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TUESDAY, AUGUST 20, 2002

Native American elders lack adequate long-term health care options, a problem that has mushroomed as the Indian population grows older, according to a series of discussion reports.

The number of older American Indians and Alaska Natives has doubled over the past decade, based on U.S. Census Bureau figures. They require dedicated services to combat high rates of diabetes, high blood pressure and other diseases.

But the overwhelming majority aren't getting long-term care, according to William F. Benson, an expert on elder issues. Life expectancy has increased but "the overall health status of Indian elders continues to be poor," he said in a recent report.

Benson's research is one of five reports that focuses on Native elders. The Indian Health Service (IHS), in partnership with the federal Administration on Aging (AOA) and the National Indian Council on Aging (NICOA), discussed the reports along with Indian Country advocates at a recent roundtable discussion.

"The American Indian and Alaska Native elder population brings special challenges for the Indian health care system," said interim IHS director Dr. Charles W. Grim. "Our goal is to help elders remain in their communities with their family for as long as possible."

According to the research, the rural nature of the Indian elder population limits their options. Elders must travel long distances to receive care and when they do, they require services that often don't exist.

At the IHS for example, elders are 8.3 percent of the patient population but use 21 percent of the services. Yet neither the IHS nor the Bureau of Indian Affairs provide long-term nursing, so Natives must turn to the Medicaid program, said Dr. Mim Dixon

"If Congress had funded either of these federal agencies to provide this essential element in the continuum of health care, then American Indians and Alaska Natives would not have to apply for Medicaid," Dixon wrote.

Despite high poverty and disability rates, there is lower participation in Medicaid and lower payments made on behalf of Native elders. Only 65 percent of American Indians who are eligible for Medicaid are receiving it, compared to 88 percent of the general population, according to Dixon's research.

Urban Natives also face obstacles, according to Ralph Forquera, executive director of the Seattle Indian Health Board. Most American Indians and Alaska Native don't live on tribal lands but receive only 1 percent of health care funds, he wrote in a report.

"[L]ittle attention has been given to Indians that live away from federal reservations, in part a result of insufficient funding for the Indian Health Service itself and other Indian programs by the U. S. Congress," the report stated.

The five reports contained in "American Indian and Alaska Native Roundtable on Long-Term Care: Final Report 2002" were discussed by federal and Indian health experts in April. The participants agreed on several principles and made recommendations to increase funding for long-term care, integrate culturally appropriate services and conduct more research on urban elders.

Get the Report:
American Indian and Alaska Native Roundtable on Long-Term Care: Final Report 2002 (IHS August 2002)

Relevant Links:
Indian Health Service - http://www.ihs.gov
Administration on Aging - http://www.aoa.gov
National Indian Council on Aging - http://www.nicoa.org

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