Health Care Issues Affecting Minority Communities In America

Floor Speech

HEALTH CARE ISSUES AFFECTING MINORITY COMMUNITIES IN AMERICA -- (House of Representatives - April 23, 2007)

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Mr. PALLONE. Thank you. I want to thank my colleague from California and also my colleague from Guam. I know that for a number of years now they have both been involved in the health care disparities issue, and have actually put together legislation that we have tried to get passed for several years. It was a little difficult with the Republican majority. And hopefully now with the Democratic majority, we can address those health disparities and concerns.

I would like to talk about the Native American aspect of this. And I also want to mention that addressing the concerns of minority health care is important in my district because we do have many Asian Americans. We have the largest number of Indian Americans of any congressional district, and by that I mean Asian Indian Americans, and also a large Latino and African American population in my district.

I just know when I go and visit some of the hospitals or community health centers, many times the issue is brought to my attention, whether it is data collection which has already been mentioned tonight, or it is the need for more minority health care professionals, be they doctors, nurses or whatever, or even that more research attention needs to be paid to diseases or afflictions that basically impact the minority communities in disproportionate ways.

It is very important that we address this and we need legislation, and we will move forward with the health care disparities legislation that my colleagues have really championed over the last few years.

I want to talk about Native Americans. I actually don't have any federally enrolled Native American tribes in my district or even in New Jersey. We have quite a few, we just don't have any recognized tribes at a Federal level. We have five that are State recognized. Unless you are federally recognized and enrolled with the Department of the Interior, you are not for the most part eligible for the health service.

American Indians are a little unique in that unlike most Americans, they have a right pursuant to their treaties and the Constitution to health care. When they gave their lands up to the Federal Government by treaty, they were given the right to health care. That, of course, doesn't necessarily mean they can all access it because a lot of them don't necessarily live on the reservation, and that is one of the reasons why we have urban health centers around the country, including several in California, because many Native Americans now do live in L.A. and in some of the larger cities, and don't necessarily live on their homelands on the reservations.

So we need to address their concerns in not only providing hospitals and clinics in their homelands, on the reservations, but also in the urban areas where many now reside.

Unfortunately, in the last few years, and I know I sound so partisan and I don't mean to be, but the amount of money that was made available in the last 12 years under the Republican Congress was really not sufficient. There is a need for a lot more dollars. This year we did budget significantly more for the Indian Health Service, but we also need to reauthorize the Indian Health Service because it hasn't been reauthorized since 2000.

I have sponsored legislation called the Indian Health Care Improvement Act which will be marked up in the Resources Committee this year and will come to the Energy and Commerce Committee and the Health Subcommittee, and we will try to get it passed in this Congress.

When you talk about Native Americans and the disparities, the disparities are just incredible. When we had a hearing on the Indian Health Care Improvement Act in the Resources Committee a few weeks ago, I asked a question about how many American Indian or Native American doctors there were in the United States. I could not believe the number. There are less than 500, somewhere between 400 and 500 Native American physicians for a Native American population that is probably over 2 million. I don't know what that works out to percentage-wise, but there is clearly a need for scholarship and grant and loan programs that would specifically target the Native American community so we can have not 400 doctors but at least 4,000 or maybe 40,000 when you talk about a community that has over 2 million people.

And the same is true, and I don't have the statistics for nurses or other health care professionals, but there are really very few Native American health care providers, and we need to boost those numbers up and allow for opportunities to get more health care professionals.

With regard to actual treatment, if they are not on the reservation and able to access the Indian health care hospital or clinic, it is very difficult. There is a huge unemployment rate. Even if you are on a reservation, sometimes distances are great because many Native Americans live in rural areas where health care is simply not available.

We also have the phenomenon of diseases or aflictions that target that community. The incidence of diabetes, juvenile or type 2 diabetes, is for many tribes over 50 percent. I have been to some where the numbers are over 60 percent. We need a lot more research into the reasons why, in the example of diabetes, but I could talk about other diseases or health care problems, why the incidence is so high and what could be done.

For example, there has been some effort to look at nutrition as an answer, the feeling that many Native Americans, for example, used to live on a subsistence diet. If they were a desert people, they would eat foods that they gathered in a desert. Or they may have lived on a ranch or in a situation where they were getting a lot more natural foods, and now as those opportunities have eased to exist and they are eating processed foods, there is a lot of evidence to suggest that is a major reason for diabetes. This is the type of thing we need. We need research into those kinds of afflictions as to what is causing a better than 60 percent diabetes situation for a number of tribes.

Even transportation needs are there because of many of the problems that are in rural areas.

So I just wanted to say when you talk about the Native American population in this country, the disparities problem is so great that it has actually gotten to the point of crisis, in my opinion; and that is why we need legislation to deal with these disparity issues, and we need to reauthorize the Indian Health Service through the Indian Health Care Improvement Act.

And to the extent that we are looking at this from the Asian population, the Latino population, or whatever population, this type of initiative is very important. I just want to commend my colleagues again for being here tonight and speaking out because I do think we need to speak out. In many cases we are talking about people who don't have people to speak out for them other than a few of us. Thank you again.

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