Document Type



Because the Indian Health Service does not provide direct services in California, data related to patient care information has been limited. In November 1991, the Indian Health Service addressed this deficiency by presenting a report to the U.S. Congress. This monograph addresses key health status and health care utilization measures from the report. This includes the health effects of the arbitrary and changing nature of federal recognition of those tribes that are eligible for health benefits. Secondary data from the State of California was used in the original report; this summary focuses on vital statistics from California birth and death certificates. Making inferences according to county of residence generated information. A random-sample survey of non-federally recognized California Indians was conducted to determine current sources of health care, and availability of alternatives to Indian Health Service. Statistics that describe the socioeconomic and health status of the Indian population in California were generated as a result of this report. The statistics show that while the California Indian population is, as a whole, better off than the norm for American Indians in the United States, they are worse off than the population of California as a whole. These statistics focus on maternal and child health statistics, infant mortality, and other causes of death. Approximately one-fourth of registered American Indians at California Indian tribal health clinics are not from federally recognized tribes. These populations are cause for special concern. The article includes a brief overall history of Indian Health Service in California. There is an unmet need for a variety of health services for California's Indian population. More research will improve the quality of the data that is necessary in order to provide available and accessible health care for both federally recognized and non-recognized tribes. Loss of Indian Health Service benefits will add stress to public programs that are already under great fiscal restraint.

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Institute for Health Policy Studies, University of California, San Francisco, California.