Disparities and Barriers to Care in Plastic and Reconstructive Surgery for Native American and First Nations Populations.

BACKGROUND

American Indian and Alaska Native and First Nations populations face well-documented health disparities, yet inequities in access to plastic and reconstructive surgery (PRS) remain underrecognized. These communities experience a higher burden of PRS-relevant conditions, including orofacial clefts, trauma, burns, and postoncological defects, but disproportionately low usage of PRS services.

METHODS

This narrative synthesizes existing literature on disparities in PRS access for Indigenous populations in the United States and Canada. The key focus areas included disease prevalence, barriers to care, and proposed strategies for improving access. Peer-reviewed articles and policy sources were reviewed to identify recurring themes and evidence-based solutions.

RESULTS

Indigenous patients face significant barriers to PRS care, including geographic isolation, chronic underfunding of systems such as the Indian Health Service, a shortage of specialized providers in rural regions, socioeconomic hardship, and cultural mistrust rooted in historical trauma. Solutions discussed include expanding telehealth, establishing residency-based domestic outreach programs, supporting short-term training for local providers, and strengthening partnerships between academic institutions and tribal health systems. Increasing Indigenous representation in PRS and promoting tribal self-determination in healthcare are also emphasized as critical components of sustainable change.

CONCLUSIONS

Efforts to address PRS disparities in Indigenous populations must be multifaceted, combining immediate access improvements with long-term investments in workforce development, infrastructure, and culturally attuned care. A coordinated approach among academic programs, policy stakeholders, and Indigenous communities is essential to achieving surgical equity.