Indian Health Services

Indian Health Services System

Overview of Indian Health Service

The Indian Health Service (IHS), a federal health system, cares for 2 million of the country's 5.2 million American Indian and Alaska Native people. This system has increasingly focused on innovative uses of health information technology and telemedicine, as well as comprehensive, locally tailored prevention and disease management programs, to promote health equity in a population facing multiple health disparities. Important recent achievements include a reduction in the life-expectancy gap between American Indian and Alaska Native people and whites (from eight years to five years) and improved measures of diabetes control (including 20 percent and 10 percent reductions in the levels of low-density lipoprotein cholesterol and hemoglobin A1C, respectively). However, disparities persist between American Indian and Alaska Native people and the overall US population. Continued innovation and increased funding are required to further improve health and achieve equity (Trujillo, 2002).

In the 2010 census, 5.2 million people identified themselves as American Indian or Alaska Native, representing 1.7 percent of the US population. American Indian and Alaska Native people experience poor health outcomes and have an average life expectancy that is more than five years shorter than that of the overall US population. The causes of this disparity span the life spectrum, beginning with high infant mortality rates, and include a high prevalence of chronic disease, mental health disorders, and substance abuse.

The Indian Health Service (IHS) was established within the Public Health Service in 1955 in order to meet federal treaty obligations to provide health services to members of federally recognized American Indian and Alaska Native tribes. Through a network of small hospitals and outpatient health centers, the system provides health care services to approximately two million people belonging to 565 tribes, particularly those residing on federal reservations or in nearby communities. The 3.2 million members of the American Indian and Alaska Native population not served by the IHS receive care through the private sector or other public systems (the Department of Veterans Affairs, Medicaid, and Medicare) (Zuckerman, Haley, Roubideaux, & Lillie-Blanton, 2004).

Through the tribally operated health facilities, recognized tribes have exercised their right to claim half of the IHS budget allocated by the federal government in order to manage their own health care programs. As of 2010, these facilities consisted of 33 hospitals, 59 health centers, and 50 health stations ("Indian Health Service", 2012).

Organizational Structure

The directors of IHS Headquarters offices, Area Offices and service units are responsible for maintaining an effective organizational