Native Americans have the highest rates of diabetes, substance abuse, and teen suicide of any group in the U.S., yet there is a dearth of medical literature about how best to prevent and treat the underlying causes of
That’s why Margaret Moss, assistant dean of diversity and inclusion for the University at Buffalo School of Nursing, and 12 other contributing writers — nine of whom are also American Indian nurses — published American Indian Health and Nursing. Released in December, it is the first textbook focused solely on providing care to this underserved population.
“This book was written to answer the disturbing lack of information and understanding of the most underrepresented group in America — as patients, health professionals, and in academia,” Moss said in a statement.
Currently, less than 1 percent of nurses are Native American.
She writes in the textbook that disparities in healthcare policy and environmental, historical, and geographical factors have all contributed to Native Americans’ health inequality. For example, of the roughly 5 million American Indians in the U.S., 78 percent live off of reservations, and more than half of that population live in cities, where they are more likely to receive care from non-Native nurses, leading to an increased occurrence of discrimination in care.
On the other hand, those who live on reservations have limited access to resources and healthcare due to geographical isolation, and the impact is tremendous; for example, the life expectancy for men on the Pine Ridge reservation in South Dakota is less than 50 years. Moss says a distrust of government based on historical events, as well as low high school and college graduation rates among American Indians, further contribute to their poor health outcomes, especially when it comes to mental health issues.
“Poverty, isolation, and overwhelming historical trauma all weigh on you and feed into how you react,” Moss says. “[In the book], we took a wider view of health to understand why this population has such poor health outcomes.”
The textbook takes a holistic approach to Native American health by looking at the topic through spiritual, mental, physical, and emotional lenses to develop culturally sensitive nurses. Creating trust between patient and provider is also paramount to the textbook’s goals.