Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trials
Substantial healthcare barriers, especially to specialty and cancer care, exist for American Indian and Alaska Native (AI/AN) individuals and communities at all levels. The unique history of AI/AN Tribal Nations and resulting policies, treaties, and relationships with the US government and federal a...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Health Services |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frhs.2025.1469501/full |
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| author | Donald Warne Twyla Baker Michael Burson Allison Kelliher Melissa Buffalo Jonathan Baines Jeremy Whalen Michelle Archambault Kimberly Jinnett Kimberly Jinnett Shalini V. Mohan Rebekah J. Fineday |
| author_facet | Donald Warne Twyla Baker Michael Burson Allison Kelliher Melissa Buffalo Jonathan Baines Jeremy Whalen Michelle Archambault Kimberly Jinnett Kimberly Jinnett Shalini V. Mohan Rebekah J. Fineday |
| author_sort | Donald Warne |
| collection | DOAJ |
| description | Substantial healthcare barriers, especially to specialty and cancer care, exist for American Indian and Alaska Native (AI/AN) individuals and communities at all levels. The unique history of AI/AN Tribal Nations and resulting policies, treaties, and relationships with the US government and federal agencies have created specific barriers to healthcare and clinical trial access for AI/AN peoples. Commonly, AI/AN peoples harbor a long-standing mistrust of the healthcare system based on lived and historical experiences. The intersection of various barriers to care for AI/AN communities results in health inequities, lack of representation in clinical research, and other disparities faced by historically marginalized and underrepresented peoples. AI/AN patients face unique barriers in their healthcare journey due to a disproportionate burden of life-threatening and chronic diseases, including many cancers. Identifying barriers specific to AI/AN peoples and improving access to high-quality care, with a focus on building on the strengths and capacities in each AI/AN community are vital to improving health equity. In this review, we describe patient, provider, and institutional barriers to healthcare, particularly specialty care and clinical research, for AI/AN peoples, with a focus on the Northern Plains AI communities. Examples and best practices to improve AI/AN patient access to health services, including screening and specialty care, as well as to clinical research, are provided. We emphasize the importance of longitudinal community-based partnerships and strength- and trust-based approaches as essential components of promoting equitable access to high-quality specialty care and recruitment and participation of AI/AN individuals and communities in clinical research. |
| format | Article |
| id | doaj-art-37f691c3aa13489f9cf4b8ebc4d50b73 |
| institution | DOAJ |
| issn | 2813-0146 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Health Services |
| spelling | doaj-art-37f691c3aa13489f9cf4b8ebc4d50b732025-08-20T03:07:20ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-04-01510.3389/frhs.2025.14695011469501Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trialsDonald Warne0Twyla Baker1Michael Burson2Allison Kelliher3Melissa Buffalo4Jonathan Baines5Jeremy Whalen6Michelle Archambault7Kimberly Jinnett8Kimberly Jinnett9Shalini V. Mohan10Rebekah J. Fineday11Johns Hopkins Bloomberg School of Public Health, and School of Nursing, Baltimore, MD, United StatesNueta Hidatsa Sahnish College, New Town, ND, United StatesSanford Roger Maris Cancer Center, Fargo, ND, United StatesJohns Hopkins Bloomberg School of Public Health, and School of Nursing, Baltimore, MD, United StatesAmerican Indian Cancer Foundation, Minneapolis, MN, United StatesMayo Clinic, Rochester, MN, United StatesGenentech, Inc., South San Francisco, CA, United StatesGenentech, Inc., South San Francisco, CA, United StatesGenentech, Inc., South San Francisco, CA, United StatesUCSF Institute for Health and Aging, San Francisco, CA, United StatesGenentech, Inc., South San Francisco, CA, United StatesSanford Health of Northern Minnesota, Bemidji, MN, United StatesSubstantial healthcare barriers, especially to specialty and cancer care, exist for American Indian and Alaska Native (AI/AN) individuals and communities at all levels. The unique history of AI/AN Tribal Nations and resulting policies, treaties, and relationships with the US government and federal agencies have created specific barriers to healthcare and clinical trial access for AI/AN peoples. Commonly, AI/AN peoples harbor a long-standing mistrust of the healthcare system based on lived and historical experiences. The intersection of various barriers to care for AI/AN communities results in health inequities, lack of representation in clinical research, and other disparities faced by historically marginalized and underrepresented peoples. AI/AN patients face unique barriers in their healthcare journey due to a disproportionate burden of life-threatening and chronic diseases, including many cancers. Identifying barriers specific to AI/AN peoples and improving access to high-quality care, with a focus on building on the strengths and capacities in each AI/AN community are vital to improving health equity. In this review, we describe patient, provider, and institutional barriers to healthcare, particularly specialty care and clinical research, for AI/AN peoples, with a focus on the Northern Plains AI communities. Examples and best practices to improve AI/AN patient access to health services, including screening and specialty care, as well as to clinical research, are provided. We emphasize the importance of longitudinal community-based partnerships and strength- and trust-based approaches as essential components of promoting equitable access to high-quality specialty care and recruitment and participation of AI/AN individuals and communities in clinical research.https://www.frontiersin.org/articles/10.3389/frhs.2025.1469501/fullAmerican Indian/Alaska Nativehealthcare accesshealthcare barriershealth equityhealth disparitiesIndian Health Service |
| spellingShingle | Donald Warne Twyla Baker Michael Burson Allison Kelliher Melissa Buffalo Jonathan Baines Jeremy Whalen Michelle Archambault Kimberly Jinnett Kimberly Jinnett Shalini V. Mohan Rebekah J. Fineday Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trials Frontiers in Health Services American Indian/Alaska Native healthcare access healthcare barriers health equity health disparities Indian Health Service |
| title | Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trials |
| title_full | Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trials |
| title_fullStr | Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trials |
| title_full_unstemmed | Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trials |
| title_short | Barriers and unmet needs related to healthcare for American Indian and Alaska Native communities: improving access to specialty care and clinical trials |
| title_sort | barriers and unmet needs related to healthcare for american indian and alaska native communities improving access to specialty care and clinical trials |
| topic | American Indian/Alaska Native healthcare access healthcare barriers health equity health disparities Indian Health Service |
| url | https://www.frontiersin.org/articles/10.3389/frhs.2025.1469501/full |
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