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Introduction

Introduction to the American Indian and Alaska Native Health Web Portal

Welcome! American Indian and Alaska Native Health is a central source for information about the health and well-being of Native Americans and Alaska Natives. It is freely available, and offers access to evaluated and authoritative resources for:

  • individuals,
  • health educators,
  • healthcare professionals.

Through sections called "Our Health" and "Our Stories," individuals will find the latest reliable information on health and wellness issues affecting American Indians and Alaska Natives (AI/AN). Health educators and healthcare professionals can access tools, research and data that they need to perform their jobs. The information on this portal comes from Tribal, state, national, and some international organizations and agencies, as well as from professional societies and universities. The links include an assortment of documents, Websites, databases, videos, and other resources. Unique sections on Traditional Healing and Traditional Tobacco Use bring together centuries of knowledge and experience.

Health on this Website is used in its broadest sense, and includes physical, mental, social, cultural, and environmental aspects. Research encompasses basic, applied, laboratory, and community, as well as research conducted in partnerships with community groups.

The American Indian and Alaska Native Health web portal was created and is maintained by the National Library of Medicine (NLM) Outreach and Special Populations Branch. They are advised and assisted by a group of native community members who invites you to Like their Facebook page.

What is included?

This portal focuses on a few key areas:

  • Health topics listed as top health disparities for American Indians and Alaska Natives from the U.S. Centers for Diseases Control (CDC).
  • Traditional healing information resources - Links to an ethnobotany database, traditional tobacco usage, and other resources that stress the health and wellness practices of AI/AN in the context of culture, indigenous knowledge, and community.
  • National Library of Medicine and National Institutes of Health (NIH) programs - Information about the many projects sponsored by NLM and NIH.
  • Emerging health concerns, based on current trends and advisement of our user group members.

Within each topic area, pages are organized to highlight the following:

  • Our Health - Patient information about diseases, conditions, and wellness strategies in easy-to-read language for individuals.
  • Our Stories - Personal experiences in print, video, and audio and includes digital stories developed with nDigiDreams.
  • For Researchers, Educators, and Health Professionals -Links to research studies, databases, statistics, and journal articles, including complete full-text articles from PubMed Central and citations from PubMed/MEDLINE.
  • Organizations and Programs - Includes healthcare access information from the Indian Health Service and the National Council of Urban Indians as well as information about Tribal-based health and wellness programs.
  • General Information for Everyone - Links to trusted health information that is not specific to American Indians and Alaska Natives and often features information from MedlinePlus.

This portal is not meant to be a comprehensive resource to all American Indian/Alaska Native health and research. Instead, it is an access point to critical health and research areas, and a broad introduction to NLM resources. Please see below Resources from the National Library of Medicine for specific information about NLM resources.

Who is featured?

According to the 2010 Census, 5.2 million people in the United States identified as American Indian and Alaska Native (AI/AN), either alone or in combination with one or more races (2010 Census Brief, PDF, 2.99 MB). The terms American Indians, Native Americans, Alaska Native, and First Nations refer to the descendants of indigenous people who inhabited the North American continent for centuries before the arrival of European settlers. They are organized into tribes, villages, pueblos, bands, communities, and nations, and the group names are still evolving and changing. Today there are over 560 federally recognized indigenous groups in the United States (Federal Register Vol.81, No. 86, PDF, 208 KB). The many AI/AN subpopulations are culturally distinctive, diverse, and complex, and some are growing faster than the general population.

How do AI/AN access health care?

AI/AN are entitled to receive health care from the federal government because of treaty obligations and the government-to-government relationships of tribes with the United States. This federal government obligation to provide education and health at a reasonable level influences the way native people access and use health care services. The Indian Health Service (IHS) provides health care through its clinics and hospitals to all AI/AN who belong to federally recognized tribes and live on or near the reservations in its 12 service areas. (Women of Color Health Data Book, 4th edition, 2014, PDF, 2.4 MB)

IHS facilities are located on or very near reservations. Because they are often in rural and remote areas where the distances are great, it is challenging for AI/AN to use the facilities. Furthermore, 7 of every 10 (71 percent) of those identifying as solely or part American Indian/Alaska Native now live in urban areas, and providing services to those individuals adds another complexity.

