Indian health as a human right

December 10th is International Human Rights Day, and I would like to take this opportunity to think about Indian health care in relation to that day. Many people, states, and organizations believe that the right to good health is a basic human right. There are many treaties that state this as fact – indeed, the United States has signed a number of these treaties. To begin with, the US helped draft the International Declaration of Human Rights and voted in favor of its adoption by the UN General Assembly. Article 25 (1) of this document states:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” (emphasis added)

The United States is also a member of the World Health Organization (WHO) and has accepted its constitution, which in its opening statement declares:

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States. Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures.”

Is the US living up to these ideals when it comes to Indian health?

At this point, it is safe to say that the United States is coming up lacking when it comes to Indian health. It is true that Obama's proposed budget would increase funding to the Indian Health Service by 13%, which is a really great step in the right direction. However, that only partially makes up for the roughly 25% cuts the IHS experienced under the Bush administration -- cuts from an already underfunded system with inadequate and outdated facilities.

Not only is there inadequate support of Indian health at an institutional level (including funding), Indians experience inflated rates of health problems. From the National Indian Health Board's fact sheet:

• 13% of Indian deaths occur in those younger than 25, a rate 3 times higher than the U.S. population.

• The U.S. Commission on Civil Rights reported in 2003 that “American Indian youths are twice as likely to commit suicide…” Also, suicide ranked as the second leading cause of death for AI/ANs aged 10 to 34 as reported by the Center for Disease Control and Prevention’s National Center for Injury Prevention and Control.

• Indians are 550% more likely to die from alcoholism, 200% more likely to die from diabetes, and 150% more likely to suffer accidental death compared with other groups.

When you combine this inadequate system with increased rates of diabetes, substance abuse, and suicide, you have a real problem. American Indians and Alaska Natives need -- and deserve -- more. This is not just an issue about the US government's trust responsibility to Native Americans; this is a matter of basic human rights. As I have discussed before, there is some legislative hope in this area right now. The Indian Health Care Improvement Act has recently passed the House, and is moving in the Senate. This is monumental! However, we need more. In order for there to be real and lasting positive change in the arena of Indian health and Indian health care, I think there needs to be a shift in the way the issue is framed. The US government -- the administration and Congress -- need to move beyond looking at Indian health as a trust responsibility; something that needs to be taken care of because the government made a promise. Congress and the administration need to look at this issue as a human rights issue, one where we have not only a legal and historic obligation, but a more obligation. The US government needs to live up to the standards it set for itself when it agreed to the Universal Declaration of Human Rights, the World Health Organization constitution, the International Covenant on Economic, Social and Cultural Rights, and the Charter of Organization of the American States.

Read more on our staff blog about the Bridget Moix's thoughts on the connections between health and war, and on fellow intern Rebecca Sheff's blog about immigrant health.

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