A Navajo health consumer survey

The findings of a health consumer survey of 309 Navajo families in three areas of the Navajo Reservation are reported. The survey shows that access to facilities and lack of safe water and sanitary supplies are continuing problems for these families. The families show consistent use of Indian Health Service providers, particularly nurses, pharmacists and physicians, as well as traditional Navajo medicine practitioners. Only incidental utilization of private medical services is reported. Extended waiting times and translation from English to Navajo are major concerns in their contacts with providers. A surprisingly high availability of third-party insurance is noted. Comparisons are made between this data base and selected national and regional surveys, and with family surveys from other groups assumed to be disadvantaged in obtaining health care. The comparisons indicate somewhat lower utilization rates and more problems in access to care for this Navajo sample. The discussion suggests that attitudes regarding free health care eventually may be a factor for Navajo people and other groups, that cultural considerations are often ignored or accepted as truisms in delivering care, and that the Navajo Reservation may serve as a unique microcosm of health care in the U.S.