These Programs Aim to Improve Indigenous Healthcare

• A multipronged approach that brings federal funds to university nursing programs could improve Indigenous healthcare in the United States. 
• The Indian Health Service recently issued grants to extend health programs and enhance Indigenous-focused nursing education. 
• The 2022 National Nursing Workforce Survey found that only 0.4% of nurses identify as American Indian or Alaska Native. 

A multipronged approach that brings federal funds to university nursing programs could improve Indigenous healthcare in the United States.

The Indian Health Service (IHS), a subsect of the U.S. Department of Health and Human Services (HHS), recently issued grants to extend health programs and enhance Indigenous-focused nursing education.

About 3.3 million Americans, or 1.3%, identify solely as American Indian or Alaska Native, according to a U.S. Census Bureau American Community Survey population estimate. Meanwhile, the 2022 National Nursing Workforce Survey found that only 0.4% of nurses identify as American Indian or Alaska Native.

Mary Smith, a member of the Cherokee Nation and national secretary of the American Bar Association (ABA), wrote in Human Rights Magazine that adequate funding is essential to bring health equity to the Native American population.

“Additionally, access to specialty care, a greater pipeline of health professionals to serve in tribal communities, including much larger scholarship and loan repayment programs, as well as technology investments and strong leadership and associated training are all needed,” Smith stated. “ …  We know how to reverse health inequities. Working with tribal leadership, the U.S. government has a moral and legal responsibility to address this crisis in health equity.”

Texas A&M Health recently partnered with IHS to provide better-quality forensic nursing care to the Indigenous population, while the University of Arizona received funding for its program that encourages Native Americans to not only pursue a nursing career but also to work on reservations. 

University Programs Could Bridge Indigenous Healthcare Gaps

Texas A&M Health announced in late October that its Center of Excellence in Forensic Nursing and IHS entered into a five-year, $5.5 million contract to improve its forensic healthcare services. The center has tailored its continuing education programming for IHS providers and “is advising on local program improvements and sustainability strategies.” 

IHS Director Roselyn Tso said in a Texas A&M Health news release that her commitment to improving forensic healthcare services is “deeply personal.”

“The pressing issue of violence calls for competent and compassionate care from health professionals who are trained to provide medical forensic care and treatment,” Tso said. “Through this partnership, our efforts will be bolstered through trainings, education and technical assistance aimed at assisting victims of violent crimes.”

Data from the Association on American Indian Affairs shows that American Indians and Alaska Natives are two-and-a-half times as likely to experience violent crimes compared to other races, including nearly 85% of women.

Stacey Mitchell, DNP, director of the center and a clinical professor in the Texas A&M College of Nursing, stated in the release that the collaboration will allow for “better access to trauma-informed, patient-centered care.”

IHS also has expanded its reach in Arizona, issuing a $1.6 million grant to the University of Arizona College of Nursing to fund its Indians in Nursing: Career Advancement and Transition Scholars (INCATS) program for five years.

Timian Godfrey, DNP, an associate clinical professor at the College of Nursing and director of the INCATS program, said in a news release that the grant supports Indigenous nursing scholars and builds a connection “with tribal communities in Arizona to strengthen the tribal nursing workforce.”

The grant, according to Godfrey, is expected to support up to six students each year. 

What the Research Says About Indigenous Healthcare 

IHS was established in 1955 to provide comprehensive health services for American Indians and Alaska Natives. But access to, and quality of, care extends beyond the federal agency all the way down to nurse education programs and the practitioners who lead them.

A recent study from the Journal of Clinical Nursing reviewed case studies across Australia, Canada, Aotearoa New Zealand, and the United States, concluding that amplifying Indigenous nurses’ voices and leadership can “transform our health systems to be fairer, caring and effective.” The authors found that having Indigenous leadership throughout academic, clinical, and policy settings “had immeasurable ripples across the health systems from bedside cultural safety practice to influencing governmental policies.”

However, they noted that workforce development strategies are needed to recruit and retain Indigenous nurses, arguing that without it, “the Indigenous nursing profession” will remain stagnant. 

The Bottom Line

More than $1 million in grants have been issued to help improve various aspects of healthcare for the Indigenous population in the United States. The funds will help bolster Texas A&M Health’s forensic nursing education and provide educational opportunities to University of Arizona nursing students who are of Indigenous ancestry. 

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