Growing up in Chinle, Ariz., the heart of the Navajo Nation, Kim Russell said she never saw the same physician twice.
“They didn’t have a high level of commitment to the community,” she said.
Facing a lack of health care providers and other opportunities, Russell said many Native Americans leave their reservations.
“It’s almost like survival mode, not being able to thrive on the reservations,” said Russell, executive director of Arizona’s Advisory Council on Indian Health Care. “Even though that’s the case, the culture remains intact for many of them because that’s our land. That’s where we’re from.”
According to the Centers for Disease Control and Prevention, 23.6 percent of Native American adults lacked a usual source of health care in 2012 – a higher proportion than any other race considered.
To help address that problem, the federal Indian Health Service has awarded the University of Arizona College of Medicine a five-year $975,000 grant to get more Native Americans into health care fields.
University officials say the Indians Into Medicine grant addresses glaring disparities between Native American communities and the rest of the country.
“We’re looking at a workforce where very few native people are physicians,” said Teshia Solomon, co-director of the university’s Native American Research and Training Center and associate professor with the UA Department of Family and Community Medicine. “While we represent 1.6 percent of the population, only 0.3 percent of us are physicians.”
Solomon said the money will go toward outreach programs that encourage Native Americans to consider careers in medicine. She also said it will fund the support systems provided to Native American medical students as they prepare for their careers.
“What we’re offering with our Indians into Medicine program is a support system that understands native students and puts into place the kinds of things they need to succeed,” Solomon said.
According to the Association of American Medical Colleges, the nation will have a shortfall of up to up to 90,000 physicians by 2025.
And Solomon said rural tribal communities will likely be the hardest hit.
“It’s always hard to draw physicians into those rural communities, regardless of whether it’s tribal,” she said. “But then not knowing a tribe or how they function can be a problem – almost like doubling the effect of already being rural and remote.”
Carlos Gonzales, assistant dean of medical student education at the university and practicing family physician, said reservations in particular need more health care professionals to address major health disparities.
“Unfortunately, most of the native nations are really dealing with an epidemic of diabetes, hypertension and cardiovascular disease,” he said. “And we need physicians who can understand the underlying case and translate into words and thoughts the people on the reservations can understand.”
Kim Russell, executive director of Arizona’s Advisory Council on Indian Health Care who grew up in the Navajo Nation, said the hardest part is keeping physicians on the reservations.
She said medical school graduates will often practice in remote areas as part of government programs to pay off their student loans.
“They’ll come in for however long they need: two years, three years, maybe four years and then they’re gone,” Russell said.
She said it’s important for Native Americans who grew up on reservations to become doctors because they’re more likely to come back.
A study published in Medical Education Online supports this, showing that Native Americans along with African-Americans and Hispanics are more likely to practice in underserved communities.
“We’re trying to grow our own health care professionals, meaning that we want to influence our children at a very young age to consider careers in medicine,” Russell said.
Right now, she said, a lack of Native American doctors to serve as role models is keeping children from being interested in health care careers.
Gonzalez, the assistant dean of medical student education, said this is the primary reason why not enough Native American students are getting into medical schools.
“Part of that problem is there’s not enough of a pool of students interested in medicine or that have done all the preparatory work in high school and undergrad to be successful in medical school,” he said.