The United States population growth rate continues to increase gradually by less than 1% per year. Over the past decade, American Indians and Alaska Natives (AIANs) population increased by 26.7%.1 According to 2010 census, there are approximately 5.2 million AIANs living in the United States representing 1.7% of the U.S. population.2 By 2050, the projected population of AIANs will reach an estimated 8.6 million.2 Alaska Natives (AN) comprise of the second largest population group in Alaska. They make up a bigger percentage of Alaska’s population than Native Americans in any other state. AN faces disadvantages when it comes to health care equity, quality, and accessibility. It is important to address health disparities in AN, since their mortality rates are significantly higher, relative to U.S. white residents (USW), in 9 of 10 leading causes of deaths in the United States. Alaska has many challenges and possible unique opportunities due to its vast size and numerous isolated rural communities to improve quality of life in the AN population.
In 2011, the proportion of Alaska’s population identified as Natives was 19.7%.3 AN have seen a big demographic change over the past 50 years. The population has tripled between 1960 and 2010, increasing from 42,522 in 1960 to 138,312 in 2010.4 The term Alaska Native is used to refer to the original inhabitants of the land that is now the state of Alaska. Alaska’s indigenous people can be divided into three major ethnic groups: Aleuts, Eskimos and Indians. However there are many different subgroups within these major groupings. Currently, there are over 550 different federally recognized tribes throughout the United States. 228 of the federal approved tribes can be found in Alaska.5
Alaska has a diverse geographic and demographic characteristic which have a profound impact on public health. Due to its size, Alaska averages slightly over one person per square mile.6 AN live in all areas of the state from small isolated communities to major urban centers. In 2000, 43% of Natives lived in urban Alaska areas.7 However AN living in urban areas, account for only 10% of the urban population. Whereas the other 57% of AN reside in rural or remote communities. AN living in these areas make up the majority of the population in villages and about 75% in surrounding communities.7 Although these groups differ in culture, language, education, income, social and economic status, their access to health care are similar.
AN communities face many health changes and continue to experience lower health status when compared to non-Natives. Mortality rates are 33% higher for AN compared to the USW.8 During 2004-2008, AN experienced an average of 28.7 years of potential life lost from all-causes.8 Leading causes of death among AN are cancer, cerebrovascular diseases, chronic liver disease and cirrhosis, chronic obstructive pulmonary diseases, diabetes, pneumonia and influenza, alcohol...