Healthcare needs and infrastructure obstacles for a state‐recognised Indigenous tribe in the United States

Abstract

Although Indigenous groups continue to experience extensive health disparities, little research explores the role of structural barriers in contributing to health disparities for state-recognised tribes, who do not receive healthcare services from the Indian Health Service. In addition, much research focuses on discrete physical health outcomes, without utilising community-based approaches to allow participants to identify healthcare priorities and needs in their own voices. In partnership with a community advisory board, a qualitative descriptive methodology was used to conduct 31 life-course interviews with participants of a state-recognised tribe in the Gulf South region of the United States to explore healthcare experiences. Participants identified unmet healthcare needs and healthcare infrastructure barriers. Some of the most common barriers and unmet healthcare needs included: Long Distance to Healthcare Services and Difficulty in Accessing Specialists, Need for Increased Communication, Long Hospital or Appointment Wait Times, Unmet Mental Health Needs, Need for Substance Use or Abuse Prevention Programs and Need for Health Education. These findings highlight some of the structural barriers that exacerbate existing health disparities and suggest important areas of intervention, such as including a focus on mental health needs. Increased healthcare resources and recognition of sovereignty for this state-recognised tribe are also needed to begin to address these barriers. In addition, because of the long history of exploitation of Indigenous communities, healthcare interventions should meaningfully include Indigenous tribes in the development and implementation of any healthcare programs.

Perspectives on snakebite envenoming care needs across different sociocultural contexts and health systems: A comparative qualitative analysis among US and Brazilian health providers

“…US participants stressed the most pressing issue was within the health system, referring to the cost of antivenom and clinical care. High costs of care is a prevalent, persistent problem in the US ( Gupta et al, 2019 ) and disproportionately impacts indigenous, rural, low-income, and racial/ethnic minority populations ( Ye and Rodriguez, 1982 ; Abdus et al, 2015 ; Rural Health Snapshot, 2017 ; Liddell and Meyer, 2022 ). While almost all US snakebite victims are able to reach care, the above populations likely face financial toxicity as a result ( Tupetz et al, 2022 ).…”

“It Adds to The Stress of the Body”: Community health needs of a state-recognized Native American tribe in the United States

“…A qualitative descriptive methodology emphasizes research participants' voices and understandings, rather than abstract descriptions of experiences, which makes it especially useful for health-focused research seeking findings to inform interventions (McKinley et al, 2014;Sullivan-Bolyai et al, 2005). The findings discussed here emerged out of a larger project exploring the reproductive and sexual health experiences of tribal members (Liddell, 2020;Liddell & Kington, 2021;Liddell & Lilly, 2022a;Liddell & Lilly 2022b;Liddell et al, 2022a;Liddell et al, 2022b;Liddell et al, 2022c;Liddell & Herzog, 2022;Liddell & Doria, 2022;Liddell, 2022;Liddell & Meyer, 2022;.…”

“‘We’d Just Patch Ourselves up’: Preference for Holistic Approaches to Healthcare and Traditional Medicine among Members of a State-Recognized Tribe”

“…Similarly, the descriptive language translates easily to intervention and policy recommendations (Burnette et al, 2014; Sullivan-Bolyai et al, 2005). Additional manuscripts emerging from this research include (Buxbaum et al, 2022; Carlson & Liddell, 2022; Liddell, 2020; Liddell, 2022; Liddell & Doria, 2022; Liddell & Herzberg, 2022; Liddell & Kington, 2021; Liddell & Lilly 2022a, 2022b; Liddell & McKinley, 2022; Liddell & Meyer, 2022; Liddell et al, 2022a, 2022b, 2022c; Liddell 2023; Sheffield & Liddell, 2023).…”