Native American Women in the United States: Access to Adequate Healthcare

The United States has openly sought to ‘give back’ to the Native American communities what colonisers once diminished amidst the country’s founding. In doing so, the federal government – over the years – has implemented a number of specialised programmes, resources, funding, and land allocations to target communities affected by the historical turmoil. However, many of these initiatives have fallen short of the US government’s promises to fulfil such rights that Native Americans are entitled to within the greater human rights setting.

More specifically, Native American women have long been confined to the margins of American society due to their gender, cultural, traditional, and racial backgrounds. Though intrinsically American, by nationality and citizenship, Native American women have experienced ongoing discrimination and lack access to the basic healthcare rights that their non-Native counterparts often obtain with greater ease. Such a contrast in access can be seen through government healthcare systems which were once formulated to enhance Native American women’s sexual and reproductive rights, but now merely isolate them from modern opportunities. While occurring in a country which does not already guarantee nationwide public healthcare to all citizens, these gaps prove even more problematic to the Native American women who suffer as a result of the inadequate and underdeveloped nature of the primary healthcare system they are given access to, namely the Indian Health Services (IHS).

IHS clinics are scattered throughout Indian reservations and territories that allow Native American residents to obtain their health services through subsidised federal funding. However, the services are often outdated, have long waiting times, or fail to fully cater to the needs of patients. A U.S. Commission on Civil Rights report, published in 2004, concluded that the IHS is so severely underfunded that it spends less than $2000 per patient annually, compared with the nearly $4000 spent per inmate incarcerated in federal institutions.

These gaps in Native American women’s access to healthcare can also be exemplified through examining the delays in obtaining the Plan B pill or emergency contraceptives which did not become readily available to Native American women through the IHS until 2015, even though it was readily available to non-Native women, over the counter at local pharmacies, prior to this date. Grassroot organisations argued that because Native American women were not able to get the pill directly through the IHS or via the reservation/territory pharmacy, that it was more restrictively unavailable for Native American women since they would have to travel further to get it, thus imposing higher unforeseen costs.

Access to abortions through the IHS has been available to a certain extent for many years (since 1996), but has yet to be updated to meet modern standards. According to the outdated text, individuals seeking an abortion are only able to do so under special circumstances, including pregnancy resulting from incest or rape, or causing life-threatening risks to the mother; but these conditions are subject to being formally documented by a doctor or law enforcement officer. Consequently, this adds an extra barrier to accessing such services for many Native American women. In comparison to other communities in the US, Native American girls and women are twice as likely to experience forms of rape and sexual harassment/assault in their lifetime, than other races or ethnicities. As a statistically more-vulnerable community, this places Native American women’s sexual assault numbers in the thousands each year, thus producing a heavier reliance on the appropriate healthcare systems and services.

With the elimination of the Native Americans’ right to arrest and prosecute offenders on Indian reservations and territories, many of the offenders who commit such gender-based violence (GBV) crimes against Native American women are never prosecuted or brought to justice; thus leaving Native American women who may have become pregnant due to rape, without the option to exercise her right to abortion services due to her inability to obtain law enforcement documentation. Notably, amongst Native American women who are survivors of such GBV, more than half of them were abused by non-Native males.

With the US’s adoption of the United Nations Declaration for Indigenous Peoples Rights in 2010, the US has openly confirmed its efforts to enhance the rights of its Native American communities, regardless of gender and race. Though non-binding in legal nature, the declaration can provide an outlet for Native American activists, communities, and organisations to reflect on the role of the US and its promises to protect Native Americans’ rights. Only then, can Native American women receive the highest attainable access to rights such as healthcare and reproductive health services, on the same basis as their non-Native, but equal, American neighbours.


Sources:

U.S. Commission on Civil Rights. A Quiet Crisis: Federal Funding and Unmet Needs in Indian Country (2004). Available at: http://www.usccr.gov/pubs/na0703/na0204.pdf.
Indian Health Services, Chapter 15 – Emergency Contraception. Available at: https://www.ihs.gov/ihm/pc/part-1/p1c15/
Native American Women’s Health Center. Indigenous Women Dialogue: Roundtable Report on the Accessibility of Plan B as an Over the Counter (OTC) Within Indian Health Services (2012). Available at: http://www.nativeshop.org/images/stories/media/pdfs/Plan-B-Report.pdf
Indian Health Services. Special General Memorandum 96-01 (1996). Available at: https://www.ihs.gov/ihm/sgm/1996/sgm-9601/
Rape, Abuse, & Incest National Network. Victims of Sexual Violence: Statistics. Available at: https://www.rainn.org/statistics/victims-sexual-violence.
Yuko, Elizabeth. We Can’t Keep Ignoring Native American Women’s Health & Human Rights (2018). Available at: http://www.sheknows.com/health-and-wellness/articles/1136467/native-womens-reproductive-health
Oliphant v. Suquamish Tribe, 435 US 191 Supreme Court (1978). Available at: https://scholar.google.com/scholar_case?case=1685760140612800397&hl=en&as_sdt=6&as_vis=1&oi=scholar
NCAI Policy Research Center. Policy Insights Brief: Statistics on Violence Against Native Women (2013). Available at: http://www.ncai.org/attachments/PolicyPaper_tWAjznFslemhAffZgNGzHUqIWMRPkCDjpFtxeKEUVKjubxfpGYK_Policy%20Insights%20Brief_VAWA_020613.pdf
Thompson, Krissah. U.S. will sign U.N. Declaration on Rights of Native People, Obama Tells Tribe (2010). Available at: http://www.washingtonpost.com/wp-dyn/content/article/2010/12/16/AR2010121603136.html

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