A critical appraisal of the Navajo health care system

The purpose of this study is to assess the health needs of the Navajo Indians of North America, and the appropriateness of the health care services provided by the Navajo Health Care System with respect to these health needs. Our study is based on the analysis of the secondary socioeconomic and health related data collected and compiled in the Navajo area, and on the interviews conducted among health care professionals and administrators working in the Area. The 'Q index' was used for priority ranking of the most prevalent diseases. Appraisal is based on the holistic health concept components. Navajo Indians have not yet reached the health status of the general US population. In spite of the fact that the Indian Health Services has decreased the disparity between the Indians and the US population in general, especially regarding communicable diseases, other more complex health problems created by biculturalism and the on-going acculturation exceed the limits of the Navajo Health Care System which is basically oriented toward medical care. Alcoholism and alcohol abuse, inadequate nutrition and lack of geographic and socio-organizational accessibility are the main risk factors in the Area. This situation is further aggravated by economic problems and the high unemployment rate of the Navajo Indians.