical time. For the sake of clarity NCUIH has identified its top three concerns for the Centers for Medicare and Medicaid Services Transition Team:

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L41 Centers for Medicaid_medical_top_3 priorities[1].pdf

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