{"id":14105,"date":"2017-12-12T10:00:00","date_gmt":"2017-12-12T10:00:00","guid":{"rendered":"http:\/\/associatednews.us\/content\/2017\/12\/12\/native-americans-feel-invisible-in-u-s-health-care-system\/"},"modified":"2017-12-12T10:00:00","modified_gmt":"2017-12-12T10:00:00","slug":"native-americans-feel-invisible-in-u-s-health-care-system","status":"publish","type":"post","link":"https:\/\/associatednews.us\/content\/native-americans-feel-invisible-in-u-s-health-care-system\/","title":{"rendered":"Native Americans Feel Invisible In U.S. Health Care System"},"content":{"rendered":"<p><span style=\"font-style:italic;font-size:16px\">By  <a class=\"colorbox\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2017\/12\/12\/569910574\/native-americans-feel-invisible-in-u-s-health-care-system?utm_medium=RSS&amp;utm_campaign=healthcare\">Eric Whitney<\/a><\/span>  <\/p>\n<div class=\"ftpimagefix\" style=\"float:left\"><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2017\/12\/12\/569910574\/native-americans-feel-invisible-in-u-s-health-care-system?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-1_custom-73636c1fa0bd1433d776b36c08e997644a21d607-s1100-c15.jpg\" alt><\/p>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-1_enl-9432c8c54a4589e0fe2f32e6e61ab0e3a385e923-s1200.jpg\"><\/a><\/div>\n<div>\n<div>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-1_enl-9432c8c54a4589e0fe2f32e6e61ab0e3a385e923-s1200.jpg\">Enlarge this image<\/a><\/div>\n<\/div>\n<div>\n<div>\n<div>\n<p>\n                Anna Whiting Sorrell, a member of the Confederated Salish and Kootenai Tribes in northwest Montana, had hernia surgery a couple of years ago. The Indian Health Service picked up a part of the tab for the surgery but denied coverage for follow-up appointments.<\/p>\n<p>                <b><\/p>\n<p>                    Mike Albans for NPR<\/p>\n<p>                <\/b><b><b>hide caption<\/b><\/b><\/p>\n<\/div>\n<p><b><b>toggle caption<\/b><\/b><\/div>\n<p><span><\/p>\n<p>        Mike Albans for NPR<\/p>\n<p>    <\/span><\/div>\n<\/div>\n<p>The life expectancy of Native Americans in some states is 20 years shorter than the national average.<\/p>\n<p>There are many reasons why.<\/p>\n<p>Among them, health programs for American Indians are <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2016\/04\/13\/473848341\/health-care-s-hard-realities-on-the-reservation-a-photo-essay\">chronically underfunded<\/a> by Congress. And, about a quarter of Native Americans reported experiencing discrimination when going to a doctor or health clinic, according to findings of a poll by NPR, the Robert Wood Johnson Foundation and Harvard T.H. Chan School of Public Health.<\/p>\n<p><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/nursing.buffalo.edu\/additional-info\/faculty-and-staff\/faculty_directory.host.html\/content\/shared\/nursing\/faculty-and-staff-directory\/faculty\/full-time-faculty-profiles\/moss-margaret.detail.html?cq_ck=1439229952149\">Margaret Moss<\/a>, a member of the Hidatsa tribe, has worked as a nurse for the Indian Health Service and in other systems. She now teaches nursing at the University of Buffalo.<\/p>\n<p>She says she has seen racism toward Native Americans in health care facilities where she&#8217;s worked, and as a mom trying to get proper care for her son.<\/p>\n<p>Once, when she was on a health policy fellowship with a U.S. Senate committee, Moss&#8217; son had a broken arm improperly set at a non-IHS health facility in Washington, D.C.<\/p>\n<p>She asked the physician about options to correct it, but he told her it was fine, she said. &#8220;Even when I, as an educated person using the right words was saying what needed to happen, [he] didn&#8217;t want to do anything for us even though we had a [health insurance] card.&#8221;<\/p>\n<aside>\n<div><\/div>\n<\/aside>\n<aside>\n<div><\/div>\n<\/aside>\n<p><!-- END ID=\"RES569959009\" CLASS=\"BUCKETWRAP INTERNALLINK INSETTWOCOLUMN INSET2COL \" --><\/p>\n<p>Moss then reluctantly pulled out a business card with the Senate logo, she recalled, and was instantly transformed in the doctor&#8217;s eyes from &#8220;this American Indian woman with my obviously minority son&#8221; to someone he could not afford to dismiss.