Document Type



The health care situation for American Indian and Alaska Native (AI/AN) urban populations varies widely throughout the United States. Some urban areas offer extensive facilities through the Indian Health Service (IHS), or other health care providers. Other urban centers have no options for AI/AN health care at all. This evaluation study examines the health care provider status for the AI/AN populations in six metropolitan sites - 1) Baltimore, Maryland; 2) Denver, Colorado; 3) Las Vegas, Nevada; 4) Minneapolis, Minnesota; 5) Phoenix, Arizona; and 6) Portland, Oregon.A series of meetings was held to discuss and clarify contract requirements, roles and responsibilities of Urban Health Program staff at IHS Headquarters. Two types of data collection were used. First, a review of existing data sources was conducted. Data sources included: 1) 1990 Census Data; 2) IHS Population Projections; and 3) Birth and Mortality Rate Data supplied by the IHS. The study authors also conducted six site visits and collected new data from each of the sites. Site data collection activities included: 1) discussions with urban center personnel; 2) IHS personnel (Headquarters and Area Office); 3) personnel from State and local agencies; and 4) representatives from local organizations.The information available from the six sites was often incomplete, inaccurate, and unsupported. The methods for data collection utilized by the various urban centers were not uniform. The study provides; 1) comparison of resource requirements; 2) site demographics; 3) overview of management and policy issues; and effects of proposed health care reform. Recommendations are provided on four specific areas: 1) establish guidelines for uniformity and consistency of data collection; 2) establish uniform accounting systems; 3) conduct a mini-census of AI/AN population; and 4) increase funding for outreach program.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857.