States with the highest American Indian and Alaska Native (AI/AN) populations have the worst health system outcomes for Native peoples, according to a new study from the Commonwealth Fund.
The report found significant disparities for AI/AN people, who have shorter life expectancies, higher rates of treatable diseases and chronic illnesses, and increased maternal and infant mortality compared to white and Hispanic populations.
Alaska, South Dakota, Montana, Arizona and North Dakota – states with large Native populations – ranked among the lowest for AI/AN health outcomes. In Wyoming, Montana and North Dakota, Native peoples had some of the highest rates nationwide for premature avoidable mortality before age 75.
The study linked poor outcomes to lack of insurance coverage and healthcare access. AI/AN populations have among the highest uninsured rates in every state. The Indian Health Service, which serves 2.6 million Native people, remains severely underfunded.
“States with the largest American Indian/Alaska Native populations have the worst health system outcomes for Native peoples,” the report stated.
North Carolina, New Mexico and California ranked highest for AI/AN health outcomes.
The report examined 25 indicators of health system performance across racial and ethnic groups. It found the most significant disparities among Black and AI/AN populations, who were least likely to have insurance, receive preventive care, and most likely to delay treatment due to cost and access issues.
See “Natives Have Worst Health System Outcomes in States with Highest Native Populations” (April 23, 2024)
