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Disability and Vocational Rehabilitation in Rural Settings pp 239–268Cite as

American Indians and Alaska Natives with Disabilities in Rural, Tribal Lands, Frontier Regions, and Plain States

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Abstract

American Indian and Alaska Native (AIAN) consists of 569 federally recognized tribes, approximately 310 reservations, 34 urban Indian communities, and more than 300 languages. Although AIANs are diverse in composition and cultural beliefs, they have a shared history of oppression, discrimination, and subjugation in the United States. The majority of AIANs reside in metropolitan areas, less than half (34%) live on reservations or tribal lands (Weaver, 2012), and others live in rural or frontier communities. Most historical issues remain current issues for AIAN: poverty, high unemployment, language and cultural barriers, rural or remote communities, lack of support services, inadequate health services, limited local resources, and lack of understanding by non-AIAN federal and state administrators and non-AIAN service providers and communities. Their rate of disability is disproportionally higher than any other group in the United States. In this chapter, information is presented on traditional cultural values and strengths, rate of disability, health behaviors, service utilization and barriers, role of tribal government in regulating vocational rehabilitation (VR) and other human services, and analysis of best practices for service delivery for AIANs with disabilities in rural, tribal lands, frontier regions, and plain states. The intent is to identify what works and what does not work in general with this population in rural, tribal, and frontier regions in the VR service delivery system and to make recommendations for effective intervention.

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Author information

Authors and Affiliations

  1. Department of Early Childhood, Special Education, and Rehabilitation Counseling, University of Kentucky, Lexington, KY, USA

    Debra A. Harley

Authors
  1. Debra A. Harley
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Corresponding author

Correspondence to Debra A. Harley .

Editor information

Editors and Affiliations

  1. Department of Early Childhood, Special, Education, and Rehabilitation Counseling, University of Kentucky, Lexington, Kentucky, USA

    Debra A. Harley

  2. College of Health and Human Services, Rehabilitation Services and Rehabilitation Counseling, Northern Illinois University, DeKalb, Illinois, USA

    Noel A. Ysasi

  3. Department of Early Childhood, Special, Education, and Rehabilitation Counseling, University of Kentucky, Lexington, Kentucky, USA

    Malachy L. Bishop

  4. Pennsylvania State University, Rehabilitation and Human Services, University Park, Pennsylvania, USA

    Allison R. Fleming

Learning Exercises

Learning Exercises

Self-Check Questions

  1. 1.

    How are AIANs disproportionately affected in health outcomes, access to human and health services, and standard of living compared to non-AIANs?

  2. 2.

    How are reservations defined that distinguish them from rural and frontier regions?

  3. 3.

    How do AIANs conceptualize the term disability?

  4. 4.

    Compare the Native model of difference to the medical model of disability.

  5. 5.

    How does historical cultural mistrust of the non-AIAN health services manifest among AIANs?

Experiential Exercises

  1. 1.

    Conduct an interview with a counselor that works with AIAN populations about what type of service delivery barriers he or she is faced with working in Indian land.

  2. 2.

    If available to you, observe a traditional AIAN ceremony. If none is available, identify and watch a documentary about traditional AIAN practices.

  3. 3.

    Develop a training workshop for counselors working with AIAN clients with disabilities in rural, frontier, and territory areas.

Multiple-Choice Questions

  1. 1.

    Which of the following is more common among AIANs living in poverty than in the general population living in poverty?

    1. (a)

      Binge drinking

    2. (b)

      Cocaine use

    3. (c)

      Prescription medication

    4. (d)

      Diet pills

  1. 2.

    Which of the following may influence health behaviors of AIANs in rural areas?

    1. (a)

      Access to services

    2. (b)

      Travel distance to services

    3. (c)

      Wait times for services

    4. (d)

      All of the above

    5. (e)

      None of the above

  1. 3.

    Which of the following is a barrier for AIANs with disabilities on tribal lands?

    1. (a)

      Federal government regulations

    2. (b)

      Limited enforcement of laws protecting people with disabilities

    3. (c)

      Overextension of paternalism from tribal counsels

    4. (d)

      Limited interpretation of the Affordable Care Act for people with disabilities

  1. 4.

    Which of the following is a protective strategy to promote resilience among AIANs?

    1. (a)

      Acculturation

    2. (b)

      Preserving the written language

    3. (c)

      Spiritual practices

    4. (d)

      Assimilation

  1. 5.

    Which of the following is a metaphor for Native resiliency?

    1. (a)

      The sky

    2. (b)

      The rainbow

    3. (c)

      The land

    4. (d)

      The water

  1. 6.

    What is the greatest time of suicide for AIAN males?

    1. (a)

      Form middle age to old age

    2. (b)

      From adulthood to middle age

    3. (c)

      From adolescence to adulthood

    4. (d)

      From childhood to adolescence

  1. 7.

    What does the title of “elder” denotes in the AIAN community?

    1. (a)

      A male tribal member with the greatest wealth

    2. (b)

      A female tribal member with the most children

    3. (c)

      A title of Grand Master

    4. (d)

      A position of leadership

  1. 8.

    Which of the following is usually a secondary expression of behavior for AIANs?

    1. (a)

      Direct eye contact

    2. (b)

      Standing tall

    3. (c)

      Speech

    4. (d)

      Emotion

  1. 9.

    Which of the following types of households are very common in a collectivist culture of AIANs?

    1. (a)

      Multigenerational

    2. (b)

      Nuclear family structure

    3. (c)

      Female-headed household

    4. (d)

      Male-headed house

  1. 10.

    Which of the following is considered as creating pathways that increase the risk of mental health and physical distress in the current generation of AIANs?

    1. (a)

      Migration from reservations to urban areas

    2. (b)

      Stigma about mental health

    3. (c)

      Dual diagnoses

    4. (d)

      Traumatic events endured during previous generations

Key

  • 1 – A

  • 2 – D

  • 3 – B

  • 4 – C

  • 5 – B

  • 6 – C

  • 7 – D

  • 8 – C

  • 9 – A

  • 10 – D

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Harley, D.A. (2018). American Indians and Alaska Natives with Disabilities in Rural, Tribal Lands, Frontier Regions, and Plain States. In: Harley, D., Ysasi, N., Bishop, M., Fleming, A. (eds) Disability and Vocational Rehabilitation in Rural Settings. Springer, Cham. https://doi.org/10.1007/978-3-319-64786-9_13

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  • DOI: https://doi.org/10.1007/978-3-319-64786-9_13

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  • Online ISBN: 978-3-319-64786-9

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