UCI Program Will Assess Indian Health

Amid singing, dancing and sacred rituals, a UC Irvine physician celebrated a labor of love on Saturday: the unveiling of one of the first programs designed to assess the health of urban American Indians in California.

Dr. Laura Williams, an assistant professor of family medicine and member of the Juaneno and Gabrieleno tribes, unveiled “Native Voices for Change” at the university’s Arboretum in a ceremony attended by tribal elders, administrators and frolicking children.

“This is a marriage between the UCI community and the tribes,” said Williams, the UC system’s first female American Indian faculty member and the force behind the program. “There is such a lack of major data on urban American Indian needs. We need to collect that data to get the ball rolling on programs and even policy.”

Made possible by a grant from the California Endowment, “Native Voices for Change” represents cooperation between tribal groups, UCI and UCLA. Noting that more than half of American Indians now live in cities, organizers said native people are often isolated from health care by cultural misunderstandings, stereotypes and the lack of access to health information.

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As bad as life can be on a reservation, once Indians leave for cities, they trade one set of hurdles and headaches for another, experts say. The problem is especially acute for elderly Indians.

“Elders in particular have encountered blatant racism and also have suffered the pernicious effects of stereotyping,” B. Josea Kramer, a Los Angeles physician, wrote in a 1992 article in the journal Cross-Cultural Medicine. “Older American Indians report that they fear non-Indian health professionals, do not expect to be treated fairly by them, and anticipate adverse contact experiences.”

Indians leaving a reservation face another dilemma: after they live 180 days off the reservation, their eligibility for federally mandated health care expires. Because there is no federally recognized tribe in Orange County, the county does not receive health care dollars for native people.

With her program, Williams’ hopes to create a medical model that incorporates western medicine and traditional American Indian healing, she said.

Some native leaders have already started to do that on a smaller scale.

“We recognize western medicine, but we remember that our elders were healers,” said Corbin Harney, 80, a Western-Shoshone spiritual chief.

Harney, who spoke at the event, started the Poo Ha Bah traditional healing retreat near Baker, Calif., at the entrance to Death Valley a year ago. There, American Indian practitioners of western medicine work in an environment that also reflects traditional Indian forms of medicine and healing. Pools with mineral water “leach the body of heavy metals and toxins,” Harney said.

“Today, the medical establishment asks you, ‘Do you have insurance, do you have money? Are you in a federally recognized tribe?”’ Harney said. “Our people, no people, should have to go through that.”

Elderly American Indians living in Southern California “rated health care as their primary concern and top priority for service,” according to a Los Angeles County study released in the late 1980s.

Urban Indians over 45 reported more problems with eyesight than Indians on reservations, according to the National Indian Council on Aging, as well as higher rates of hypertension, diabetes, asthma, strokes, speech and liver problems, and to a lesser extent, cancer.

Urban elders were also less likely than on-reservation elders to get information about access to psychological services from their physicians, Kramer’s report noted.

The difficulties Indians face also age them prematurely. A 1992 study noted that on reservations persons “appeared to be old at 45 years of age, and in urban areas American Indians appeared old by age 55.”

Participants in Saturday’s event said the program was a valuable first step they hoped would lead to bigger advances in health care.

“Indians are not known to be a vocal people. We do not have our own Martin Luther King,” said Yahola Simms, a Seminole and graduate student at the California School for Professional Psychologists in San Diego. “But we need to take the lead in assessing our own people’s needs, because no one is going to do it for us.”