<\/p>\n<p>&#8220;It wasn&#8217;t until the person &#8230; felt they could get in trouble for this &#8230; then the person did something,&#8221; said Moss. &#8220;I felt like it was racism. Not everybody has a card they can just whip out.&#8221;<\/p>\n<p>She says she feels discrimination is more overt, &#8220;in areas where American Indians are known about,&#8221; like the Dakotas and parts of the American Southwest, but also exists in places without big tribal populations.<\/p>\n<p>In the <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/2017\/11\/14\/563306555\/poll-native-americans-see-far-more-discrimination-in-areas-where-they-are-a-majo\">NPR poll<\/a>, Native Americans who live in areas where they are in the majority reported experiencing prejudice at rates far higher than in areas where they constituted a minority.<\/p>\n<p>In places where there are few American Indians, Moss says, &#8220;people don&#8217;t expect to see American Indians; they think they are from days gone by, and so you are misidentified. And that&#8217;s another form of discrimination.&#8221;<\/p>\n<p>Health care systems outside the Indian Health Service generally see very few Native American patients, because it&#8217;s so hard for American Indians to access care in the private sector. A lot of that has to do with high poverty and uninsured rates among American Indians, who also often live in rural areas with few health care providers.<\/p>\n<p>&#8220;The strikes against people trying to get care are huge: geographic, transportation, monetary,&#8221; Moss says.<\/p>\n<p>A persistent myth inside and outside Indian Country is that Native Americans get free health care from the federal government.<\/p>\n<p>&#8220;I hear that all the time,&#8221; says Moss, sighing.<\/p>\n<div>\n<div><img decoding=\"async\" src=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-3_custom-7cf756c07215c7055b1d3c3a5f5f82054ede801e-s1100-c15.jpg\" alt><\/p>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-3_enl-054af77457a127b4e2319ed9a7f501e68c4eb8f8-s1200.jpg\">Enlarge this image<\/a><\/div>\n<\/div>\n<div>\n<div>\n<div>\n<p>\n                Sorrell started exercising and going on walks after her experience with hernia surgery.<\/p>\n<p>                <b><\/p>\n<p>                    Mike Albans for NPR<\/p>\n<p>                <\/b><b><b>hide caption<\/b><\/b><\/p>\n<\/div>\n<p><b><b>toggle caption<\/b><\/b><\/div>\n<p><span><\/p>\n<p>        Mike Albans for NPR<\/p>\n<p>    <\/span><\/div>\n<\/div>\n<p>The federal government promised to take care of Native Americans&#8217; health when it signed the treaties in which tribes gave up almost all of their land.<\/p>\n<p>&#8220;Unfortunately, they have not kept up their end of the bargain,&#8221; Moss says.<\/p>\n<p>Congress has long failed to allocate enough money to meet Native American health needs. In 2016 it set the Indian Health Service budget at $4.8 billion. Spread across the US population of 3.7 million American Indians and Alaska Natives, that&#8217;s $1,297 per person. That compares to $6,973 per inmate in the federal prison system.<\/p>\n<p>Moss says the IHS can be less an aid to people than another bureaucratic barrier. &#8220;It is highly complicated,&#8221; Moss says, &#8220;even if you took out the racism, perceived or real.&#8221;<\/p>\n<p>The IHS isn&#8217;t insurance. It&#8217;s more like the Veterans Administration, running clinics and hospitals where its members can get care. But the <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/oig.hhs.gov\/oei\/reports\/oei-06-14-00011.pdf\">IHS is far smaller<\/a> than the VA.<\/p>\n<p>Federal funding is also supposed to pay for care in the private sector that IHS hospitals can&#8217;t provide. But, quoting a sardonic joke familiar to many in Indian Country, Moss says it&#8217;s well known that &#8220;you&#8217;d better get sick by June, because there won&#8217;t be any more money, or it&#8217;s life and limb only, those are the things that would be authorized.&#8221;<\/p>\n<p>Anna Whiting Sorrell, a member of the Confederated Salish and Kootenai Tribes in northwest Montana experienced that firsthand. The IHS picked up part of the tab for her hernia surgery at a hospital outside of the IHS a couple of years ago, but when it was time to schedule follow-up appointments, Sorrell was out of luck.