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      The Unseen Picture: Issues with Health Care, Discrimination, Police and Safety, and Housing Experienced by Native American Populations in Rural America

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          Abstract

          Purpose

          Despite increased national attention to improving rural health, rural Native American populations face unique problems that are often unseen in aggregate research on the rural United States. The objective of this study was to examine rural Native Americans’ experiences with serious problems across domains important to health, using rural Whites as a comparison group.

          Methods

          Using 2 probability‐based national telephone surveys (2017 and 2019), we examined rural Native American adults’ reported problems in health care, discrimination, police and safety, and housing. We then compared Native American‐White differences in reported problems across domains.

          Findings

          Among rural Native American adults, 33% reported recent problems accessing health care when they needed it, 28% reported they or family members recently experienced major problems paying for medical bills, and 28% reported recent problems with health care quality. Several Native American‐White differences were reported, including experiencing racial violence (34% vs 5%, P < .001), discrimination in health care (19% vs 3%, P = .003), unfair police treatment (27% vs 5%, P = .002), and major housing problems (48% vs 26%, P < .001).

          Conclusions

          Rural Native American adults report ongoing and widespread problems with health care, discrimination, the police, safety, and housing. These findings support many national policy recommendations to improve federal funding and oversight for programs serving Native American populations living in rural areas.

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          Most cited references19

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          Sensitive questions in surveys.

          Psychologists have worried about the distortions introduced into standardized personality measures by social desirability bias. Survey researchers have had similar concerns about the accuracy of survey reports about such topics as illicit drug use, abortion, and sexual behavior. The article reviews the research done by survey methodologists on reporting errors in surveys on sensitive topics, noting parallels and differences from the psychological literature on social desirability. The findings from the survey studies suggest that misreporting about sensitive topics is quite common and that it is largely situational. The extent of misreporting depends on whether the respondent has anything embarrassing to report and on design features of the survey. The survey evidence also indicates that misreporting on sensitive topics is a more or less motivated process in which respondents edit the information they report to avoid embarrassing themselves in the presence of an interviewer or to avoid repercussions from third parties. PsycINFO Database Record (c) 2007 APA, all rights reserved
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            Comparing the Accuracy of RDD Telephone Surveys and Internet Surveys Conducted with Probability and Non-Probability Samples

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              Rural Healthy People 2020: New Decade, Same Challenges.

              The health of rural America is more important than ever to the health of the United States and the world. Rural Healthy People 2020's goal is to serve as a counterpart to Healthy People 2020, providing evidence of rural stakeholders' assessment of rural health priorities and allowing national and state rural stakeholders to reflect on and measure progress in meeting those goals. The specific aim of the Rural Healthy People 2020 national survey was to identify rural health priorities from among the Healthy People 2020's (HP2020) national priorities.
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                Author and article information

                Contributors
                mgorski@hsph.harvard.edu
                Journal
                J Rural Health
                J Rural Health
                10.1111/(ISSN)1748-0361
                JRH
                The Journal of Rural Health
                John Wiley and Sons Inc. (Hoboken )
                0890-765X
                1748-0361
                06 October 2020
                Winter 2022
                : 38
                : 1 ( doiID: 10.1111/jrh.v38.1 )
                : 180-186
                Affiliations
                [ 1 ] Department of Health Policy & Management Harvard T.H. Chan School of Public Health Boston Massachusetts
                [ 2 ] Research, Evaluation, and Learning Unit Robert Wood Johnson Foundation Princeton New Jersey
                Author notes
                [*] [* ]For further information, contact: Mary T.G. Findling, PhD, ScM, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Room 417, Boston, MA 02115; e‐mail: mgorski@ 123456hsph.harvard.edu

                Author information
                https://orcid.org/0000-0002-7214-5239
                Article
                JRH12517
                10.1111/jrh.12517
                9290671
                33022083
                f44f2553-ec35-4905-a538-c7d0ea87e2f5
                © 2020 The Authors. The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 0, Tables: 2, Pages: 7, Words: 3920
                Categories
                Brief Report
                Rural Health Care Disparities
                Custom metadata
                2.0
                Winter 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:18.07.2022

                american indian/alaska natives,health care,native americans,rural health,social determinants of health

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