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Measuring Rural-Urban Differences in Indigenous American Indian and Alaska Native Health

Research center:
Lead researcher:
Project funded:
September 2024
Anticipated completion date:
August 2025

In the United States, there are 574 federally recognized tribes and approximately 9.7 million Indigenous American Indian and Alaska Native (AI/AN) people. Many AI/AN people in the United States are rural residents, with 40% of AI/AN people living in rural areas, both on and off tribal land (13% live on reservations). AI/AN people also have lower life expectancy and face persistent challenges in access to and quality of health.

AI/AN people living in rural areas may experience particular health risks. Rural counties where more than half of the residents are AI/AN show elevated rates of premature death. Among AI/AN people, rural residents tend to suffer worse health outcomes and have more challenges accessing care than urban AI/AN people, partly due to residing in remote locations. Current and comprehensive data on AI/AN health and health care access are needed to inform policy and decision-making. The federal government has a unique relationship with sovereign tribal nations, and both legal decisions and treaty agreements establish a federal trust responsibility for AI/AN health.

This project describes rural-urban differences in the health of AI/AN people and measures differences in health care access for AI/AN people in rural communities, identifying promising practices and opportunities to improve health for rural AI/AN people.