The health disparities faced by American Indians and Alaska Natives (AI/AN) are far greater than what official vital statistics report, according to a recent study led by a researcher from Boston University School of Public Health (BUSPH).
Published in JAMA, the study revealed that death certificates for over 41% of AI/AN individuals did not accurately identify them as such, often misreporting their race as “white.” This misclassification leads to a significant underestimation of AI/AN mortality rates, an overestimation of their life expectancy, and a minimization of the mortality disparities between AI/AN and other Americans.
The research shows that the actual life expectancy gap between AI/AN individuals and the national average is 6.5 years, nearly three times larger than previously reported. This gap has been increasing over the years, reaching 8 years between 2017-2019. On average, AI/AN life expectancy stands at 72.7 years, similar to countries like El Salvador and Bangladesh.
The study also highlights that AI/AN mortality rates are particularly high among young and middle-aged adults, surpassing the national average for both on and off-reservation AI/AN communities. Even AI/AN individuals with a college education have significantly shorter lifespans compared to non-AI/AN counterparts, with heart disease, cancer, and diabetes contributing to the major causes of mortality disparities.
The research team utilized data from the 2008 American Community Survey linked with mortality data from US vital statistics to accurately assess mortality rates among self-identified AI/AN individuals. Dr. Jacob Bor, the lead author of the study, emphasizes the historical erasure faced by Indigenous populations and the urgent need for accurate public health data to address the existing health inequities.
The study’s co-author, Dr. Michael Bird, emphasizes the ongoing impact of historical genocidal policies on AI/AN communities and stresses the importance of acknowledging and rectifying the gaps in data on Indigenous peoples’ health and mortality.
Moving forward, the researchers recommend increased collaboration with AI/AN tribes to ensure accurate measurement of AI/AN health data, updating misclassification ratios in vital statistics, and providing training for funeral directors to collect precise race and ethnicity information.
This study sheds light on the pressing need for improved data collection and healthcare investment to address the significant health disparities faced by American Indian and Alaska Native populations. For more information, you can access the full study published in JAMA.
