Year(s) Funded: 2024-2025
Topic(s): American Indians and Alaska Natives, Health Disparities and Health Equity, Healthcare Access, Rural Statistics and Demographics, Social Determinants of Health
Project Lead: Katy Kozhimannil
In the United States, there are 574 federally recognized tribes and approximately 9.7 million Indigenous American Indian and Alaska Native (AI/AN) people. Many AI/AN people in the United States are rural residents, with 40% of AI/AN people living in rural areas, both on and off tribal land (13% live on reservations). AI/AN people also have lower life expectancy and face persistent challenges in access to and quality of health.
AI/AN people living in rural areas may experience particular health risks. Rural counties where more than half of the residents are AI/AN show elevated rates of premature death. Among AI/AN people, rural residents tend to suffer worse health outcomes and have more challenges accessing care than urban AI/AN people, partly due to residing in remote locations. Current and comprehensive data on AI/AN health and health care access are needed to inform policy and decision-making. The federal government has a unique relationship with sovereign tribal nations, and both legal decisions and treaty agreements establish a federal trust responsibility for AI/AN health.
This project describes rural-urban differences in the health of AI/AN people and measures differences in health care access for AI/AN people in rural communities, identifying promising practices and opportunities to improve health for rural AI/AN people.
Related Publications
- Community Healers: How Cherokee Indian Hospital Authority Leads in Health and Wellness, December 12th, 2025
- Rural/Urban Differences among American Indian/Alaska Native Peoples in Health Care Access and Outcomes, 2019–2023, November 14th, 2025
- Reasons for Experiencing Delayed or Forgone Health Care among Rural American Indian/Alaska Native and Rural Non-Hispanic White Individuals, 2022, September 4th, 2025