Health of American Indian and Alaska Native Adults, by Urbanization Level: United States, 2014–2018

Questions for Maria Villarroel, Health Statistician and Lead Author of “Health of American Indian and Alaska Native Adults, by Urbanization Level: United States, 2014–2018.”

Q: Why did you decide to do a report on health in American Indian and Alaska Native (AIAN) adults?

MV: There is limited information about the health of the American Indian and Alaska Native adults at the national level. Few national surveys are large enough to be able to provide reliable estimates about American Indian and Alaska Native adults. The National Health Interview Survey (NHIS) is one such survey that can inform on the health status and health conditions of civilian non-institutionalized adults residing in households across the country who identify as American Indian and Alaska Native.

Q: Can you summarize how the data varied by urbanization level?

MV: This report has two objectives.

The first objective was to compare the health of American Indian and Alaska Native adults by urbanization level.  The report findings indicate that the conditions examined did not follow a single pattern by urbanization level. The percentage of American Indian and Alaska Native adults with disabilities increased with higher urbanization level, multiple chronic conditions increased with lower urbanization level, diagnosed diabetes was highest in rural areas, diagnosed hypertension was highest for those in medium and small metropolitan areas and in rural areas, and those in fair or poor health status did not differ by urbanization level.

The second objective was to assess whether the percentage of American Indian and Alaska Native adults with selected conditions was similar to the percentage found, on average, among all U.S. adults. The report findings indicate that American Indian and Alaska Native adults were more likely to be in fair or poor health, have a disability, have multiple chronic conditions, and to have been diagnosed with hypertension and diabetes compared with all U.S. adults. This finding was consistent across most urbanization levels.

Q: Was there a specific finding in the data that surprised you from this report?

MV: Among American Indian and Alaska Native adults, the selected conditions examined did not follow a single pattern by urbanization level, and that across most urbanization levels, the percentage of American Indian and Alaska Native adults with these selected conditions was higher than found on average among U.S. adults.

Q: Is this the first time you have reported data on AIAN?  If not, do you have any trend data?

MV: Yes, this is the first time we have used NHIS data to examine selected health conditions among American Indian and Alaska Native adults in the US. We are not aware of a previous trend report and have not examined trends among this population ourselves.

Q: What is the take home message for this report?

MV: Among American Indian and Alaska Native adults, the conditions examined did not follow a single pattern by urbanization level, and across most urbanization levels, the percentage of American Indian and Alaska Native adults with these selected conditions was higher than found on average among U.S. adults.