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- By Elyse Wild
States with the largest American Indian/Alaska Native populations have the worst health system outcomes for Native peoples, according to a new study.
The report, titled Advancing Racial Equity in U.S. Health Care: The Commonwealth Fund 2024 State Health Disparities Report,comes from the Common Wealth Fund, a private foundation that examines health care in the U.S. to advance equitable outcomes. It collected data for 25 indicators of health system performance, including access to and quality of care for Black, white, Hispanic, American Indian/Alaska Native and Asian American, Native Hawaiian, and Pacific Islander populations.
The report found the most significant disparities among Black and AI/AN people, who live fewer years than white and Hispanic people, are more likely to die of treatable diseases, have a higher risk of chronic illness and have higher rates of maternal and infant mortality. They are also among the least likely to have health insurance, receive preventable care such as vaccines, and are more likely to delay care because of access and cost.
North Carolina, New Mexico and California ranked highest in health outcomes for AI/AN, meanwhile Alaska, South Dakota, Montana, Arizona and North Dakota —states that have the highest Native populations— have among the lowest.
Native peoples in Wyoming, Montana, and North Dakota had among the highest rates of any group in any state for pre-mature avoidable mortality or death before the age of 75 from conditions considered to be preventable and treatable. The first year of COVID-19 deaths were factored into the report.
The study drew a correlation between lack of insurance coverage and access to care. Research has found that AI/AN has among the highest uninsured rates in every state. The Indian Health System (IHS) is the primary source of care in Indian Country, serving 2.6 million Native peoples, according to its website. It has been historically underfunded to the tune of billions of dollars. Its 2024 budget fell $43.64 billion short of what it requested from Congress. ‘
The report comes on the heels of a study published in the Journal of American Medical Association (JAMA) Psychiatry that found AI/AN have the highest rates of deaths of despair.
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