Given that the prevalence of back and neck pain is quite high in the general population, it is also a likely common problem among Native American peoples. The American Indian/Alaska Native population may benefit greatly from improved access to services provided by a Doctor of Chiropractic that include a unique, drug-free approach to spinal infirmities, neuro-musculoskeletal pain and dysfunction, and other human ailments. In addition to treating back and neck pain, Doctors of Chiropractic advocate self-care and prevention and are keenly aware of the public health impact of chronic illness such as diabetes, obesity, and cardiovascular risks. Chiropractors promote healthy lifestyles and manage chronic disease with behavior modification and improvement in diet and exercise. Patient focused Integrative health care approaches, provided with cultural sensitivity, not only help coordinate health care delivery between chiropractors, medical physicians, dentists, allied health professionals, and traditional Native healers but should serve as a healthy medical home model for IHS. We believe this is key to reducing chronic disease, disabilities, back surgeries, and improving overall quality of life.
Information on the role of Doctors of Chiropractic in serving the needs of Native Americans is limited, and more research is needed. Gathering current data on the numbers of graduating Doctors of Chiropractic (DC’s) who are American Indian or Alaska Native directly from the colleges has been difficult because of confidentiality issues. All chiropractic colleges who receive federal financial aid must provide the federal government with ethnicity/race information through the Integrated Postsecondary Education Data System (IPEDS). For the period 1996-2007, 119 American Indian/Alaska Native persons graduated from US chiropractic colleges (89 males, 30 females) with the DC degree. The total number of AI/AN Doctors of Chiropractic is unknown other than those found between 1996-2007.
While there are many native and non native chiropractors working in the vicinity of tribal reservations, there are only seven (7) confirmed Native American DC’s employed in Tribal Self Governed health facilities. There are additionally two chiropractors serving as medical directors for Tribal health facilities.
The Indian Health Care Improvement Act (IHCIA), the cornerstone legal authority for the provision of health care to American Indians and Alaska Natives, which had expired in 2000, was made permanent as part of the HR 3590, Patient Protection and Affordable Care Act passed and signed on March 23, 2010 by President Obama. The version of the IHCIA signed into law differs in several respects from the original version passed by Congress in 1976. It includes many major changes and improvements to facilitate the delivery of health care services, such as: to increase the proportion of all degrees in the health professions and allied and associated health professions awarded to Indians so that the proportion of Indian Health professionals in each Service Area is raised to at least the level of that of the general population. And the term ‘health profession’ means allopathic medicine, family medicine…pediatrics…nursing…public health…dentistry…psychology…social work…marriage and family therapy, chiropractic medicine…naturopathic medicine, allied health professions and any other health profession.
Tribal Self-Governance has changed the face of Indian Health Care, and the tribes are legitimately trying to make the best health care decisions for their peoples. In recent years complementary medicine has surged in popularity in the United States, but Indian Health Service (IHS) had taken a ‘no demand no need’ position on these occupations between FY 2004-2011. Although chiropractic services are included in the (IHCIA), most Native Americans are being denied rightful access to chiropractic care. As well, Native American Doctors of Chiropractic are not afforded the same opportunities for employment within IHS as other designated health care occupations.
In January of this year 2012, a major change was initiated by Indian Health Service Director General, Dr. Yvette Roubideaux, when she posted new guidelines in the Federal Register that now include doctors of chiropractic, naturopathic doctors and acupuncturists among others as ‘Needed Professions” in the loan repayment program of IHS.. Since April of this year, 3 new awards have been given to American Indian Alaska Native Chiropractic Doctors who are working full time (40 hour work week) in Tribal Health Care facilities. Each award has been for $20,000 plus required tax obligations for each year of a 2-year contract.
It is for these reasons that an American Indian Alaska Native Doctors of Chiropractic Association needs to organize, to create more opportunities for employment within Tribal and IHS health facilities and it needs your support.