Critical Values is the go-to resource for the entire laboratory team, providing insight and information on the latest research, information, and issues within pathology and laboratory medicine. The print and online magazine invites submissions on topics including, but not limited to, advocacy, education, technology, global health, workforce, workplace best practices, and leadership.
E. Blair Holladay, PhD, MASCP, SCT(ASCP)CM
Chief Executive Officer
Molly Strzelecki Editor
Susan Montgomery Contributing Editor
Martin Tyminski Creative Director
Jennifer Brinson Art Direction and Design
There are more than an estimated 370 million indigenous people living throughout the world.1 In the United States, today’s Native Americans and Alaskan Natives descend from a people who inhabited areas before settlers first arrived, and their unique traditions and social, cultural, and economic traits set them apart.
Monday, October 11 is Indigenous People’s Day, a holiday that celebrates and honors Native American and other indigenous peoples and commemorates their history and culture. Through ASCP’s Diversity, Equity and Inclusion initiative, the Society has been recognizing the rich tapestry of cultures and races that are interwoven into our nation’s history and the unique contributions that each of us brings to this world.
Through that lens, we take a closer look at the particular issues affecting the healthcare needs of indigenous populations in the U.S. in order to provide better patient care. Health care for Native Americans trails other groups, despite the United States’ legal commitment to provide health care to Native Americans and Alaskan Natives. Both populations have a shorter life expectancy than all other races in the U.S., and have higher mortality rates from preventable illness.2
Key challenges are access to quality care and the shortage of medical personnel in rural communities, especially those in remote reservation locations. “Some reservations are very isolated, especially in Alaska, and Native Americans may not have cars. That makes it difficult to get to a medical appointment,” says Terese Abreu, MLS(ASCP)CM, who served for many years as director of a medical laboratory science program at a university located on land within the Yakama Indian Reservation, in Toppenish, WA.
“Our program serves local people—the native and migrant families located in the agricultural area of central Washington State, where many fruit trees, hops and grapes are grown,” says Ms. Abreu, who retired last year. “Our residents want a place that is close, with hours that are flexible and educators who understand their unique needs. Our students want to be able to live at home while attending school, so that they can also work and support their families and communities.”
Diabetes and mental health issues are significant health concerns in the Native American population, as is suicide among its young people.
“The youth suicide rate in Native people in the highest in the Western Hemisphere and higher than the national average. It is heartbreaking,” Ms. Abreu says. “It reflects the deleterious effects of the government boarding school colonization efforts. When students returned to their homes, they were no longer able to communicate effectively with their elders. They were foreign in a way. They were neither a part of their own culture nor the white culture. This created a gap in their support structure.”
Today, healthcare providers need to be sensitive that Native Americans are very private individuals and have trust issues with the white population.
“They look at health differently than we do,” Ms. Abreu explains. “They have a holistic perspective. It’s called ‘to walk in beauty,’ which means that one must live in balance with their body, mind, and spirit and in harmony with their community and the environment. When they don’t, illness or injury occurs. Healing is a sacred calling and includes spiritual rituals and ceremonies. It is foreign to them to need to see several doctors to get well. Being asked a lot of questions and being touched is very invasive for them.”
Ms. Abreu is pleased that the school where she taught recently received the federal designation as a Native American Serving Non-Tribal Institution. It is now one of only two universities in the nation that holds this designation, along with one for serving the Latinx population.
There is much progress yet to be made to ensure that the United States’ indigenous population receives the high quality of health care it deserves. Yet, Ms. Abreu is heartened by the increasing awareness that people of diverse cultures are receiving in this country. She has learned so much from her years working with them.
“Life is tough,” she reflects, “and it will take listening to everyone’s perspective, working together and a sense of humor for us all to survive. We are so much more together than we are by ourselves.”
Indigenous Peoples, Indigenous Voices Factsheet; United Nations Permanent Forum on Indigenous Issues. https://www.un.org/esa/socdev/unpfii/documents/5session_factsheet1.pdf. Accessed Oct. 5, 2021.
Mary Smith, Native Americans: A Crisis in Health Equity, American Bar Association. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/native-american-crisis-in-health-equity/. Accessed Oct. 5 2021.