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Diabetes in Urban Native American Populations

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(Mason, 2007, p.50) As the Patient Protection and Affordable Care Act represents the largest reform in health policy in over 50 years, the specific impact needs to be understood for each individual, group, and institution in the sector. Native Americans receive certain benefits under public law that are intended to improve historical conditions related to discrimination and poverty in communities, and these policies can be made more effective by informed implementation. 10 11 Funding for Treatment 11 Funding for Prevention 11 Funding for Education 12 Recommendation to the Institute of Medicine 2010 13 Policy Implementation 13 Policy Implementation Goals 14 The Role of Nursing in Policy Implementation 14 Diabetes Treatment Long Term Care 15 Conclusion 15 The Use of Public Resources in Health Care 16 The Need to Address Minority Issues Related to Ethnic Discrimination 16 Nursing through Educated Care-giving 17 References 18 Appendix 20 Diabetes in Urban Native American Populations Introduction The loss of the traditional Native American lifestyle has led to an increase in the prevalence of diabetes in Indian people across America. As Dorothy Gohdes wrote in Diabetes in North American Indians and Alaska Natives (1995), The epidemic of non-insulin-dependent diabetes mellitus (NIDDM) in Native American communities has occurred primarily during the second half of this century. Although NIDDM has a genetic component, with rates highest in full-blooded Native Americans, the incidence and prevalence of the disease have increased dramatically as traditional lifestyles have been abandoned in favor of westernization, with accompanying increases in body weight and diminished physical activity. (Gohdes, 1995, p.1) The problem of diabetes in Native American urban populations is one that has been recognized and studied by a wide range of government organizations as a priority in public health care policy. The reasons for this include the fact that Native Americans are statistically in the lower range of socio-economic status in society, often lacking official health care insurance or the means to pay for it for themselves or their children. More than 67% of Native families live below the federal poverty line.(Seva, 2011, para. 1) The Patient Protection and Affordable Care Act includes numerous clauses and exceptions that are written specifically for the health care needs of Native Americans living outside of traditional reservations. Additionally, the Act provides for specific policies to be implemented with regard to diabetes treatment. (U.S. Senate, 2011, p.63) According to the Henry J. Kaiser Family Foundation, The Patient Protection and Affordable Care Act reauthorize(s) and amend(s) the Indian Health Care Improvement Act. (Effective upon enactment) (The Henry J. Kaiser Family Foundation, 2011, p.13) This essay is a policy review of the Patient Protection and Affordable Care Act that will focus specifically on the issues related to diabetes in Native American communities in urban areas, suggesting approaches in treatment, prevention, and education that can work within public