Map of the United States showing the 12 Indian Health Service areas, which includes tribal nations, and the top 10 states with the largest percentage of American Indians and Alaska Natives according to the Census Bureau.
This profile offers an overview of the social, economic, and environmental factors that shape the health of the American Indian and Alaska Native (AI/AN) population in the United States. Considering the unique environments, cultures, histories, and circumstances of AI/AN populations is fundamental to improving their health outcomes and reducing longstanding disparities and inequities. These factors, known as social determinants of health (SDOH), affect various health, functioning, and quality-of-life outcomes and risks. Non-medical factors like poverty, limited access to healthcare, and lack of education are all examples of individual SDOH that contribute to health disparities and inequities.
Visit Healthy People 2030 to learn more about SDOH.
AMERICAN INDIAN AND ALASKA NATIVE POPULATION INFORMATION
The U.S. Census Bureau defines the AI/AN population as people having origins in any of the original peoples of North and South America (including Central America), who maintain tribal affiliation or community attachment. According to the U.S. Census Bureau's American Community Survey (ACS) population estimates, in 2023, about 3.3 million people identified as AI/AN alone, accounting for 1.3% of all people living in the United States. Over 8.8 million people identified as AI/AN alone or in combination with one or more races.
According to the Bureau of Indian Affairs, there are approximately 326 federally recognized American Indian reservations in the United States. Based on 2020 U.S. Census data, the Indian Health Service (IHS), an agency within the U.S. Department of Health and Human Services, estimates that approximately 87% of the AI/AN population live in urban areas, while 13% live on reservations or Tribal lands.
In 2023, the ten states with the largest percentage of AI/AN populations were: Alaska (15.6%), New Mexico (11.4%), Oklahoma (9.5%), South Dakota (8.5%), Montana (6.4%), North Dakota (5.3%), Arizona (5.2%), Wyoming (2.8%), Washington (2.0%), and Oregon (1.9%). As of 2024, there are 574 federally recognized tribes and a number of tribes recognized at the individual state level. There are also many tribes that are not state or federally recognized.
IHS is responsible for providing federal health services to American Indians and Alaska Natives. The IHS provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives in 37 states.
According to 2023 ACS estimates, 18.9% of the non-Hispanic AI/AN alone population age 5 years and older speaks a language other than English at home, with 4.0% speaking English less than “very well.”
According to 2023 ACS estimates, 84.9% of non-Hispanic American Indians and Alaska Natives age 25 years and older have at least a high school diploma, compared to 94.4% of non-Hispanic whites. 16.3% of non-Hispanic American Indians and Alaska Natives have at least a bachelor's degree, in comparison to 40.0% of non-Hispanic whites, and 5.8% of non-Hispanic American Indians and Alaska Natives held an advanced graduate or professional degree, compared to 15.8% of non-Hispanic whites.
According to 2023 ACS estimates, the median 12-month household income for non-Hispanic American Indian and Alaska Native households is $51,238, compared to $83,121 for non-Hispanic white households. 19.7% of non-Hispanic American Indian and Alaska Native families were experiencing poverty, compared to 5.9% of non-Hispanic white families. 2022 estimates from the U.S. Department of Labor show the overall unemployment rate for American Indians and Alaska Natives was 6.2% compared to 3.2% for whites.
According to ACS estimates, in 2023, 43.1% of non-Hispanic American Indians and Alaska Natives alone had private health insurance, compared to 73.8% of non-Hispanic whites. 50.7% of non-Hispanic American Indians and Alaska Natives alone had Medicaid or public health insurance coverage, compared to 36.6% of non-Hispanic whites, and 16.0% had no health insurance coverage, compared to 5.1% of non-Hispanic whites.
American Indians and Alaska Natives have the lowest life expectancy at birth among all racial and ethnic groups in the United States. According to the Centers for Disease Control and Prevention (CDC), in 2022 the average estimated life expectancy at birth for American Indians and Alaska Natives is 67.9 years (71.3 for females and 64.6 for males), compared to 77.5 years for non-Hispanic Whites (80.1 for females and 75.1 for males). In 2023, 21.8% of people who identify as American Indian or Alaska Native alone reported being in fair or poor health – the highest rate among all racial groups.
In 2021, the leading causes of death in non-Hispanic American Indians and Alaska Natives were COVID-19, heart disease, cancer, unintentional injuries, and chronic liver disease.