Public Health Issues Among Older American Indians and Alaska Natives.

This article discusses public health issues among older American Indians and Alaska Natives. Provision of services to specific populations, particularly those groups who face barriers to equity in healthcare, has always been an important focus of public health. The public health perspective outlines a societal approach to protecting and promoting health, which emphasizes prevention, macro-level interventions, and the reshaping of public policy. Given that health behavior and health outcomes are known to differ by ethnicity, researchers must understand diverse populations without assuming that all diverse populations are the same. When universal models and norms of health are applied across groups, differences can be misinterpreted as "deficits." The purpose of this article is to illustrate how differences make it necessary to reject the notion of universality when applying a public health approach. Tremendous variation exists across ethnic groups, reflecting differences in socioeconomic status, histories, and cultural norms. Within-group diversity is also dynamic individuals of an ethnic identity may differ from the group as they reject or adapt to the mainstream culture.