<\/p>\n<p>&#8220;It got denied. My follow-up got denied,&#8221; Sorrell says. &#8220;[The hospital] didn&#8217;t even ask if I was willing to pay,&#8221; she says, and that felt like discrimination. &#8220;They would assume that other non-Indians would pay for it themselves, why do we as Indian people not get to make those decisions ourselves?&#8221; Sorrell asks.<\/p>\n<p>She felt like she was falling through a crack in the health care system at a particularly poignant time.<\/p>\n<div>\n<div><img decoding=\"async\" src=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-2_custom-c29f4caa7f6d55e74c67935177d57855e9c5f645-s1100-c15.jpg\" alt><\/p>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-2_enl-0e461bdf4e2aa23168679c6b77e914290ff4e750-s1200.jpg\">Enlarge this image<\/a><\/div>\n<\/div>\n<div>\n<div>\n<div>\n<p>\n                Anna and her husband, Gene Sorrell, outside their home in Evaro, Mont. Anna eventually received follow-up care for her surgery, but the process took years.<\/p>\n<p>                <b><\/p>\n<p>                    Mike Albans for NPR<\/p>\n<p>                <\/b><b><b>hide caption<\/b><\/b><\/p>\n<\/div>\n<p><b><b>toggle caption<\/b><\/b><\/div>\n<p><span><\/p>\n<p>        Mike Albans for NPR<\/p>\n<p>    <\/span><\/div>\n<\/div>\n<p>&#8220;I was 57 years old. My mom died at 57,&#8221; Sorrell says. In Montana, the life expectancy for Native American women is 62, that&#8217;s 20 years less than for non-Native American women. The life expectancy for Native American men in Montana is 56.<\/p>\n<p>With help from her tribe, Sorrell eventually got her follow-up care, but her journey from diagnosis to actually getting surgery took years, and the University of Buffalo&#8217;s Margaret Moss says a lot of Native Americans just give up.<\/p>\n<p>&#8220;That is the idea out there in Indian Country &#8230; , &#8216;I&#8217;m not even going to try, because it&#8217;s not going to happen.&#8217; Or they hear so many stories of people who did try, and it didn&#8217;t happen,&#8221; Moss says.<\/p>\n<p>That means a lot of American Indians simply put up with what she calls, &#8220;tolerated illness.<\/p>\n<p>&#8220;They say they&#8217;re fine, but they&#8217;re not,&#8221; Moss says, and their health problems often progress until it&#8217;s too late for treatment to help.<\/p>\n<p>Anna Whiting Sorrell, a health care administrator for her tribes, says she is optimistic that the Affordable Care Act will make a big difference for Native Americans. It gives lower-income people access to affordable insurance coverage outside the IHS. Many Natives Americans who weren&#8217;t eligible for Medicaid before the ACA <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2016\/03\/23\/471567014\/signups-exceed-expectations-for-montanas-medicaid-expansion\">now are<\/a>, too.<\/p>\n<p>Moss is more skeptical that the ACA will make a big difference, in part because of entrenched institutional discrimination toward Native Americans in healthcare.<\/p>\n<p>&#8220;Until attitudes change,&#8221; Moss says, &#8220;we&#8217;re still going to be in a sad situation.&#8221;<\/p>\n<p><em>Our ongoing <\/em><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/series\/559149737\/you-me-and-them-experiencing-discrimination-in-america\">series<\/a><em> &#8220;You, Me and Them: Experiencing Discrimination in America&#8221; is based in part on a <\/em><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/documents\/2017\/nov\/npr-discrimination-lgbtq-final.pdf\">poll<\/a><em> by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. We have previously released results for African-Americans, Latinos, Asian-Americans, whites and women.<\/em><\/p>\n<p><em>You can follow Montana Public Radio&#8217;s Eric Whitney on Twitter: <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/twitter.com\/MTPRND\">@MTPRND<\/a><\/em><\/p>\n<p><strong><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/blockads.fivefilters.org\/\">Let&#8217;s block ads!<\/a><\/strong> <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/blockads.fivefilters.org\/acceptable.html\">(Why?)