Barriers to Health from Culture, Socioeconomics, Education, and Sociopolitical Factors

 

AI/ANs culture creates barriers in accessing health care due to language barriers, making it challenging for providers to offer appropriate preventative interventions. They practice traditional healing, which lowers their health-seeking behaviors. Socioeconomic status and level of education are predictors of health status (Mangla & Agarwal, 2021). AI/ANs have a high population that has not completed high school. Besides, approximately 19% of the population has incomes lower than the federal poverty level (Carron, 2020). The low socioeconomic and poverty status has contributed to poor health-seeking behaviors and low insurance coverage rates, limiting healthcare access. Sociopolitical factors further limit access to health for AI/ANs. From the late 19th century, federal governments enacted various policies to wipe out the native culture and identity. The policies caused the banning of the native language and religious practices, confiscation of land, and ban of traditional healers, which led to a profound mistrust in the community (Mangla & Agarwal, 2021). As a result, AI/ANs have mistrust in accessing care from providers from other communities, limiting their access to healthcare.

Health Promotion Activities Practiced By AI/ANs

Health promotion activities practiced by AI/ANs include traditional healing practices using allopathic medicine and native herbal remedies to improve health and wellbeing. Spiritual treatments are vital for health promotion and healing in the AI/ANs community. Natives in Arizona run every day to greet the dawn, promoting physical health and spiritual wellbeing. Besides, they use stories and legends to reinforce positive behaviors and the implications of failing to uphold the laws of nature. AI/ANs use manipulative therapies, herbs, ceremonies, and prayer in different combinations to prevent and treat diseases.

Health Promotion Approach

The primary level of health promotion attempts to remove the possibility of getting a disease. It is likely to be most effective in a care plan for AI/ANs, considering the population’s high prevalence of chronic illnesses and mental health disorders. Through primary health promotion, individuals can be provided health education directed on preventing chronic diseases such as diabetes and heart disease (Peckham et al., 2017). For instance, it can target excessive alcohol consumption, inadequate exercise, and unhealthy dietary patterns, thus reducing the chances of liver disease, obesity, diabetes, and accidents. Primary prevention is the most effective choice since it can help change the community’s behaviors, thus lowering their chance of developing diseases caused by unhealthy behaviors.

Cultural Beliefs/Practices to Consider When Creating a Care Plan

Providers must understand the differences in cultural beliefs and practices among various ethnic groups when developing a care plan. Health providers should consider the differences present in the belief of individuals from the AI/AN community. Even though many AI/AN tribes have adopted Christianity, their culture remains deep-rooted in their traditions (Mangla & Agarwal, 2021). Therefore, they should be considered to ensure the provision of culturally appropriate care. The nurses creating the care plan for an AI/AN individual or community should obtain information on their health practices, cultural beliefs, dietary customs, and cultural rituals.

The Purnell Model for Cultural Competence would be ideal for fostering culturally competent health promotion for AI/ANs. The Purnell Model enables providers to collect patient information and conduct health promotion activities focusing on 12 cultural domains (Purnell, 2019). The cultural domains are: high-risk behaviors, health care practices, nutrition, pregnancy, family roles and organization, heritage, communication, spirituality, workforce issues, biocultural ecology, health care professionals, and death rituals (Purnell, 2019). Consequently, the Purnell Model can establish unhealthy behaviors among AI/ANs and plan health promotion activities for the population.

Conclusion

AI/ANs AI have a poor health status evidenced by a lower quality of life, a lower life expectancy, and a higher prevalence of illnesses such as diabetes, obesity, liver disease/hepatitis, and mental disorders. They face substantial health disparities in various areas, including metabolic and mental disorders. Health disparities are apparent in accidents, diabetes, chronic liver diseases, and mental disorders. Besides, their lower socioeconomic and educational status is connected with worse health outcomes. Primary prevention is the most effective for this population to modify behaviors that cause chronic illnesses.