Policy challenges in American Indian/Alaska Native health professions education.

Disparities exist in the numbers of American Indians and Alaska Natives (AI/ANs) in the health professions as compared with the general United States (US) population. Numerous factors contribute to this disparity, including inequities in education, healthcare and economic development opportunities. The basis for inequality is rooted in the policy arena. Issues in health professions education blend the arenas of health policy and education policy. Although AI/ANs have a birth right to healthcare and to education programs as a result of treaties signed between the US and tribal governments, these programs are severely under funded. To understand the disparities in health professions education for AI/ANs today, it is important to understand the history of US federal Indian policy over the last two centuries. Following a history of removal, assimilation, reorganization and termination, the current phase of federal Indian policy is tribal self-determination. As a result, opportunities exist to reduce disparities in the number of AI/AN health professionals and in health disparities. AI/AN tribes have the opportunity to work in partnership to coordinate health, education, social and economic development policy to increase the numbers of AI/AN health professionals. Tribes can also make it a priority to coordinate political advocacy efforts to improve funding for AI/AN health and education programs.