Introduction
The healthcare quality access barrier is one of the critical ones for indigenous settlers in the Alaskan rural areas, particularly those in which Interactions of many social determinants such as geography, culture, socioeconomic status, and discrimination are severe threats to the equity of healthcare services and are the sources of the health discrepancies among Alaska Native communities. Identifying the most deep-rooted group of factors that feed the inequalities and implementing workable solutions are essential to inspiring health equity and achieving favourable health results for indigenous persons.
Understanding the Health Issues and Health Disparities
The healthcare quality is affected by many factors in the remote rural Alaska tribes areas, further aggravating the problem of health disparity. Geographical isolation has a crucial location effect: reaching some villages may depend on air or water travel, translating into lengthy, time-consuming and costly transportation. Additionally, the Arctic climate adds a layer of complexity to healthcare delivery with harsh environmental conditions that make even the overall functioning of patients and healthcare workers difficult due to extreme weather and limited daylight hours. The few people in these communities are also underserved regarding healthcare infrastructure, including a severe shortage of facilities and medical personnel in many villages, both being viewed as systemic issues (Bowleg, 2021).
Cultural obstacles represent an additional difficulty, and, in some cases, a person’s cultural belief system of the Indigenous peoples may be very different from that of Western healthcare organizations. Language barriers go hand in hand with these problematic trends, as it is not uncommon to find many Alaska Natives who are not fluent in English and, therefore, are unwilling or unable to communicate adequately. This leads to ineffective communication, a lack of cultural understanding among healthcare workers, and inefficient treatment options (Bowleg, 2021). Colonialism and marginalization in historical times interfered with the Native people entering the Western system of healthcare; therefore, accessing treatment services became more complex.
The effect of these barriers is a very imperative one since the Alaskan native populations develop chronic illnesses like cardiovascular disease, diabetes, etc., at much higher rates compared to the entire population of the United States. Moreover, the tremendous medical support disparity also leads to health outcomes disparity, which has an even worse effect on the life expectancy and general health status of Alaska Native communities (Bowleg, 2021). Dealing with these issues is complicated and demands complex solutions based on educating the public, engaging society, and developing a healthcare system that adapts to the situation of native Alaskan people.
Examining Upstream Social Determinants through an Intersectional Lens
An intersectional method of approach exposes the fact that social determinants are multifactorial, and upstream disabilities and healthcare inequalities are a function of class and income. The colonization that began historically and still goes on has played a crucial role in how Alaskan aboriginal communities function and how their medical systems work. Due to European influence, they lost their traditional medical practices, leading to implementing the Western medical model that was inappropriate for their worldview. Thus, this historical context results in systematic injustices, creating an unequal healthcare system for everyone. The inequalities of socioeconomic background, which is the case for most Alaskan native populations, such as poverty and lack of built-in transportation infrastructure, impair their access to healthcare services (Bowleg, 2021). More so, the very tenets of cultural beliefs and customs, which are mainly steeped in Indigenous cultures, may contradict Western medical approaches, leading to misinterpretations and poor understanding of the health care provision. These difficulties include communication breakdowns induced by language barriers, which hinder care providers from achieving the best possible outcomes.
A part of health disparity is undoubtedly the existence of the racially rooted system of healthcare. Alaskan Indigenous people are frequently discriminated against and treated in a biased manner, and as a consequence, they get the diagnoses relatively late; sometimes, they accept unnecessary or ineffective treatment, and their health conditions deteriorate rapidly (Bowleg, 2021). This systemic racism pushes these populations into the low-scoring category, deepening the inequality and making them even more distanced from the advantaged individuals in terms of their position within society.
Dealing with these gaps would need a multipronged and multifaceted set of strategies, considering that health disparities and intersections are intertwined. To achieve healthcare improvement objectives from the point of view of Alaska Native communities, one has to propose actions such as overcoming historical trauma, using culturally competent methods attentive to cultural intricacy, overinvesting in the economy, improving transportation infrastructure, and combating systemic racism inside the healthcare system (Bowleg, 2021). Through the treatment of fundamental social health determinants, it is possible to achieve justice in healthcare and subsequently meet the medical requirements of everyone without distinction to their background or identity.
Proposed Solutions to Address the Health Disparities
In order to provide equal fairness in obtaining quality healthcare for Alaska Native people, one strategy can be utilized to address these problems from various angles. The culturally comprehensive health care service is conducted so that the providers appreciate and honour the values, beliefs, practices, and preferences of Alaska Native patients. This means drawing in the element of traditional healing practices and incorporating the Indigenous approach in healthcare delivery. Furthermore, providing more financing for rural healthcare infrastructure is indispensable to local economies heavily dependent upon agriculture and susceptible to drought, flooding, or other natural disasters (Napoleon, 1991). Convenient transportation, like road expansion and subsidies on medical commutes, can contribute to possible geographical barriers disrupting healthcare accessibility.
Such healthcare delivery approaches lead to essential care for those who live in rural communities by letting them communicate online and monitor their health. Engaging in community-driven programs that embrace Indigenous know-how and healing methods encourages the representation that Alaska native communities are taking their health and wellness into their own hands. The second important aspect of Indigenous health in our health systems is the promotion of partnerships and collaboration between Indigenous communities and healthcare providers to create mutual respect and understanding that eventually contribute to better delivery of these healthcare services. Promoting policy changes that include systemic racism and inequities in the health care system is crucial to deconstructing the blocks to health care and achieving a levelled ground (Napoleon, 1991). Lastly, the most vigorous advocacy for Alaska Native health would be to ensure that Indigenous leaders and representation are included in the decision-making processes so that their particular experiences and requirements are well-addressed.
Implications of Health Disparities for Public Health
According to Schulz & Mullings (2006), people’s health conditions differ because of race or class and gender, which are determined by structuring life chances and, thus, whether it will be a life or death matter. This means these individuals experience unfairness within systems that restrict their access to resources and conditions, leading to poor health outcomes and shortening their life spans. In contrast, those favoured have the opposite trend. One main implication of this unhealthy situation, which is to bring public awareness into the picture, is to tear down those structural inequalities which permeate every aspect of society (Schulz & Mullings, 2006). A crucial part of public health activity is to address the social determinants of health, such as racial injustice, economic disparities and prejudice. Therefore, you will get health equity for all groups involved.
Conclusion
So, finally, the complicated system of hurdles in getting quality healthcare promoted for the Alaska Native community demands a multi-dimensional perspective which identifies the root causes of the health disparities. Developing culturally responsive health services, augmenting funding for rural health facilities, developing programmes initiated and driven by the community, and making legal changes to fight discrimination may ensure that all have equal opportunities to enjoy good health. Having indigenous communities prioritized in their decision-making processes about healthcare interventions is crucial to ensure that their cultural backgrounds are not left out during implementation and that the interventions are working perfectly to meet their specific needs as Alaska Natives.
References
Bowleg, L. (2021). Evolving intersectionality within public health: from analysis to action. American journal of public health, 111(1), 88-90. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2020.306031
Napoleon, H. (1991). Yuuyaraq: The way of the human being. Fairbanks: University of Alaska Fairbanks, Center for Cross-Cultural Studies. https://www.degruyter.com/document/doi/10.1515/9780822390831-014/pdf?licenseType=restricted
Schulz, A. J., & Mullings, L. E. (2006). Gender, race, class, & health: Intersectional approaches. Jossey-Bass/Wiley. https://psycnet.apa.org/record/2006-08469-000
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