Pleasant Point: Tribal Health Care Discrimination Examined

By Diana Graettinger, Bangor Daily News, Maine

Jun. 6–PLEASANT POINT — Perceived discrimination against American Indians and how it affects their health care was the focus Tuesday of a workshop on the Passamaquoddy reservation.

Patrik Johansson, a medical doctor and researcher from Washington, D.C., met with members of the Passamaquoddy Tribe, along with three representatives from Calais Regional Hospital, including the chairwoman of the hospital’s board of directors.

Although hospital staff members from Downeast Community Hospital in Machias were invited, they were unable to attend because of scheduling problems.

“We do know that perceived racial and ethnic discrimination is associated with poor health and poor quality of life,” Johansson said by way of introduction.

The Institute of Medicine, a not-for-profit advisory agency to the U.S. government, has documented that racial and ethnic minorities receive lower quality of care even when “accounting for access-related factors such as insurance and income,” he said. Most of the studies examining perceived discrimination in health care focus on African Americans. The studies found that “10-26 percent of African Americans perceive discrimination while receiving health care,” he said.

However, there is one published study that examines the same topic in American Indian and Alaska native populations where an association was found between discrimination and increased depressive symptoms in adults, he said.

Johansson then reviewed the findings of a survey that had been conducted in California. “Among racial groups participating in the California Heath Survey, American Indians and Alaskan natives report the highest prevalence of perceived discrimination,” the doctor said.

Future research is needed, he added.

Johansson’s remarks led to a lively discussion.

Sandi Yarmal, director of the Pleasant Point Health Center, said it was important to look at how things were working within the tribe’s own health care delivery system. “We need to look at the way we are treating our people within our community,” she said.

The group also discussed opiate addiction and medical providers’ reactions to tribal members who are perceived to have drug-related problems.

“We do have a high addiction rate,” said Denise Altvater who is the director of the Maine Wabanaki Program. “Sometimes we get new providers over there [at the health center] and you go into the doctor’s office, the first thing they’ll say to you is, ‘I don’t’ prescribe opiate drugs,’ before you even tell them what’s wrong with you,” she said.

Yarmal said after the meeting that she viewed the workshop as an important first step in setting up a dialogue between the Passamaquoddys and area medical providers. She also said the health center would be working with state officials to figure out a way to conduct a survey on the reservation at Pleasant Point and share those results.

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