The most disturbing health disparity in North Dakota is the disproportionate number of American Indians that are affected by diabetes-related deaths. According to North Dakota Health Disparity Report (2017), 57.5 per 100,000 American Indians are affected by diabetes-related deaths compared to 24.8 per 1,000 whites. The health disparity reduces the life expectancy of the American Indians by a huge margin. While the life expectancy of Americans is more than 75 years, the life expectancy of an American Indian from North Dakota is less than this due to diabetes-related death. Secondly, diabetes contributes to other sources of death such as hypertension and stroke (Miller & Scully, 2015), which is expected to be high among American Indians in North Dakota. The presences of other illnesses related to diabetes increases the mortality rate in this population. Lastly, if the health disparity issue is not tackled, then the underlying or causative factors as well will not be tackled which are detrimental to the health of the American Indians. Some of the factors that contribute to the high diabetes rates among this population include lack of access to healthy diet, poverty, lack of recreational spaces for physical activity, and low educational attainment.
The issue can be resolved by first determining the social determinants of diabetes (health) in North Dakota for the affected population. Some of the social determinants of Type-2 diabetes as determined by Clark & Utz (2014) are built environment, education, economic stability, social and community supports, and healthcare. Addressing the social determinants will be the first step in solving the health disparity. Secondly, there is need for resources, policies and programs to prevent the disease from spreading among the American Indians in North Dakota.
Informal organizations in the health sector comprises of informal health care providers that lack formal training, collect payments from individuals they serve rather than institutions, are not registered by government regulatory bodies and they have no professional affiliations. Informal organizations provide health services such as herbal medicine, acupuncture, among others that can complement treatment and medicine from the formal organizations. Informal relationships exists between healthcare organizations or entities where there is little degree of standardization, formalization and tangibility (Maneechay & Pongpirul, 2015). The informal relationship primarily exists between formal and non-formal healthcare organizations and providers. It is important to note that the informal organizations can be providing either health services or non-health services such as finances.
Various informal organizations in North Dakota can assist in reducing diabetes health disparity among the American Indians. Firstly, academic research centers are crucial in the assessment of social determinants of diabetes in North Dakota. North Dakota State University (NDSU) is a potential partner in this course as they have previously researched on diabetes such as tools for screening pre-diabetes (Schmidt, 2019). Secondly, the Diabetes coalition is a statewide organization that endeavors to prevent diabetes and assist those living with the illness. The community can have an informal relationship with the organization to educate constituents of North Dakota about the disease as well as improve the access to quality healthcare especially for the underprivileged and most affected groups such as the American Indians.
There are benefits and shortcomings of informal relationships. Informal relationship bridges the gaps that may exist in the provision of healthcare in the community due to the bolstered community-level interventions. In addition, the informal relationship boosts the participation of the members of the community thus improving healthcare. The informal relationships is expected to improve the operations and development of health service system. The primary disadvantage is the difference in expectations between the informal caregivers and professionals (Hengelaar et al., 2017). The second disadvantage is the anecdotal evidence on the treatment and medicine provided by the informal caregivers.