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Indian Health Care Improvement Act Amendments of 2007

Floor Speech

By:
Date:
Location: Washington, DC


INDIAN HEALTH CARE IMPROVEMENT ACT AMENDMENTS OF 2007--Continued -- (Senate - January 22, 2008)

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Mr. OBAMA. Mr. President, I commend Senator Dorgan and the Committee on Indian Affairs for their leadership on the long-overdue Indian Health Care Improvement Act, IHCIA, Amendments of 2007.

The historical treatment of Native Americans is a tarnished mark on American history. Lawmakers must ensure that this Nation fulfills its treaty obligations to Native Americans and address the injustices that continue to be suffered by the first Americans. I am committed to making sure that Native Americans are treated with respect, dignity, and equality both now and in the future and to ensure that promises made by this great Nation are promises kept as well. As such, I believe it is this country's moral imperative to address the significant health disparities between Native Americans and the American population as a whole.

Diabetes is perhaps the most striking example of such health disparities. American Indians have the highest rate of diabetes in the world. The American Diabetes Association reports that American Indians and Alaska Natives are more than twice as likely to be diagnosed with diabetes as non-Hispanic Whites, and the death rate from diabetes is three times higher among American Indians and Alaska Natives than the rate in the general U.S. population. Yet these statistical averages mask the fact that certain tribal populations are experiencing epidemic rates of diabetes. About half of adult Pima Indians, for example, have diabetes. Even worse, on average, Pima Indians are only 36 years old when they develop diabetes, which contrasts to an average age of 60 years for White diabetics.

Unfortunately, diabetes is not the only health condition that disproportionately affects American Indians. Death rates from heart disease and stroke are respectively 20 and 14 percent greater among American Indians compared to the average U.S. population. We know the infant mortality rate is 150 percent higher for Indian infants than White infants. The rate of suicide for Indians is 2 1/2 times greater than the national rate, and methamphetamine use has ravaged Indian reservations all across the country.

Urban Indians are not exempt from these dire health challenges. In addition to facing higher than average rates of chronic disease and mental health and substance abuse disorders, urban Indians experience serious difficulties accessing needed health care services. Given that over half of the Native American population no longer reside on reservations, our efforts to improve Indian health and health care must include explicit focus on the urban Indian population.

For these reasons, I am proud to be an original cosponsor of the Indian Health Care Improvement Act. Our tribal health care programs must be modernized and prepared to provide preventive and chronic disease health care services and to address other key issues such as access and quality of care concerns. And these activities must be supported while honoring the principle of tribal sovereignty.

The bill before us would enact much needed advancements in the scope and delivery of health care services to Native Americans. In particular, it authorizes a host of new health services, makes crucial organizational improvements, and provides greater funding for facilities construction. Through scholarships, investments in recruitment activities, loan repayment programs, and grants to institutions of higher education, IHCIA also takes steps to help increase the number of Native Americans entering the health services field.

I am especially pleased that the bill addresses well-documented health problems affecting urban Indian communities as well. This proposal provides grants and increased aid for diabetes prevention and treatment, community health programs, behavioral health training, school health education programs, and youth drug abuse programs in urban areas.

I trust my colleagues will agree with me on the critical need to address health disparities facing the Native American community. I urge the Senate to act quickly to pass this bill.

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