Health service access, use, and insurance coverage among American Indians/Alaska Natives and Whites: what role does the Indian Health Service play?
OBJECTIVE
We compared access and utilization of health services among American Indians/Alaska Natives (AIANs) with that among non-Hispanic Whites.


METHODS
We used data from the 1997 and 1999 National Survey of America's Families to estimate odds ratios for several measures of access and utilization and the effects of Indian Health Service (IHS) coverage.


RESULTS
AIANs had less insurance coverage and worse access and utilization than Whites. Over half of low-income uninsured AIANs did not have access to the IHS. However, among the low-income population, AIANs with only IHS access fared better than uninsured AIANs and as well as insured Whites for key measures but received less preventive care.


CONCLUSIONS
The IHS partially offsets lack of insurance for some uninsured AIANs, but important needs were potentially unmet.
Zuckerman
Stephen
S
Urban Institute, Health Policy Center, Washington, DC 20037, USA. szuckerm@ui.urban.org
Haley
Jennifer
J
Roubideaux
Yvette
Y
Lillie-Blanton
Marsha
M
D000293:Adolescent; D000328:Adult; D000413:Alaska; D002648:Child; D002675:Child, Preschool; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics; D006301:Health Services Needs and Demand; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011635:Public Health Administration / Q000191:economics / Q000592:standards*; D012959:Socioeconomic Factors; D014481:United States; D016549:United States Indian Health Service / Q000458:organization & administration*; D035862:Vulnerable Populations; D044465:White People / Q000706:statistics & numerical data*