This health care evaluation has three purposes: 1) identify and measure the health status of Alaska Natives in the Chugach Region to provide the basis for planning health care services; 2) increase the awareness of Chugach Region Natives about their health and the dynamics of the health systems surrounding them; and 3) develop a spirit and vehicle of collaboration among Native consumers and non-Native health care providers in the region. The audience for the study was the participants themselves--the individual communities, health care providers, and health planners. A responsive-naturalistic evaluation approach was used to evaluate the health status of the region. A multi-disciplinary team of health care providers, community research assistants, consultants in anthropology, health planning and medical anthropology, and the Health Department of the North Pacific Rim designed and conducted the evaluation project. Objective data about health problems, health care facilities, and manpower were derived from the Indian Health Service Reporting System, a regional inventory, and various public reports. To gather behavioral and attitudinal information about health practices and utilization of available health care services, a community-involvement approach was used. The sample to be surveyed in each community was determined by the local community research assistants after a community meeting was held to introduce the project, its purpose, and the survey process. The principal causes of mortality and morbidity seem to originate largely from the lifestyle of the population and the physical and social environment in which they live. The present medical care system, while still much needed, is not equipped to deal with the types of health problems indicated. The regional health status data related to accidents, mortality, alcoholism and admissions to Alaska Psychiatric Institute indicate that the etiology of illness in the Native population lies in the social, psychological, and behavioral domains rather than the biological domain as traditionally diagnosed and treated by western medicine. Conclusions: Each community contributed specific recommendations for improving health care in their own community. Some shared recommendations were: 1) to clear the confusion concerning funding procedures and coverage; 2) to orient health care providers to behavioral and attitudinal norms of Natives regarding health and illness; 3) and to provide preventive medical education and consumer education about medical and dental services.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-53).
Brelsford G. Ggwangkumtenek Sungcarluta Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-53). 1977