Over five million people identify as American Indian & Alaska Natives (AI/AN), and over half depend upon services provided by the Indian Health Service (HIS) for healthcare services. Poverty, lack of education, lower life expectancy, cultural differences, and discrimination are deemed to be responsible for their significant disease burden in this population (IHS, 2019). Compared to all other races in the United States (U.S.), AI/AN Americans have higher incidences of death related to diabetes, injuries, suicide, respiratory infections, assault, homicide, liver disease, and cirrhosis with a life expectancy shorted by five years (IHS, 2019).

AI/AN peoples are more likely to be uninsured (approximately half of all families are below the poverty line), have difficulty accessing care due to far away from care locations, and about half of families are unable to access IHS services due to the federal government not recognizing some peoples tribes (Katz, 2004). Even though there is additional funding for care through Healthcare.gov, such as Medicaid and CHIPS, it is still limited to federally recognized tribes. The Centers for Disease Control are investing in providing community health services to encourage healthier behaviors (CDC, 2019), but there is still a long way to go to reach the majority. This can be an excellent opportunity for nurse practitioners to provide culturally-sensitive care to a large group of people that are currently severely lacking in support services.

References
Centers for Disease Control [CDC]. (2019). Healthy Tribes. Retrieved from: https://www.cdc.gov/healthytribes/index.htm
Indian Health Service [IHS]. (2019). Disparities. Retrieved from: https://www.ihs.gov/newsroom/factsheets/disparities/

Sample Solution