Rural Health Research Gateway

Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural American Indian Elders

Funder: Office of Rural Health Policy (ORHP)
Research center: Upper Midwest Rural Health Research Center
Phone: 612.624.8618
Lead researcher: Ira Moscovice, PhD
Contact: Alana Knudson, PhD, 701.777.4205, aknudson@medicine.nodak.edu
Project funded: September 2004
Project completed:November 2006
Topics: Aging
American Indians and Alaska Natives
Frontier health
Health insurance and the uninsured
Minority health
Rural statistics and demographics

This project determined what types of health insurance coverage rural Native American elders have and examined how different types of health insurance coverage and lack of health insurance coverage impact access to health care services among Native American elders by geographic location (rural frontier, rural non-frontier and urban).

The study addressed the following research questions:

  • What is the rate of health insurance coverage among Native American elders living in rural frontier, rural non-frontier and urban counties?
  • What types of health insurance coverage do Native American elders living in rural frontier, rural non-frontier and urban counties have?
  • Who are the uninsured Native American elders and what is their demographic make-up?
  • What is the relationship between health insurance coverage, geographic location, key demographic factors and health status indicators among Native American elders?
  • What is the relationship between health insurance coverage and access to health care services among Native American elders?

The study analyzed national data from Identifying Our Needs: A Survey of Elders II, a Native elder social and health needs assessment project conducted by the NRCNAA in collaboration with tribes throughout the country. To allow analyses by rural, frontier, and urban location, the Native Elder II survey data were linked to Urban Influence Code variables from the Area Resource File and frontier variables from the Census data using county FIPS codes.

Publications

  • Health Insurance Coverage and Access to Health Care for American Indian and Alaska Native Elders
    Date: 10 / 2007
    Policy brief reporting findings from a study assessing health insurance coverage and access to health care among American Indian and Alaska Native elders (Native elders), using data from a national survey that included more than 8,300 Native elders.
  • Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural Native American Elders
    Author(s): Alana Knudson, Mary Wakefield, Kyle Muus, Jacque Gray, Leander McDonald, Richard Ludtke, Gestur Davidson
    Report Number: Final Report No. 6
    Date: 10 / 2007
    Examines health insurance coverage and access to health care among American Indian and Alaska Native elders (Native elders) -- defined as 55 years or older. Young elders, 55 to 64 years of age, are most likely to be uninsured with one-third reporting having no insurance, while 15% of older elders, 65 years of age and over, report they are uninsured. Uninsured Native elders are about twice as likely as insured Native elders to indicate they have no regular provider. In addition, one out of 10 Native elders report they were not able to get care when they needed it during the preceding 12 months. Reasons cited for not getting health care when it was needed included long waiting times, transportation problems, and cost. The authors conclude it is essential to develop policies that address the financial, geographical, and cultural aspects that negatively impact access to culturally appropriate healthcare. Full report available on request by contacting aknudson@medicine.nodak.edu.