Native American culture is an underrepresented but essential part of American society. Most of its members live on remote reservations and face various health problems due to limited access to health care resources, low incomes, cultural backgrounds, and traditions. At the same time, chronic obstructive pulmonary disease (COPD) is one of the most common conditions in the United States and causes of death among Native Americans, although it can be prevented (Hancu, 2019). Consequently, this paper will consider the factors and cultural characteristics of Native Americans to formulate a plan for preventing and reducing COPD.
Background of Native Americans and Related Health Factors
The culture of Native Americans is longstanding and mature. However, the colonization of America and the subsequent acculturation followed the Native Americans in the minority, and their culture is preserved mainly by the inhabitants of the reservations. A cultural feature is that modern Native Americans combine the available benefits of civilization and American culture’s habits with traditional practices and rituals. These ceremonies may differ depending on the tribe, but in general, they are based on the belief in spirits and respect and reverence for nature (Cohen, 2018). These features are, in some cases, beneficial to the health of the residents of the reservations; however, most often, they are associated with risks.
First, the remoteness of reservations from cities and the population’s social status hinder their access to health services. For example, one of the risk factors for developing COPD complications is the common cold or infectious diseases (Johnston et al., 2017). Reservation residents rely on healing methods or often neglect timely treatment, since it is difficult for them to reach cities, which leads to complications of COPD. In addition, remoteness from cities also means limited work opportunities for residents, which affects their income levels, insurance availability, and access to food. Many Native Americans participate in nutrition government programs; however, these foods often lack essential nutrients (Warne & Wescott, 2019). This lack of nutrients leads to decreased immunity as well as complications of COPD. According to Hancu (2019), malnutrition is associated with higher mortality from COPD, and Attaway et al. (2020) note that Native Americans, Asians, and Pacific Islanders are more likely to be diagnosed with muscle loss related to it. Consequently, inadequacies in location, welfare, and infrastructure for Native Americans are a major contributor to their health problems.
Moreover, cultural traditions and practices are also contributing factors for the development of COPD. First, Native Americans have the highest alcohol abuse rates, which are often culturally related (Fish et al., 2017). Although alcohol consumption is not a direct risk factor for COPD, abuse leads to a general weakening of immunity, dysfunction of the body, and increase risk of infectious diseases. Smoking and tobacco use are also common practices in tribes as they are used for different rites and customs. As Cohen (2018) notes, the most common rituals are smoking dry leaves, blowing smoke on the patient, and smudging by burning leaves. In addition, many Native Americans also smoke regular cigarettes, for example, 33.9% in 2016 (“American Indians,” 2019). Hence, since smoking is a major reason for COPD, these data demonstrate that Native Americans have a high risk of this disease development.
Most of the described risk factors faced by Native Americans demonstrate that they can be avoided through external influences and changes. The remoteness of reservations and limited access to medical infrastructure is a problem in the national system. Poor nutrition is also a consequence of the lack of education of Native Americans and poor food quality from government programs. Traditions and customs associated with the use of harmful substances such as alcohol and nicotine, as well as neglect of early treatment, are also related to false beliefs that can be changed by quality education. Thus, a prevention and reduction program is necessary for members of the Native American culture, since without national changes outside the cultural group, its internal processes will lead to worsening public health problems.
Components of Plan
The analysis demonstrates that the plan’s main components should focus on systemic change in the states and the country. First, the program should aim to create an infrastructure that will increase the access of residents of the reservation to medical services, such as creating a small local medical center or the organization of regular transport to cities. Second, the plan should cover improving nutrition programs and adding more nutritious foods. Third, the plan should include the delivery of lectures and the inclusion of educational lessons in schools to convey the ideas of disease prevention, proper nutrition, hygiene standards, and the harms of smoking and alcohol consumption. In addition, education can also be directed to local healers or anyone interested to teach them the basics of medical care. Such a step can help Native Americans move away from traditional ineffective practices and refer sick people to centralized hospitals.
Implementation of the Plan
The described steps of the plan have two levels of implementation, national and local. Improving infrastructure and nutrition programs depends on the state and country governments. Thus, these steps could be implemented by attracting public attention, publishing scientific papers, performing for healthcare associations, and appealing to government officials. Although this plan is long-term, without initiative and medical professionals’ data, the problem may go unnoticed. Education of Native Americans can be achieved by organizations, local hospitals, and volunteers. The main psychological theory that can be applied in this case is The Health Belief Model. Its application will help nurses identify the main barriers in the population to preventative action and direct educational efforts toward them. For example, if the reservation residents do not take action due to the inability to see perceived severity or susceptibility of disease, the effort will be directed toward information provision (“The health belief,” 2018). However, if the main problem is the lack of cues to action and perceived benefits, actions should be more focused on removing barriers (“The health belief,” 2018). Thus, healthcare professionals and educators will be able to change the population’s perception of preventive measures and bad habits, motivate them, and reduce COPD incidence. At the same time, this plan differs in that it includes internal and external influences on a cultural group.
The implementation plan also demonstrates the main barriers to the COPD prevention and reduction program, such as lack of funds and change resistance. The first barrier is associated with a limited budget and the reluctance of governments to allocate funds to implement the plan. A possible solution, in this case, is to create petitions and appeals to representatives, as well as to attract the public, which will pay attention to the issue. In addition, the involvement of healthcare organizations and fundraising can also help fulfill the material part of the plan. The barrier to resistance to change, as described above, can be overcome by analyzing the motives and customs of the population and applying The Health Belief Model. Thus, while this plan takes a long time to complete, it can reduce the incidence of COPD as well as improve the overall health of Native Americans due to the consistency of change.
Attaway, A. H., Welch, N., Hatipoğlu, U., Zein, J. G., & Dasarathy, S. (2020). Muscle loss contributes to higher morbidity and mortality in COPD: An analysis of national trends. Respirology, 26(1), 62–71.
Cohen, K.S. (2018). Honoring the medicine: The essential guide to Native American healing. Random House Publishing Group.
Fish, J., Osberg, T. M., & Syed, M. (2017). “This is the way we were raised”: Alcohol beliefs and acculturation in relation to alcohol consumption among Native Americans. Journal of Ethnicity in Substance Abuse, 16(2), 219–245.
Hancu A. (2019). Nutritional status as a risk factor in COPD. Maedica, 14(2), 140–143. Web.
Johnston, N. W., Olsson, M., Edsbäcker, S., Gerhardsson de Verdier, M., Gustafson, P., McCrae, C., Coyle, P. V., & McIvor, R. A. (2017). Colds as predictors of the onset and severity of COPD exacerbations. International Journal of Chronic Obstructive Pulmonary Disease, 12, 839–848.
The Health Belief Model. (2018).
Warne, D., & Wescott, S. (2019). Social determinants of American Indian nutritional health. Current Developments in Nutrition, 3(2), 12–18.