Streamline funding to Tribal Organizations. Need more funding for Rural Areas
Encourage more consultation with Tribes on SAMSHA. Most Tribes are in Rural areas Unfortunately, while Tribes have been successful at reducing the burden of certain health problems, there is strong evidence that other types of diseases are on the rise for Indian people. For example, national data for Indian people compared to the U.S. all races rates indicate they are 638 percent more likely to die from alcoholism, 400 percent greater to die from tuberculosis, 291 percent greater to die from diabetes complications, 91 percent greater to die from suicide,
1 FY 2000-2001 Regional Differences Report, Indian Health Service, available: www.ihs.gov.
and 67 percent more likely to die from pneumonia and influenza.2 In the Northwest, stagnation in the data indicates a growing gap between the AI/AN death rate and that for the general population might be widening in recent years. In 1994, average life expectancy at birth for AI/ANs born in Washington State was 74.8 years, and is 2.8 years less than the life expectancy for the general population. For 2000-2002, AI/AN life expectancy were at 74 years and the disparity gap had risen to 4 years compared to the general population. The infant mortality rate for AI/AN in the Northwest declined from 20.0 per 1,000 live births per year in 1985-1988 to 7.7 per 1,000 in 1993-1996, and then showed an increasing trend, rising to 10.5 per 1,000 in 2001.3
Rural and Agricultural areas constitute a culture; where's our cultural competence when it comes to meeting the needs of those who are in this population?