American Indian and Alaska Native Health

The U.S. Census Bureau defines the “American Indian and Alaska Native (AI/AN)” population as people having origins in any of the original peoples of North and South America (including Central America), who maintain tribal affiliation or community attachment. According to the U.S. Census Bureau's American Community Survey (ACS) population estimates, in 2024, about 1.8 million people identified as non-Hispanic AI/AN alone, and over 9.1 million people identified as AI/AN alone or in combination with one or more races.

According to the Bureau of Indian Affairs, there are approximately 326 federally recognized American Indian reservations in the United States. Based on 2020 U.S. Census data, the Indian Health Service (IHS), an agency within the U.S. Department of Health and Human Services, estimates that approximately 87% of the AI/AN population live in urban areas, while 13% live on reservations or tribal lands.

In 2024, the ten U.S. states with the largest populations of AI/AN people were: Alaska (13.5%), New Mexico (8.3%), South Dakota (7.2%), Oklahoma (6.6%), Montana (5.1%), North Dakota (4.1%), Arizona (3.1%), Wyoming (1.4%), North Carolina (0.8%) and Washington (0.8%). As of 2024, there are 574 federally recognized tribes and a number of tribes recognized at the individual state level. There are also many tribes that are not state or federally recognized.

IHS is responsible for providing federal health services to American Indians and Alaska Natives. The IHS provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives in 37 states.

According to 2024 ACS estimates, 18.2% of non-Hispanic American Indians and Alaska Natives age 5 years and older speaks a language other than English at home, with 3.7% speaking English less than “very well.”

According to 2024 ACS estimates, 34.9% of non-Hispanic American Indians and Alaska Natives age 25 years and older have at least a high school diploma, compared to 25.7% of the total U.S. population. 11.3% of non-Hispanic American Indians and Alaska Natives have at least a bachelor's degree, in comparison to 22.1% of the total U.S. population, and 6.1% of non-Hispanic American Indians and Alaska Natives held an advanced graduate or professional degree, compared to 14.7% of the total U.S. population.

According to 2024 ACS estimates, the median 12-month household income for non-Hispanic American Indian and Alaska Native alone households is $54,485, compared to $81,604 for all U.S. households. 19.0% of non-Hispanic American Indian and Alaska Native alone families were experiencing poverty, compared to 8.5% of U.S. families. The unemployment rate for non-Hispanic American Indians and Alaska Natives alone was 7.8% compared to 4.5% for the total U.S. population.

According to ACS estimates, in 2024, 44.8% of non-Hispanic American Indians and Alaska Natives alone had private health insurance, compared to 67.2% of the total U.S. population. 49.1% of non-Hispanic American Indians and Alaska Natives alone had public health insurance coverage, compared to 36.8% of the U.S. population, and 16.2% had no health insurance coverage, compared to 8.2% of the U.S. population.

American Indians and Alaska Natives have the lowest life expectancy at birth among all racial and ethnic groups in the United States. According to the Centers for Disease Control and Prevention (CDC), in 2023 the average estimated life expectancy at birth for non-Hispanic American Indians and Alaska Natives was 70.1 years (73.5 for females and 66.7 for males), compared to 78.4 years for all races, 85.2 for Asian Americans, 81.3 for Hispanic/Latinos, 78.4 for Whites, and 74.0 for Black/African Americans. In 2024, 24.4% of people who identify as American Indian or Alaska Native alone reported being in fair or poor health – the highest rate among all racial groups.

In 2023, the leading causes of death in non-Hispanic American Indians and Alaska Natives were heart disease, cancer, unintentional injuries, chronic liver disease, and diabetes.