Disparities/Minority Health

Nearly half of urban American Indians and Alaskan Natives travel back to their reservation to visit during the year

The health of American Indians and Alaska Natives (AI/ANs) is worse than that of the general population in the United States, with a life expectancy nearly 5 years lower. Of the more than two million AI/ANs living in the United States today, only 25 percent reside on reservations, while 60 percent live in cities. Those who live in cities often travel to reservations, yet little is known how this travel may be related to health. This study, supported in part by the Agency for Healthcare Research and Quality (HS10854), is one of the few to provide information on AI/AN travel to reservations and its relationship to health status and use of health services among urban AI/ANs.

Researchers surveyed more than 500 AI/AN adults at a primary care clinic in Seattle about time spent visiting a reservation during the past year, and sociodemographic, cultural, and clinical characteristics. Thirty-four percent of respondents had spent up to 30 days traveling, 14 percent had spent more than 30 days traveling, and 52 percent had not traveled to reservations. Strong Native American cultural identification, presence of lung disease, absence of thyroid or mental problems, and greater dissatisfaction with care were independently associated with more travel to reservations.

Reservation visits were not consistently linked to self-reported health outcomes, nor could the researchers determine how often respondents traveled to the reservation for health care. The findings underscore the importance of considering the role of culture as well as residence and patterns of travel in both research and clinical care involving AI/ANs.

See "Characteristics associated with reservation travel among urban Native American outpatients," by Dorothy A. Rhoades, M.D., M.P.H., Spero M. Manson, Ph.D., Carolyn Noonan, M.S., and Dedra Buchwald, M.D., in the August 2005 Journal of Health Care for the Poor and Underserved 16, pp. 464-474.

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