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The average life expectancy of a male born on the Pine Ridge reservation in South Dakota today is 40 years oldóthe lowest life expectancy of all peoples not only in the U.S. but also in the entire Western Hemisphere. Written by and for nurses, this is the first text to focus exclusively on American Indian health and nursing. It addresses the profound disparities in policy, health care law, and health outcomes that affect American Indians, and describes how these disparities, bound into the cultural, environmental, historical, and geopolitical fabric of American Indian society, are responsible for the marked lack of wellbeing of American Indians. American Indian nurse authors, natives of nine unique American Indian cultures, address the four domains of healthóphysical, mental, spiritual, and emotional--within each region to underscore the many stunning disparities of opportunity for health and wellbeing within the American Indian culture as opposed to those of "Anglo" culture. In an era of cultural competency, these expert nurse authors bring awareness about what is perhaps the least understood minority population in the U.S. The text covers the history of American Indians with a focus on the drastic changes that occurred following European contact. Included are relevant journal articles, historical reports, interviews with tribal health officials, and case studies. The book addresses issues surrounding American Indian nursing and nursing education, and health care within nine unique American Indian cultural populations. Also discussed are the health care needs of American Indians living in urban areas. Additionally, the book examines the future of American Indian Nursing in regard to the Affordable Care Act. Key Features: Focuses exclusively on American Indian health and nursing, the first book to do so Written by predominately American Indian nurses Covers four domains of health: physical, mental, spiritual and emotional Highlights nine specific cultural areas of Indian country, each with its own unique history and context Includes chapter objectives, end-of-chapter review questions, and case studies
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
The reported population of American Indians and Alaska Natives has grown rapidly over the past 20 years. These changes raise questions for the Indian Health Service and other agencies responsible for serving the American Indian population. How big is the population? What are its health care and insurance needs? This volume presents an up-to-date summary of what is known about the demography of American Indian and Alaska Native populationâ€"their age and geographic distributions, household structure, employment, and disability and disease patterns. This information is critical for health care planners who must determine the eligible population for Indian health services and the costs of providing them. The volume will also be of interest to researchers and policymakers concerned about the future characteristics and needs of the American Indian population.
This book draws on 15 years of IDRC-funded health systems research undertaken by researchers working closely with communities and decision-makers. They have generated contextually relevant evidence at local, national, regional, and global levels to tackle the entrenched health systems challenges.
This pathbreaking book documents the transformation of reproductive practices and politics on Indian reservations from the late nineteenth century to the present, integrating a localized history of childbearing, motherhood, and activism on the Crow Reservation in Montana with an analysis of trends affecting Indigenous women more broadly. As Brianna Theobald illustrates, the federal government and local authorities have long sought to control Indigenous families and women's reproduction, using tactics such as coercive sterilization and removal of Indigenous children into the white foster care system. But Theobald examines women's resistance, showing how they have worked within families, tribal networks, and activist groups to confront these issues. Blending local and intimate family histories with the histories of broader movements such as WARN (Women of All Red Nations), Theobald links the federal government's intrusion into Indigenous women's reproductive and familial decisions to the wider history of eugenics and the reproductive rights movement. She argues convincingly that colonial politics have always been--and remain--reproductive politics. By looking deeply at one tribal nation over more than a century, Theobald offers an especially rich analysis of how Indigenous women experienced pregnancy and motherhood under evolving federal Indian policy. At the heart of this history are the Crow women who displayed creativity and fortitude in struggling for reproductive self-determination.
Suicide prevention initiatives are part of much broader systems connected to activities such as the diagnosis of mental illness, the recognition of clinical risk, improving access to care, and coordinating with a broad range of outside agencies and entities around both prevention and public health efforts. Yet suicide is also an intensely personal issue that continues to be surrounded by stigma. On September 11-12, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, to discuss preventing suicide among people with serious mental illness. The workshop was designed to illustrate and discuss what is known, what is currently being done, and what needs to be done to identify and reduce suicide risk. Improving Care to Prevent Suicide Among People with Serious Mental Illness summarizes presentations and discussions of the workshop.