The IHS Office of Urban Indian Health Programs consists of 34 non-profit 501 (c)(3) programs nationwide. The programs are funded through grants and contracts from the IHS and other governmental agencies, such as HRSA, to provide services and care. These Indian-operated urban facilities, health clinics, community services and referrals are there for the AI/AN living in urban areas who can't receive care at IHS facilities on reservations either as the result of distance or due to being disqualified by living away from them for 180 days. The urban facilities also serve members of tribes that are not federally recognized (i.e., recognized only by their states). A caveat of services in urban areas and in off-reservation rural areas is that they are often very limited.

The National Council of Indian Urban Health is a national 501(c)(3) organization devoted to the support and development of quality, accessible, and culturally-competent health services for AI/AN living in urban settings off-reservations. Their efforts help improve those services through direct assistance, advocacy, and training.

The Indian Health Service has a locator on its website to help people find services. There is also a list of some of the urban services.

Answers to frequently asked questions regarding access to healthcare can be found on the IHS website.

What are the health disparities?

Health issues and wellness methods are often reported and measured through the agencies that provide AI/AN healthcare or by Tribal groups. This results in some unevenness in statistics, but the fact remains obvious that there are significant health disparities between AI/AN and other U.S. populations. For example, in 2007-2009, the AI/AN age-adjusted death rates for the following causes were considerably higher than death rates for the overall U.S. population in 2008 (Trends in Indian Health, 2014 ed., DHHS, IHS, PDF, 13.8 MB):

  • Alcohol-related - 520% greater;
  • Tuberculosis - 450% greater;
  • Chronic liver disease and cirrhosis - 368% greater;
  • Motor Vehicle Crashes - 207% greater;
  • Diabetes mellitus - 177% greater;
  • Unintentional injuries - 141% greater;
  • Poisoning - 118% greater;
  • Homicide - 86% greater;
  • Suicide - 60% greater;
  • Pneumonia and influenza - 37% greater; and
  • Firearm injury - 16% greater.

Why this Web Portal?

The National Library of Medicine developed this portal and launched it in 2004 to provide AI/AN communities with access to consistent, evaluated, and reliable health information.

This site provides many links to NLM and NIH health information resources that can be used for health education and health decision making. Studies have shown that making health information available can directly or indirectly help reduce some health disparities.

Since the inception of the Web portal, the NLM has involved native people through focus groups, user groups, presentations, and consultations. Their feedback and advice are highly valued and inform the direction and content of the portal.

Resources from the National Library of Medicine

Included on the portal are many links to the information resources of the NLM. Two primary ones include:

MedlinePlus

This resource brings you information about diseases, conditions, and wellness issues in language you can understand. MedlinePlus offers reliable, up-to-date health information, anytime, anywhere, for free. It provides extensive information from the National Institutes of Health and other trusted sources on over 1000 diseases and conditions and provides directories, a medical encyclopedia and a medical dictionary, easy-to-understand tutorials on common conditions, tests, and treatments, health information in Spanish, extensive information on prescription and nonprescription drugs, and links to thousands of clinical trials. MedlinePlus is updated daily and can be bookmarked at the URL: https://medlineplus.gov/. There is no advertising on this site, nor does MedlinePlus endorse any company or product. Frequently asked questions about MedlinePlus are available at: https://medlineplus.gov/faq/faq.html

PubMed/MEDLINE

This trusted resource from the National Library of Medicine has more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may also include full-text articles from PubMed Central, publisher web sites, and institutional repositories. Tutorials on how to use this site are available at: https://learn.nlm.nih.gov/rest/training-packets/T0042010P.html. The American Indian and Alaska Native Health Web Portal has preformulated searches from this resource under each of its health topics. These links take the user directly into the PubMed database to review the very latest scientific research related to indigenous people and the specific health issue.