Health and the Urban Indian

There have been numerous previous reports that indicate Indians living on or near reservations served by the U.S. Indian Health Service, the federal agency that serves the health care needs of American Indians living mostly on rural reservations, experience poorer health than other racial and ethnic groups in America. The new report by the UIHI is the most comprehensive study of its kind that specifically focuses on Indians living in urban environments. The new report was issued on the 10th anniversary of the first and only health status report on urban Indians, published in 1994 in the Journal of the American Medical Association.

The new study looked at census data from 1990 and 2000 as well as information from the National Center for Health Statistics and from a network of 34 Urban Indian Health Organizations in 82 counties across the United States that help urban Indians access health care. The study found that from 1990 to 1999 urban Indians experienced chronic liver disease at rates of 126 percent higher than the general population and alcohol related deaths at 178 percent higher than average. Diabetes among urban Indians was reported at 54 percent higher than the general population and the rates of death due to accidents were 38 percent higher. As alarming as those statistics are, they may still not reflect the true nature of the health plight of Indians living in urban areas.

"We believe these findings grossly underestimate the true extent of the problem,” said Ralph Forquera, Executive Director for the Seattle Indian Health Board and Director of the Urban Indian Health Institute. "We know, for example, many metropolitan areas do not keep good records on urban Indians. We also know there is significant racial misclassification on official records like birth and death certificates used to determine health statistics. The lack of sound record keeping has hampered our ability to accurately describe the problem."