Trends in Physical and Mental Health, Mortality, Life Expectancy, and Social Inequalities Among American Indians and Alaska Natives, 1990-2019

Objective: To address the continuing gap in data and research on health socioeconomic inequities characterizing Native Americans United States, this study examines major social inequality trends for American Indian Alaska (AIAN) populations covering several broad areas, including infant child health, life expectancy leading causes of death, physical mental chronic disease prevalence, disability, health-risk behaviors, care access quality. Methods: We used trend from 1990-2019 National Vital Statistics System, 2014-2018 Health Interview Survey, Community Survey to examine care, mortality, patterns AIANs relation other racial/ethnic groups general population. Life tables, age-adjusted rates, risk ratios, logistic regression were inequalities. Results: In 2019, was 76.9 years, 11.3 years shorter than that Asian/Pacific Islanders. The mortality rate 8.7 per 1,000 live births, 79% higher non-Hispanic Whites. Risks birth defects, low birthweight/prematurity, maternal complications, SIDS, unintentional injury significantly greater among compared with non Hispanic Excess AIANs, particularly rural found working ages, diabetes, liver cirrhosis, alcohol-related causes, youth suicide, injuries. About 18% assessed their overall as fair or poor, at twice Whites 10% AIAN adults experienced serious psychological distress, 2-to-5 times prevalence groups. had highest ambulatory uninsurance, unemployment, poverty rates US, differences these indicators varying markedly across tribes. Conclusion Implications Translation: remain a disadvantaged segment US population number key living conditions, some tribal approaching exceeding 40%.