American Indians and Alaska Natives: Health Disparities Overview

The phrase American Indian and Alaska Native refers to people descended from any of the original peoples of North and South America (including Central America) and who maintain tribal affiliation or community attachment. (US Bureau of the Census, 2002a).

The American Indian and Alaska Native population is diverse, geographically dispersed, and economically disadvantaged. Disease patterns among American Indians and Alaska Natives are strongly associated with the adverse consequences of poverty, limited access to health services, and cultural dislocation. Inadequate education, high rates of unemployment, discrimination, and cultural differences all contribute to unhealthy lifestyles and disparities in access to health care for many American Indian and Alaska Native people. [Read more]

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Download whole section [PDF, KB]

History [PDF, KB]

  • Diversity in Language and Culture
  • Sociocultural Experience

Demographics [PDF, KB]

  • Size and Location of Population
  • Size of Tribal or Nation Groups
  • Education
  • Income and Employment
  • Poverty

Health Status [PDF, KB]

  • Infants, Children, and Youth
  • Life Expectancy
  • Mortality
  • Men's Health
  • Women's Health
  • Specific Concerns for Alaska Natives

Traditional Health Beliefs and Practices [PDF, KB]

  • Religion, Philosophy, and Spirituality
  • Specific Traditional Illness
  • Traditional Healers
  • Specific American Indian and Alaska Native Groups

Risk Factors and Challenges [PDF, KB]

  • Access to Health Care
  • Environment
  • Obesity
  • Pharmacological Issues
  • Smoking
  • Substance Abuse
  • Urban Life

Strengths and Protective Factors [PDF, KB]

  • Adaptability
  • Community Strength
  • Connection with the Past
  • Family and Elders
  • Holistic Thinking
  • Identification with Culture
  • Abstinence from Alcohol

Diet [PDF, KB]

Adherence Factors [PDF, KB]

  • Communication: Verbal and Nonverbal
  • Communicating with Elders
  • Decision-making
  • Diet
  • Historical Distrust
  • Interpretations of Disease and Disability

Complementary and Alternative Medicine [PDF, KB]

  • Navajo
  • Specific Practices

References and Resources [PDF, KB]

Compared with other Americans, Indians experience disproportionately high mortality from alcoholism, tuberculosis, diabetes, injuries, suicide, and homicide. Tribal leaders report that diabetes, unintentional injuries, alcoholism, and substance abuse are rising to crisis proportions in American Indian and Alaska Native communities. (Indian Health Service, 2001e).

Underlying Causes of Health Disparities: Income and Education
Inequalities in income and education underlie many health disparities in the US. Income and education are intrinsically related and often serve as proxy measures for each other. In general, population groups that suffer the worst health status are also those that have the highest poverty rates and the least education. Disparities in income and education levels are associated with differences in the occurrence of death and illness, including heart disease, diabetes, obesity, elevated blood lead level, and low birth weight. Higher incomes permit increased access to medical care, enable people to afford better housing and live in safer neighborhoods, and increase the opportunity to engage in health-promoting behaviors. (US DHHS, 2000).

Health disparities are believed to be the result of the complex interaction among genetic variations, environmental factors, and specific health behaviors. (US DHHS, 2000). This section highlights the health disparities among American Indians and Alaska Natives.