Many of the others are distant from IHS sites, as those sites are in areas with high concentrations of Native Americans, but those same services are unavailable outside of those areas. Katz (2004) notes that when the IHS was created, the majority of Native Americans lived on reservations but that today, a large percentage of the Native American population lives in urban areas.
With 60% of Native Americans living in urban areas, they are either ineligible for health care from IHS or do not have access to IHS facilities (ACOG, 2012). The outcomes for this community in urban areas tend to be poor – higher rates of teenaged pregnancy, late or no prenatal care, alcohol and tobacco use during pregnancy, higher infant mortality, higher SIDS and higher preterm birth. These outcomes are the result of a lack of access to care for urban Native American women (ACOG, 2012).
One of the issues facing underserved communities in general is that there are a lack of trained physicians for such communities. This means that majority ethnicity physicians ultimately end up playing an important role in care delivery, but also points to a potential solution for improving care to…
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