The IHS has the responsibility for the delivery of health services to more than 1.6 million Federally-recognized American Indians and Alaska Natives (AI/ANs) through a system of IHS, tribal, and urban (I/T/U) operated facilities and programs based on treaties, judicial determinations, and Acts of Congress. The agency goal is to provide effective, efficient services while being sensitive to the cultural and social aspects of the Native American community. They are to provide health services while protecting the sovereign rights of the tribes.
"Two major pieces of legislation are at the core of the Federal government's responsibility for meeting the health needs of American Indians/Alaska Natives (AI/ANs): The Snyder Act of 1921, P.L.67-85, and the Indian Health Care Improvement Act (IHCIA), P.L.94-437. The Snyder Act authorized regular appropriations for "the relief of distress and conservation of health" of American Indians/Alaska Natives. The IHCIA was enacted "to implement the Federal responsibility for the care and education of the Indian people by improving the services and facilities of Federal Indian health programs and encouraging maximum participation of Indians in such programs" (Lincoln, 2003).
According to Michael Lincoln, Deputy Director of the Indian Health Service, major disparities exist in the overall health of the Native American population, as compared with the general American public. For example, the incidence of Alcoholism is 77% higher and diabetes is 420% higher. The risk of accidents, suicide and homicide amongst Native Americans is also approximately 200% higher, respectively.
Lawmakers are interested in focusing on providing more nursing care and upgrade tribal health facilities, as well as to address the challenges of delivering care since most Native Americans no longer live on reservations (Swindell, 2002). While most Americans have become accustomed to the
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