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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2004.053942v1 96/8/1478    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Castor, M. L. Articles by Forquera, R. A. Search for Related Content PubMed PubMed Citation Articles by Castor, M. L. Articles by Forquera, R. A. Related Collections Birth Outcomes Pregnancy Native Americans Socioeconomic Factors Mortality Urban Health

Mei L. Castor, MD, MPH, Michael S. Smyser, MPH, Maile M. Taualii, MPH, Alice N. Park, MPH, Shelley A. Lawson, MPA and Ralph A. Forquera, MPH

Mei L. Castor, Maile M. Taualii, Alice N. Park, and Ralph A. Forquera are with the Urban Indian Health Institute, Seattle Indian Health Board, Seattle, Wash. Mei L. Castor is also with the Indian Health Service, Albuquerque, NM. Michael S. Smyser and Shelly A. Lawson are with Public Health–Seattle and King County, Seattle.

Correspondence: Requests for reprints should be sent to Mei L. Castor, MD, MPH, Urban Indian Health Institute, Seattle Indian Health Board, PO Box 3364, 606 12th Ave S, Seattle, WA 98114 (e-mail: meic{at}uihi.org).

Objectives. Despite their increasing numbers, little is known about the health of American Indians/Alaska Natives living in urban areas. We examined the health status of American Indian/Alaska Native populations served by 34 federally funded urban Indian health organizations.

Methods. We analyzed US census data and vital statistics data for the period 1990 to 2000.

Results. Disparities were revealed in socioeconomic, maternal and child health, and mortality indicators between American Indians/Alaska Natives and the general populations in urban Indian health organization service areas and nationwide. American Indians/Alaska Natives were approximately twice as likely as these general populations to be poor, to be unemployed, and to not have a college degree. Similar differences were observed in births among mothers who received late or no prenatal care or consumed alcohol and in mortality attributed to sudden infant death syndrome, chronic liver disease, and alcohol consumption.

Conclusions. We found health disparities between American Indians/Alaska Natives and the general populations living in selected urban areas and nationwide. Such disparities can be addressed through improvements in health care access, high-quality data collection, and policy initiatives designed to provide sufficient resources and a more unified vision of the health of urban American Indians/Alaska Natives.

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