Table 9–2 Comparison of Selected Health Status Indicators—All Races and American Indians and Alaska Natives: 2007
Morbidity and Mortality
The American Indian and Alaska Native people have long experienced lower health status when compared with other Americans. Lower life expectancy and the disproportionate disease burden exist perhaps because of inadequate educa- tion, disproportionate poverty, discrimination in the delivery of health services, and cultural differences. These are broad quality-of-life issues rooted in eco- nomic adversity and poor social conditions.
American Indians and Alaska Natives born today have a life expec- tancy that is 2.4 years less than the U.S. population of all races (74.5 to 76.9 years, respectively). American Indian and Alaska Native infants die at a rate of nearly 10 per every 1,000 live births, as compared to 7 per 1,000 for the U.S. population (2001–2003 rates). Given the higher health status enjoyed by most Americans, the lingering health disparities of American Indians and Alaska Natives are troubling. In trying to account for the disparities, health care experts, policymakers, and tribal leaders are looking at many factors that impact the health of Indian people, including the adequacy of funding for the American Indian health care delivery system (U.S. Department of Health and Human Services, IHS, 2011).
The American Indian and Alaska Native population has several charac- teristics different from the U.S. population that would impact assessing the cost for providing similar health services enjoyed by most Americans. The American Indian population is younger, because of higher mortality, than all other U.S. races. The Indian Health Service (IHS) population is predomi- nately rural, which should suggest lower costs; however, the disproportion- ate incidence of disease and medical conditions experienced by the American Indian population raises the costs, which almost obliterates the lower cost offsets. Table 9–2 compares selected health status indicators for all races and American Indians. As can be seen in Table 9–2, the crude birth rate among American Indians/Alaska Natives is higher than that of the general popula- tion; the infant mortality rate is higher; and the male suicide and homicide rates in 2004 are higher than in the general population. The incidence of both breast cancer and prostate cancer is lower.
The bold entries in Table 9–3 illustrate the greatest areas of disparity between American Indians and all other races in the United States. Diabetes, homicide, infant deaths, and so forth are notably higher. Another way to realize the gravity of the disparities is to examine Table 9–3 that presents the ratios between the total U.S. population and the American Indian/Alaska Native populations.
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Table 9–2 Comparison of Selected Health Status Indicators—All Races and American Indians and Alaska Natives: 2007