Indian Health Service Case Study

The Indian Health Service (IHS), had its beginning in 1784 with the first treaty between the government of the US and Indian tribes, but it was not until 1994 with the appointment of Dr. Michael Trujillo as Director of the IHS that initiated major organizational changes that improve the American Indians and Alaska Natives healthcare service of 500 tribes. He is remarkable in the IHS history because he was the first IHS Director pointed by the President of the US, first pure-blood American Indian, and his family had an active participation in the political Indian community that inculcated to him the culture of being the advocate for Indian people (Ginter, Duncan, & Swayne, 2014). He served and represented more than 1.4 million American Indian

and Alaska Natives in 35 States. Dr. Trujillo coordinated with tribal and urban leaders of how to improve the healthcare service based in their budget focused in traditional medicine, children, adolescent and elder care, woman health with domestic and child abuse prevention, healthcare financing, and healthcare service facilities (“Michael Trujillo begins”, 1988).
The HIS is a dynamic organization such as other healthcare organizations but with the characteristic that has a unique population (American Indian and Alaska Natives). Despite the effort of its leaders, the health outcomes of this population are lower compared with the nation’s health and they experience higher mortality rates with short life expectancy. This may be due to external and internal environmental factors that contribute to the low healthcare in this ethnic group. For external environmental factors, it can be mentioned the political factor that with treaties between the government and AI/AN (American Indian/ Alaska Natives) takes years to make changes and agreements, its budget allocation is not enough, and they have the scarcity of facilities and equipment to improve its health care services. Internal Environment factors are their community leadership did not recognized the health care as a priority. The AI/AN culture is unique, their wellness is related with the harmony within the mind, body, spirit and their environment, but they develop chronic diseases (heart and lung diseases, cancer, and diabetes) and mental health disorders that diminish their health and life expectancy and increase their mortality rate. They have a different perception of how important is the health care for them, making difficult to implement health care services that join their culture with the health care services. In addition to the few resources, they have shortages of health care employees.