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The National Indian Health Board is committed to ensuring that funding for the Indian Health Service and other agencies affecting health care in Indian Country is increased. The federal promise to provide Indian health services was made long ago. The United States made this promise in a series of treaties with Tribes, exchanging compensation and benefits for Tribal land and peace. The Snyder Act of 1921 (25 USC 13) legislatively affirmed this trust responsibility. To facilitate upholding its responsibility, the federal government created the Indian Health Service (IHS) and tasked the agency with providing health services to American Indians and Alaska Natives (AI/ANs). Since its creation in 1955, IHS has worked to fulfill the federal promise to provide health care to Native people.
In passing the Affordable Care Act, Congress also reauthorized and made permanent the Indian Health Care Improvement Act (IHCIA). In renewing the IHCIA, Congress reaffirmed the duty of the federal government to American Indians and Alaska Natives, declaring that “it is the policy of this Nation, in fulfillment of its special trust responsibilities and legal obligations to Indians -- to ensure the highest possible health status for Indians and urban Indians and to provide all resources necessary to effect that policy.” For American Indians and Alaska Natives (AI/ANs), the federal budget is not just a fiscal document, but also a moral and ethical commitment. The budget request for Indian health care services reflects the extent to which the United States honors its promises of justice, health, and prosperity to Indian people. Despite some funding increases over the last several years, IHS is still funded at only 59 percent of total need and our people continue to experience some of the worst health discrepancies in the country.
Devastating consequences from historical trauma, poverty, and a lack of adequate treatment resources continue to plague Tribal communities. AI/ANs have a life expectancy 4.2 years less than other Americans, but in some areas, the life expectancy is far worse. For instance, white men in Montana lived 19 years longer than American Indian men, and white women lived 20 years longer than American Indian women. In South Dakota, in 2014, for white residents the median age at death was 81, compared to 58 for American Indians. AI/ANs also suffer significantly higher mortality rates from suicide, type 2 diabetes, and heart disease than other Americans. According to CDC data, 45.9 percent of Native women experience intimate partner violence, the highest rate of any ethnic group in the United States. American Indian / Alaska Native children have an average of six decayed teeth, when other US children have only one. These health statistics are no surprise when you compare the per capita spending of the IHS and other federal health care programs. In 2015, the IHS per capita expenditures for patient health services were just $3,136, compared to $8,097 per person for health care spending nationally.