Publication Date: January 15th, 2026
Publication Type: Policy Brief
Topic(s): American Indians and Alaska Natives, Health Disparities and Health Equity, Healthcare Access, Poverty, Social Determinants of Health, Uninsured and Underinsured
Author(s): Jacobson I, Rydberg K, Swendener A, Hill KX, Kozhimannil KB, and Henning-Smith C
The Indian Health Service (IHS) provides comprehensive free health services to eligible individuals, and may alleviate health care affordability issues for American Indian and Alaska Native (AI/AN) people; however, the IHS operates overwhelmingly in rural areas, and data on rural/urban differences in IHS use and health care affordability issues among AI/AN people are lacking. In this policy brief, we examine rural/urban differences in rates of health care affordability and IHS use among AI/AN people, as well as within rural AI/AN residents.