Rural Health Research Gateway

American Indians and Alaska Natives

Publications

Listed by publication date. You can also view these publications alphabetically.

2008

  • Access to Specialty Health Care for Rural American Indians in Two States
    Author(s): Baldwin LM, Hollow WB, Casey S, Hart LG, Larson EH, Moore K, Lewis E, Andrilla CHA, Grossman DC
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health services, Minority health
    Citation: Journal of Rural Health 24(3), 269-278
    Date: 2008
    The Indian Health Service (IHS), whose per capita expenditure for American Indian and Alaska Native (AI/AN) health services is about half that of the US civilian population, is the only source of health care funding for many rural AI/ANs. Specialty services, largely funded through contracts with outside practitioners, may be limited by low IHS funding levels. This study outlines the examination of specialty service access among rural Indian populations in two states. Results indicate that limitations in specialty care access for rural Indian clinic patients appear to be influenced by financial constraints. Health care systems factors may play a role in perceived differences in specialty access between rural Indian and non-Indian clinic patients.

2007

  • 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
    Research center: Upper Midwest Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health insurance and the uninsured, Minority health
    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.
  • Health Insurance Coverage and Access to Health Care for American Indian and Alaska Native Elders
    Research center: Upper Midwest Rural Health Research Center
    Topics: Aging, American Indians and Alaska Natives, Health insurance and the uninsured, Minority health
    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.
  • National Trends in the Perinatal and Infant Health of Rural American Indians (AIs) and Alaska Natives (ANs): Have the Disparities Between AI/ANs and Whites Narrowed?
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Children, Maternal and child health, Minority health, Women
    Date: 09 / 2007
    Brief overview of findings from a study examining trends in prenatal care receipt, low-birthweight rates, neonatal and postneonatal death rates, and cause of death among rural American Indians/Alaska Natives (AI/ANs) and whites between 1985 and 1997.

2006

  • Clearing the Path to Medical School for American Indians and Alaska Natives: New Strategies
    Author(s): Walter B. Hollow, Apanakhi Buckley, Davis G. Patterson, Polly M. Olsen, Joycelyn Dorscher, Rustem Medora, Lori Morin, R. Steven Padilla, Jerry Tahsequah, Laura-Mae Baldwin
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Physicians, Workforce
    Report Number: Working Paper No. 101
    Date: 01 / 2006
    Two recent studies examining recruitment and retention of American Indians and Alaska Natives (AI/ANs) in medical school identified significant challenges in the pursuit of a medical career by AI/AN students: the academic rigor of medical school, the needs of their communities and families, financial concerns, feelings that their perspectives on healing and spirituality were excluded from medical school, and the paucity of role models and mentors, especially those who shared their culture. Using the results of this research and their experience conducting programs to support AI/ANs pursuing health professions, the authors recommend several strategies for improving recruitment and retention of AI/AN medical students. These strategies include: 1. providing role models, advisors, and mentors; 2. providing early research opportunities by involving AI/AN communities in research on Native health issues; 3. anticipating students' traditional Native spiritual practices; 4. providing professional socialization opportunities for faculty and AI/AN medical students; 5. creating and implementing rigorous curricula that include indigenous perspectives; and 6. developing a pro-diversity institutional mission statement to inform admissions policies. The authors identify governmental and nongovernmental organizations in a position to fund and implement these strategies, as well as a list of resources. Collaboration with AI/AN individuals, organizations, and communities is critical to this effort but not a familiar role for most academic medical centers; suggestions for cross-cultural outreach and collaboration are provided.
  • Health Risks Factors Among American Indians and Alaska Native Elders
    Author(s): Leander McDonald, Richard Ludtke, Kyle Muus
    Research center: Upper Midwest Rural Health Research Center
    Topics: Aging, American Indians and Alaska Natives, Minority health
    Citation: Journal of Native Aging and Health, July-August 2006, 1(2), 17-24
    Date: 2006
    Chronic disease rates are higher among American Indian and Alaska Native elders although they exercise more and have higher rates of participation in multiple exercise activities. Research concerning the relationship between chronic disease and health risk factors is limited for American Indian and Alaska Native elder populations. This paper indicated results of an analysis of the effect of risk factors on chronic disease from a survey of 9,296 Native elders, representing 171 tribes from 88 sites. The sampling design employed systematic random sampling for larger tribes, with smaller tribes (fewer than 200) interviewing all or the majority of their elders. The data suggest that smokers, drinkers, and non-exercisers are at increase risk for chronic disease.
  • American Indians and Alaska Natives: How Do They Find Their Path to Medical School?
    Author(s): Walter B. Hollow, Davis G. Patterson, Polly M. Olsen, Laura-Mae Baldwin
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Workforce
    Citation: Academic Medicine, 81(10), S65-S69
    Date: 2006
    Describes findings of a study to understand the supports and barriers that American Indian and Alaska Native (AI/AN) students encountered on their path to successful medical school entry.

