Document Type

Article

Keywords

American Indian, Healthcare, Women, Health insurance

Disciplines

Social Work

Abstract

Background: Extensive health disparities exist for American Indian groups throughout the United States. Although insurance status is linked to important healthcare outcomes, this topic has infrequently been explored for American Indian tribes. For state-recognized tribes, who do not receive healthcare services through the Indian Health Service, this topic has yet to be explored. The purpose of this study is to explore how having limited access to health insurance (being uninsured or under-insured) impact American Indian women’s healthcare experiences?.

Methods: In partnership with a community advisory board, this study used a qualitative description approach to conduct thirty-one semi-structured life-course interviews with American Indian women who are members of a state-recognized tribe in the Gulf Coast (United States) to explore their Western healthcare experiences. Interview were conducted at community centers, participant homes, and other locations identifed by participants. Interviews were transcribed verbatim and fndings were analyzed in NVivo using conventional content analysis. Findings were presented at tribal council meetings and to participants for member checking.

Results: Themes identified by participants included: (a) lack of insurance as a barrier to healthcare; (b) pre-paying for childbirth when uninsured; and (c) access to public health insurance coverage. Twenty-four women mentioned the role or importance of insurance in discussing their healthcare experiences, which was referenced a total of 59 times.

Conclusion: These findings begin to fill an important gap in the literature about the health insurance experiences of American Indian tribal members. Not having insurance was an important concern for participants, particularly for elderly and pregnant tribal members. Not having insurance also kept tribal members from seeking healthcare services, and from getting needed prescriptions. In addition to promoting knowledge about, and expanding insurance options and enrollment, increased sovereignty and resources for state-recognized tribes is needed to address the health disparities experienced by American Indian groups.

Publication Title

Global Health Research and Policy

Volume

7

Issue

5

Article Number

1039

Publication Date

2022

DOI of Published Version

https://doi.org/10.1186/s41256-022-00236-4

Language

English

Peer Reviewed

1

Version

Published

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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