Healthcare needs and infrastructure obstacles for a state-recognised Indigenous tribe in the United States.

Although Indigenous groups continue to experience extensive health disparities, little research explores the role of structural barriers in contributing to health disparities for state-recognised tribes, who do not receive healthcare services from the Indian Health Service. In addition, much research focuses on discrete physical health outcomes, without utilising community-based approaches to allow participants to identify healthcare priorities and needs in their own voices. In partnership with a community advisory board, a qualitative descriptive methodology was used to conduct 31 life-course interviews with participants of a state-recognised tribe in the Gulf South region of the United States to explore healthcare experiences. Participants identified unmet healthcare needs and healthcare infrastructure barriers. Some of the most common barriers and unmet healthcare needs included: Long Distance to Healthcare Services and Difficulty in Accessing Specialists, Need for Increased Communication, Long Hospital or Appointment Wait Times, Unmet Mental Health Needs, Need for Substance Use or Abuse Prevention Programs and Need for Health Education. These findings highlight some of the structural barriers that exacerbate existing health disparities and suggest important areas of intervention, such as including a focus on mental health needs. Increased healthcare resources and recognition of sovereignty for this state-recognised tribe are also needed to begin to address these barriers. In addition, because of the long history of exploitation of Indigenous communities, healthcare interventions should meaningfully include Indigenous tribes in the development and implementation of any healthcare programs.