<\/a><\/p>\n<p>Source:: <a href=\"https:\/\/www.npr.org\/sections\/health-shots\/2017\/12\/12\/569910574\/native-americans-feel-invisible-in-u-s-health-care-system?utm_medium=RSS&amp;utm_campaign=healthcare\" class=\"colorbox\" title=\"Native Americans Feel Invisible In U.S. Health Care System\" rel=\"nofollow\">https:\/\/www.npr.org\/sections\/health-shots\/2017\/12\/12\/569910574\/native-americans-feel-invisible-in-u-s-health-care-system?utm_medium=RSS&amp;utm_campaign=healthcare<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"ftpimagefix\" style=\"float:left\"><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2017\/12\/12\/569910574\/native-americans-feel-invisible-in-u-s-health-care-system?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-1_custom-73636c1fa0bd1433d776b36c08e997644a21d607-s1100-c15.jpg\" alt><\/p>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-1_enl-9432c8c54a4589e0fe2f32e6e61ab0e3a385e923-s1200.jpg\"><\/a><\/div>\n<div>\n<div>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-1_enl-9432c8c54a4589e0fe2f32e6e61ab0e3a385e923-s1200.jpg\">Enlarge this image<\/a><\/div>\n<\/div>\n<div>\n<div>\n<div>\n<p>\n                Anna Whiting Sorrell, a member of the Confederated Salish and Kootenai Tribes in northwest Montana, had hernia surgery a couple of years ago. The Indian Health Service picked up a part of the tab for the surgery but denied coverage for follow-up appointments.<\/p>\n<p>                <b><\/p>\n<p>                    Mike Albans for NPR<\/p>\n<p>                <\/b><b><b>hide caption<\/b><\/b><\/p>\n<\/div>\n<p><b><b>toggle caption<\/b><\/b><\/div>\n<p><span><\/p>\n<p>        Mike Albans for NPR<\/p>\n<p>    <\/span><\/div>\n<\/div>\n<p>The life expectancy of Native Americans in some states is 20 years shorter than the national average.<\/p>\n<p>There are many reasons why.<\/p>\n<p>Among them, health programs for American Indians are <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2016\/04\/13\/473848341\/health-care-s-hard-realities-on-the-reservation-a-photo-essay\">chronically underfunded<\/a> by Congress. And, about a quarter of Native Americans reported experiencing discrimination when going to a doctor or health clinic, according to findings of a poll by NPR, the Robert Wood Johnson Foundation and Harvard T.H. Chan School of Public Health.<\/p>\n<p><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/nursing.buffalo.edu\/additional-info\/faculty-and-staff\/faculty_directory.host.html\/content\/shared\/nursing\/faculty-and-staff-directory\/faculty\/full-time-faculty-profiles\/moss-margaret.detail.html?cq_ck=1439229952149\">Margaret Moss<\/a>, a member of the Hidatsa tribe, has worked as a nurse for the Indian Health Service and in other systems. She now teaches nursing at the University of Buffalo.<\/p>\n<p>She says she has seen racism toward Native Americans in health care facilities where she&#8217;s worked, and as a mom trying to get proper care for her son.<\/p>\n<p>Once, when she was on a health policy fellowship with a U.S. Senate committee, Moss&#8217; son had a broken arm improperly set at a non-IHS health facility in Washington, D.C.<\/p>\n<p>She asked the physician about options to correct it, but he told her it was fine, she said. &#8220;Even when I, as an educated person using the right words was saying what needed to happen, [he] didn&#8217;t want to do anything for us even though we had a [health insurance] card.&#8221;<\/p>\n<aside>\n<div><\/div>\n<\/aside>\n<aside>\n<div><\/div>\n<\/aside>\n<p><!-- END ID=\"RES569959009\" CLASS=\"BUCKETWRAP INTERNALLINK INSETTWOCOLUMN INSET2COL \" --><\/p>\n<p>Moss then reluctantly pulled out a business card with the Senate logo, she recalled, and was instantly transformed in the doctor&#8217;s eyes from &#8220;this American Indian woman with my obviously minority son&#8221; to someone he could not afford to dismiss.<\/p>\n<p>&#8220;It wasn&#8217;t until the person &#8230; felt they could get in trouble for this &#8230; then the person did something,&#8221; said Moss. &#8220;I felt like it was racism. Not everybody has a card they can just whip out.&#8221;<\/p>\n<p>She says she feels discrimination is more overt, &#8220;in areas where American Indians are known about,&#8221; like the Dakotas and parts of the American Southwest, but also exists in places without big tribal populations.