The major minority ethnic/racial populations in the United States (U.S) include African Americans, Asians, American Indians/Alaska Natives, Pacific Islanders, and Hispanics. The minority groups face many cultural, socioeconomic, and sociopolitical barriers in accessing health care resulting in poor health status (Stanley et al., 2020). Consequently, the barriers cause major health disparities in these communities, which cause high morbidity and mortality rates. In this regard, this paper will discuss the health status of American Indians/Alaska Natives, including their health status, health disparities, healthcare barriers, and health promotion activities they practice.
American Indians/Alaska Natives
American Indians/Alaska Natives (AI/AN) are a minority population in the US consisting of individuals with origins from the people originating from North, Central, and South America, who keep up with the tribal or community affiliation. According to the U.S Office of Minority Health (OMH), approximately 5.7 million persons in 2019 were identified as only AI/AN or mixed with another ethnicity. AI/ANs constitute 1.7% of the overall U.S. population. Of this population, 27.5% (1.6 million) were below 18 years (OMH, 2021). The AI/AN tribes recognized federally receive health and education assistance through the Indian Health Service (IHS), a government agency. The IHS manages an all-inclusive health service delivery system for about 2.6 million AI/ANs. The AI/ANs living in urban areas generally have limited access to healthcare. Studies on AI/ANs living in urban areas have established a pattern of poor health and few health care options.
Health Status of AI/ANs
AI/ANs generally have a poor health status evidenced by a lower quality of life, a lower life expectancy, and a higher prevalence of many chronic illnesses. The 2020 life expectancies at birth for AI/ANs were 78.4 years, 81.1 years for females, and 75.8 years for males (OMH, 2021). The expectancy is lower than that of non-Hispanic whites, 80.6 years, 82.7 years for females, and 78.4 years for males. The prevalent diseases and common causes of mortality include diabetes, heart disease, unintentional injuries, cancer, and stroke. In addition, they have a high occurrence and risk factors for mental health disorders, suicide, substance use, teenage pregnancy, obesity, sudden infant death syndrome (SIDS), liver disease, and hepatitis (OMH, 2021). They also have a high TB rate, seven-fold higher than Whites. Race/ethnicity influences health for AI/ANs as they face issues that bar them from receiving quality health care. The issues include geographic isolation, cultural barriers, low income, and inadequate sewage disposal.
Health Disparities and Nutritional Challenges
AI/ANs have most of the debilitating health disparities in the U.S. According to the National Vital Statistics Reports, accidents contributed to 11.6% of total mortalities in 2017 among AI/ANs compared to 6.0% of total mortalities in the general US population (Heron, 2019). Besides, diabetes caused 5.8%, and chronic liver disease/cirrhosis led to 5.5% of AI/ANs mortalities. Depression is a major disparity among AI/ANs. AI/ANs are 2.5 fold highly likely than non-Hispanic Whites to develop severe psychological distress. Furthermore, alcohol consumption causes AI/AN accident mortality, which is the third common cause of mortality, while cirrhosis/chronic liver disease is the fifth leading (Heron, 2019). Suicide is also a significant health disparity for AI/ANs with mental health and social elements. The suicide mortality rate for AI/ANs is 16.9/100,000, while for Whites is 13.1/100,000.
The AI/ANs experience significant nutrition-related chronic illnesses, such as diabetes, obesity, cancer, and heart disease. They have higher obesity rates than nearly all ethnic groups (Carron, 2020). Poverty, in addition to a history of sponsored food programs, have contributed to diets high in calories and with poor nutritional value. Warne and Wescott (2019) explain that lack of access to traditional AI/ANs food systems and limited financial opportunities on most AI/ANs reservations are major social determinants that put the population at high risk for obesity. Furthermore, AI/ANs face challenges of limited access to grocery stores supplying healthy foods resulting in a high intake of unhealthy foods.
Barriers to Health from Culture, Socioeconomics, Education, and Sociopolitical Factors
AI/ANs culture creates barriers in accessing health care due to language barriers, making it challenging for providers to offer appropriate preventative interventions. They practice traditional healing, which lowers their health-seeking behaviors. Socioeconomic status and level of education are predictors of health status (Mangla & Agarwal, 2021). AI/ANs have a high populat
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