American Indian and Alaska native health equity

Abstract

Health equity, social justice, and determinants/drivers of health (e.g., social, structural, political) are integral to understanding health in the United States, yet the relationships among these concepts are complex. Health disparities are preventable variations in disease burden or the chance for optimal wellness between socially disadvantaged groups and privileged groups and are a public health priority. For centuries, health disparities have existed between American Indian/Alaska Native (AIAN) people and other groups. This chapter describes the social determinants/drivers of health that disproportionately affect AIAN populations. It explains the historical factors and federal policies that have contributed to health disparities among AIAN people. The chapter discusses the legal obligations of the U.S. government in providing healthcare services to AIAN populations and the impact of underfunding the Indian Health Service. It describes strategies for reducing health disparities and improving health equity for AIAN people.