<\/p>\n<p>In the <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/2017\/11\/14\/563306555\/poll-native-americans-see-far-more-discrimination-in-areas-where-they-are-a-majo\">NPR poll<\/a>, Native Americans who live in areas where they are in the majority reported experiencing prejudice at rates far higher than in areas where they constituted a minority.<\/p>\n<p>In places where there are few American Indians, Moss says, &#8220;people don&#8217;t expect to see American Indians; they think they are from days gone by, and so you are misidentified. And that&#8217;s another form of discrimination.&#8221;<\/p>\n<p>Health care systems outside the Indian Health Service generally see very few Native American patients, because it&#8217;s so hard for American Indians to access care in the private sector. A lot of that has to do with high poverty and uninsured rates among American Indians, who also often live in rural areas with few health care providers.<\/p>\n<p>&#8220;The strikes against people trying to get care are huge: geographic, transportation, monetary,&#8221; Moss says.<\/p>\n<p>A persistent myth inside and outside Indian Country is that Native Americans get free health care from the federal government.<\/p>\n<p>&#8220;I hear that all the time,&#8221; says Moss, sighing.<\/p>\n<div>\n<div><img decoding=\"async\" src=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-3_custom-7cf756c07215c7055b1d3c3a5f5f82054ede801e-s1100-c15.jpg\" alt><\/p>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-3_enl-054af77457a127b4e2319ed9a7f501e68c4eb8f8-s1200.jpg\">Enlarge this image<\/a><\/div>\n<\/div>\n<div>\n<div>\n<div>\n<p>\n                Sorrell started exercising and going on walks after her experience with hernia surgery.<\/p>\n<p>                <b><\/p>\n<p>                    Mike Albans for NPR<\/p>\n<p>                <\/b><b><b>hide caption<\/b><\/b><\/p>\n<\/div>\n<p><b><b>toggle caption<\/b><\/b><\/div>\n<p><span><\/p>\n<p>        Mike Albans for NPR<\/p>\n<p>    <\/span><\/div>\n<\/div>\n<p>The federal government promised to take care of Native Americans&#8217; health when it signed the treaties in which tribes gave up almost all of their land.<\/p>\n<p>&#8220;Unfortunately, they have not kept up their end of the bargain,&#8221; Moss says.<\/p>\n<p>Congress has long failed to allocate enough money to meet Native American health needs. In 2016 it set the Indian Health Service budget at $4.8 billion. Spread across the US population of 3.7 million American Indians and Alaska Natives, that&#8217;s $1,297 per person. That compares to $6,973 per inmate in the federal prison system.<\/p>\n<p>Moss says the IHS can be less an aid to people than another bureaucratic barrier. &#8220;It is highly complicated,&#8221; Moss says, &#8220;even if you took out the racism, perceived or real.&#8221;<\/p>\n<p>The IHS isn&#8217;t insurance. It&#8217;s more like the Veterans Administration, running clinics and hospitals where its members can get care. But the <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/oig.hhs.gov\/oei\/reports\/oei-06-14-00011.pdf\">IHS is far smaller<\/a> than the VA.<\/p>\n<p>Federal funding is also supposed to pay for care in the private sector that IHS hospitals can&#8217;t provide. But, quoting a sardonic joke familiar to many in Indian Country, Moss says it&#8217;s well known that &#8220;you&#8217;d better get sick by June, because there won&#8217;t be any more money, or it&#8217;s life and limb only, those are the things that would be authorized.&#8221;<\/p>\n<p>Anna Whiting Sorrell, a member of the Confederated Salish and Kootenai Tribes in northwest Montana experienced that firsthand. The IHS picked up part of the tab for her hernia surgery at a hospital outside of the IHS a couple of years ago, but when it was time to schedule follow-up appointments, Sorrell was out of luck.<\/p>\n<p>&#8220;It got denied. My follow-up got denied,&#8221; Sorrell says. &#8220;[The hospital] didn&#8217;t even ask if I was willing to pay,&#8221; she says, and that felt like discrimination. &#8220;They would assume that other non-Indians would pay for it themselves, why do we as Indian people not get to make those decisions ourselves?&#8221; Sorrell asks.<\/p>\n<p>She felt like she was falling through a crack in the health care system at a particularly poignant time.