Document Type



The purpose of this report is to present findings on the health status and health needs ofAmerican Indians and Alaska Natives (AI/ANs) in six urban areas not currently served byurban Indian health programs funded by the Indian Health Service (IHS). In accordancewith requirements of Title V, Section 504, of the Indian Health Care Improvement Act, ahealth needs assessment was conducted in six U.S. cities to determine the health status andhealth needs of AI/AN residents in these urban areas.Several methods were used to conduct the assessment including: 1) analysis of 1990 Census population data; 2) analysis of city-specific mortality data; 3) meetings with AI/AN community leaders; 4) meetings with local health officials; and 5) analysis of selected health indicators, Health Risk Appraisals, and Community Health Assessment data.Heart disease is the leading cause of death among urban AI/ANs. Certain cardiovascular risk behaviors such as smoking, obesity, and lack of exercise, are more prevalent among assessment participants than among the U.S. general population. Accidents are the third leading cause of death among urban AI/ANs. Injury associated risk factors include lack seat belt use, drinking and driving, and binge drinking. Twelve percent of assessment participants report they are diabetic. Leading problems reported by participants when seeking health care include cost, lack of health insurance, and lack of AI/AN health providers. Lack of knowledge of available local health services and the perception that mainstream health providers don't understand their health needs are also problems reported by participants.The study produced recommendations in the following areas: 1) steps needed for local urban AI/AN organizations to pursue Title V funding through the Indian Health Care Improvement Act for additional urban Indian health programs; 2) increase awareness on the part of the city, county, and state health officials of the need to improve the accuracy of mortality and morbidity statistics for AI/ANs living in urban areas; and 3) increase awareness on the part of health department and community health center administrators of the need for health services among their community's AI/AN population.

Publication Date



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