Healthcare experiences of uninsured and under-insured American Indian women in the United States

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...

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Main Authors: Jessica L. Liddell, Jenn M. Lilly
Format: Article
Language:English
Published: BMC 2022-02-01
Series:Global Health Research and Policy
Subjects:
Online Access:https://doi.org/10.1186/s41256-022-00236-4
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author Jessica L. Liddell
Jenn M. Lilly
author_facet Jessica L. Liddell
Jenn M. Lilly
author_sort Jessica L. Liddell
collection DOAJ
description 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 identified by participants. Interviews were transcribed verbatim and findings 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.
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spelling doaj.art-428766db8c304805bab813ac2fc58ff72022-12-21T23:44:57ZengBMCGlobal Health Research and Policy2397-06422022-02-017111110.1186/s41256-022-00236-4Healthcare experiences of uninsured and under-insured American Indian women in the United StatesJessica L. Liddell0Jenn M. Lilly1University of Montana School of Social WorkFordham University Graduate School of Social ServiceAbstract 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 identified by participants. Interviews were transcribed verbatim and findings 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.https://doi.org/10.1186/s41256-022-00236-4American IndianHealthcareWomenHealth insurance
spellingShingle Jessica L. Liddell
Jenn M. Lilly
Healthcare experiences of uninsured and under-insured American Indian women in the United States
Global Health Research and Policy
American Indian
Healthcare
Women
Health insurance
title Healthcare experiences of uninsured and under-insured American Indian women in the United States
title_full Healthcare experiences of uninsured and under-insured American Indian women in the United States
title_fullStr Healthcare experiences of uninsured and under-insured American Indian women in the United States
title_full_unstemmed Healthcare experiences of uninsured and under-insured American Indian women in the United States
title_short Healthcare experiences of uninsured and under-insured American Indian women in the United States
title_sort healthcare experiences of uninsured and under insured american indian women in the united states
topic American Indian
Healthcare
Women
Health insurance
url https://doi.org/10.1186/s41256-022-00236-4
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