<\/p>\n<div>\n<div><img decoding=\"async\" src=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-2_custom-c29f4caa7f6d55e74c67935177d57855e9c5f645-s1100-c15.jpg\" alt><\/p>\n<div><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/media.npr.org\/assets\/img\/2017\/12\/11\/anna-2_enl-0e461bdf4e2aa23168679c6b77e914290ff4e750-s1200.jpg\">Enlarge this image<\/a><\/div>\n<\/div>\n<div>\n<div>\n<div>\n<p>\n                Anna and her husband, Gene Sorrell, outside their home in Evaro, Mont. Anna eventually received follow-up care for her surgery, but the process took years.<\/p>\n<p>                <b><\/p>\n<p>                    Mike Albans for NPR<\/p>\n<p>                <\/b><b><b>hide caption<\/b><\/b><\/p>\n<\/div>\n<p><b><b>toggle caption<\/b><\/b><\/div>\n<p><span><\/p>\n<p>        Mike Albans for NPR<\/p>\n<p>    <\/span><\/div>\n<\/div>\n<p>&#8220;I was 57 years old. My mom died at 57,&#8221; Sorrell says. In Montana, the life expectancy for Native American women is 62, that&#8217;s 20 years less than for non-Native American women. The life expectancy for Native American men in Montana is 56.<\/p>\n<p>With help from her tribe, Sorrell eventually got her follow-up care, but her journey from diagnosis to actually getting surgery took years, and the University of Buffalo&#8217;s Margaret Moss says a lot of Native Americans just give up.<\/p>\n<p>&#8220;That is the idea out there in Indian Country &#8230; , &#8216;I&#8217;m not even going to try, because it&#8217;s not going to happen.&#8217; Or they hear so many stories of people who did try, and it didn&#8217;t happen,&#8221; Moss says.<\/p>\n<p>That means a lot of American Indians simply put up with what she calls, &#8220;tolerated illness.<\/p>\n<p>&#8220;They say they&#8217;re fine, but they&#8217;re not,&#8221; Moss says, and their health problems often progress until it&#8217;s too late for treatment to help.<\/p>\n<p>Anna Whiting Sorrell, a health care administrator for her tribes, says she is optimistic that the Affordable Care Act will make a big difference for Native Americans. It gives lower-income people access to affordable insurance coverage outside the IHS. Many Natives Americans who weren&#8217;t eligible for Medicaid before the ACA <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2016\/03\/23\/471567014\/signups-exceed-expectations-for-montanas-medicaid-expansion\">now are<\/a>, too.<\/p>\n<p>Moss is more skeptical that the ACA will make a big difference, in part because of entrenched institutional discrimination toward Native Americans in healthcare.<\/p>\n<p>&#8220;Until attitudes change,&#8221; Moss says, &#8220;we&#8217;re still going to be in a sad situation.&#8221;<\/p>\n<p><em>Our ongoing <\/em><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/series\/559149737\/you-me-and-them-experiencing-discrimination-in-america\">series<\/a><em> &#8220;You, Me and Them: Experiencing Discrimination in America&#8221; is based in part on a <\/em><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.npr.org\/documents\/2017\/nov\/npr-discrimination-lgbtq-final.pdf\">poll<\/a><em> by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. We have previously released results for African-Americans, Latinos, Asian-Americans, whites and women.<\/em><\/p>\n<p><em>You can follow Montana Public Radio&#8217;s Eric Whitney on Twitter: <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/twitter.com\/MTPRND\">@MTPRND<\/a><\/em><\/p>\n<p><strong><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/blockads.fivefilters.org\/\">Let&#8217;s block ads!<\/a><\/strong> <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/blockads.fivefilters.org\/acceptable.html\">(Why?)<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47],"tags":[],"class_list":["post-14105","post","type-post","status-publish","format-standard","hentry","category-health"],"_links":{"self":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts\/14105","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/comments?post=14105"}],"version-history":[{"count":0,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts\/14105\/revisions"}],"wp:attachment":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/media?parent=14105"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/categories?post=14105"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/tags?post=14105"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}