2005

  • Prevalence of Chronic Disease Among American Indian and Alaska Native Elders
    Author(s): Patricia Moulton, Leander McDonald, Kyle Muus, Alana Knudson, Mary Wakefield, Richard Ludtke
    Research center: Upper Midwest Rural Health Research Center
    Topics: Aging, American Indians and Alaska Natives, Chronic diseases and conditions, Minority health
    Date: 10 / 2005
    Examines chronic disease prevalence and functional limitations among American Indian/Alaska Natives by rurality, gender, age, health care access, and health behaviors. Includes policy recommendations.
  • Chronic Disease in American Indian/Alaska Native Elders
    Author(s): Patricia L. Moulton, Leander R. McDonald, Kyle J. Muus, Alana D. Knudson, Richard L. Ludtke
    Research center: Upper Midwest Rural Health Research Center
    Topics: American Indians and Alaska Natives, Chronic diseases and conditions, Minority health
    Citation: The IHS Primary Care Provider, 30(5), 53-54
    Date: 2005
    Describes the prevalence of chronic diseases among Native American elders.
  • More Culturally Sensitive Neuropsychological Tests (and Normative Data) Needed
    Author(s): F. Richard Ferraro, Leander R. McDonald
    Research center: Upper Midwest Rural Health Research Center
    Topics: American Indians and Alaska Natives, Cultural competency, Minority health
    Citation: Alzheimer Disease and Associated Disorders, 19(2), 53
    Date: 2005
    Discusses the need for culturally sensitive tests and normative data regarding the Native elder population.
  • Chronic Disease and Functional Limitation Among American Indian and Alaska Native Elders
    Author(s): Leander McDonald, Richard Ludtke, Kyle Muus
    Research center: Upper Midwest Rural Health Research Center
    Topics: American Indians and Alaska Natives, Chronic diseases and conditions, Minority health
    Citation: Journal of Native Aging and Health, November-December 2005
    Date: 2005
    Reports the results of an analysis of chronic disease's effect on functional limitation from a survey of 7,107 Native elders representing 143 tribes from 77 sites.

2004

  • Indian Health Care Improvement Act: Implications for North Dakota Tribes
    Author(s): Francine McDonald
    Research center: Upper Midwest Rural Health Research Center
    Topics: American Indians and Alaska Natives, Legislation and regulation, Minority health
    Date: 11 / 2004
    Policy brief providing an overview of health care issues facing American Indians in North Dakota, with discussion of the impact of the Indian Health Care Improvement Act.
  • Access to Specialty Health Care for Rural American Indians: Provider Perceptions in Two States
    Author(s): Laura-Mae Baldwin, Waler B. Hollow, Susan Casey, L. Gary Hart, Eric H. Larson, Kelly Moore, Ervin Lewis, David C. Grossman
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health services, Minority health, Physicians
    Report Number: Working Paper No. 78
    Date: 10 / 2004
    Examines access to specialty services among rural Indian populations in Montana and New Mexico, based on a survey sent to primary care providers addressing access to specialty physicians, perceived barriers to access, and access to nonphysician clinical services. Report available upon request by contacting rhrc@fammed.washington.edu.
  • American Indians and Alaska Natives: How Do They Find Their Path to Medical School?
    Author(s): Walter B. Hollow, Davis G. Patterson, Polly M. Olsen, Laura-Mae Baldwin
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Physicians, Workforce
    Report Number: Working Paper No. 86
    Date: 01 / 2004
    Describes the findings of a study to understand the paths of American Indian and Alaska Native (AI/AN) students who successfully entered medical school.

2002

  • Perinatal and Infant Health Among Rural and Urban American Indians/Alaska Natives
    Author(s): Laura-Mae Baldwin, David C. Grossman, Susan Casey, Walter Hollow, Jonathan R. Sugarman, William L. Freeman, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Children, Maternal and child health, Rural statistics and demographics
    Citation: American Journal of Public Health, 92(9), 1491-1497
    Date: 09 / 2002
    Provides a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health.

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This web site includes content provided by and adapted from the Maine Rural Health Research Center, University of Southern Maine under a Cooperative Agreement with the University of North Dakota.