American Indian/Alaska Native - The Office of Minority Health


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Overview (Demographics): This racial group includes people having origins in any of the original peoples of North, South America, and Central America, who maintain tribal affiliation or community attachment. As of 2017, there were an estimated 5.6 million people who were classified as American Indian and Alaska Native alone or in combination with one or more other races. This racial group comprises 1.7 percent of the total U.S. population.

The 2010 Census reveals that 78 percent of the AI/AN live outside of tribal statistical areas. 22 percent of American Indians and Alaska Natives live on reservations or other trust lands. 60 percent of American Indians and Alaska Natives live in metropolitan areas; this is the lowest metropolitan percentage of any racial group. In 2017, 1.6 million American Indian and Alaska Natives were under the age of 18, which comprised 28.7 percent of this racial group. In 2017, ten states with the largest American Indian/Alaska Native populations were: California, Oklahoma, Arizona, Texas, New Medico, Washington, New York, North Carolina, Florida, and Alaska.

Currently, there are 573 federally recognized (AI/AN) tribes, and more than 100 state recognized tribes. There also are tribes that are not state or federally recognized. Federally recognized tribes are provided health and educational assistance through a government agency called Indian Health Service (IHS), U.S. Department of Health and Human Services. The IHS operates a comprehensive health service delivery system for approximately 2.2 million American Indians and Alaska Natives. Typically, this urban clientele has less accessibility to hospitals, health clinics or contract health services provided by the IHS and tribal health programs. Studies on urban American Indian and Alaska Native populations have documented a frequency of poor health and limited health care options for this group.

Since 1972, IHS has embarked upon a series of initiatives to fund health-related activities in off-reservation settings, which make health care services accessible to urban American Indians and Alaska Natives. Currently, the IHS funds 41 urban Indian health organizations, which operate at sites located in cites throughout the United States. Approximately 70 percent of American Indians and Alaska Natives live in urban areas, and are eligible to utilize this program. The programs administer medical services, dental services, community services, alcohol and drug use prevention, education and treatment, HIV and sexually transmitted disease education and prevention services, mental health services, nutrition education and counseling services, pharmacy services, health education, optometry services, social services, and home health care.

Language Fluency: In 2017, 26.9 percent of American Indians/Alaska Natives alone spoke a language other than English at home.

Educational Attainment: In 2017, 83.8 percent of American Indians and Alaska Natives alone or in combination had at least a high school diploma, as compared to 92.9 percent of non-Hispanic whites. 19.6 percent of American Indians and Alaska Natives age 25 and over had at least a bachelor's degree, in comparison to 35.8 percent of non-Hispanic whites. 6.8 percent of American Indians and Alaska Natives held an advanced graduate or professional degree, as compared to 13.8 percent of the non-Hispanic white population.

Economics: The median household income for American Indian and Alaska Natives is $45,448, as compared to $65,845 for non-Hispanic white households. 30.5 percent of American Indians and Alaska Natives age 16 and over work in management and professional occupations, in comparison to 42.9 percent of whites. Also, 21.9 percent of this racial group live at the poverty level, as compared to 9.6 percent of non-Hispanic whites, in 2017.

Insurance Coverage: In 2017, 51.3 percent of American Indians and Alaska Natives alone or in combination had private health insurance coverage. 43.2 percent of AI/ANs relied on Medicaid or public coverage, and 14.9 percent of AI/ANs had no health insurance coverage. This compares to non-Hispanic whites by 75.4 percent, 33.7 percent, and 5.9 percent respectively.

Health: According to Census Bureau projections, the 2015 life expectancies at birth for American Indians/Alaska Natives are 77.5 years, with 80.3 years for women, and 74.7 years for men. For non-Hispanic whites the projected life expectancies are 79.8 years, with 82.0 years for women, and 77.5 years for men. It is significant to note that American Indians/Alaska Natives frequently contend with issues that prevent them from receiving quality medical care. These issues include cultural barriers, geographic isolation, inadequate sewage disposal, and low income.

Some of the leading diseases and causes of death among AI/AN are heart disease, cancer, unintentional injuries (accidents), diabetes, and stroke. American Indians/Alaska Natives also have a high prevalence and risk factors for mental health and suicide, unintentional injuries, obesity, substance use, sudden infant death syndrome (SIDS), teenage pregnancy, diabetes, liver disease, and hepatitis.

Other Health Concerns: The tuberculosis rate in 2017 was almost 4 times higher for American Indians/Alaska Natives, with an incidence rate of 3.9, as compared to 0.5 for the white population.¹

For more information about tribal health issues:
Indian Health Service
Bureau of Indian Affairs Tribal Leaders Directory
National Indian Health Board
Urban Indian Health Institute