Health outcomes in a national sample of American Indian and Alaska Native adults: Differences between multiple-race and single-race subgroups

• Published in: PloS one Vol. 15; no. 12; p. e0242934
• Main Authors: Running Bear, Ursula, Asdigian, Nancy L, Beals, Janette, Manson, Spero M, Kaufman, Carol E
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.12.2020; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Alaska Natives - statistics & numerical data; American Indian or Alaska Native - statistics & numerical data; American Indians; Asian Americans; Biology and Life Sciences; Chronic diseases; Chronic illnesses; Demographic aspects; Diagnosis; Discrimination; Earth Sciences; Female; Health aspects; Health behavior; Health care; Health care access; Health care expenditures; Health care services accessibility; Health risk assessment; Health risks; Health services; Health Status; Humans; Male; Medicine and Health Sciences; Mental health; Middle Aged; Native Americans (United States); Native North Americans; Obesity; Public health; Race; Racial differences; Racial Groups - statistics & numerical data; Racial identity; Regression analysis; Regression models; Research and Analysis Methods; Risk analysis; Risk behavior; Risk factors; Risk taking; Skin cancer; Social Sciences; Subgroups; Surveillance; Urban areas; White people; Young Adult; United States; United States > US; Alaska; Colorado
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0242934

To determine differences among multi-race (MR) American Indian and Alaska Natives (AIAN), single race (SR) AIANs, and SR-Whites on multiple health outcomes. We tested the following hypotheses: MR-AIANs will have worse health outcomes than SR-AIANs; SR-AIANs will have worse health outcomes than SR-Whites; MR-AIANs will have worse health outcomes than SR-Whites. Behavioral Risk Factor Surveillance System data were used to examine general health, risk behaviors, access to health care, and diagnosed chronic health conditions. Those identifying as SR-White, SR-AIAN, and MR-AIAN were included in multinomial logistic regression models. Compared to SR-AIANs, MR-AIANs had more activity limitations, a greater likelihood of experiencing cost as a barrier to health care and were more likely to be at increased risk and diagnosed with more chronic health conditions. Both SR and MR-AIANs have worse health than SR-Whites; MR-AIANs appear to be at increased risk for poor health. The current study examined access to health care and nine chronic health conditions, neither of which have been considered in prior work. MR AIANs are at increased risk compared to SR groups. These observations beg for further inquire into the mechanisms underlying these differences including stress related to identify, access to care, and discrimination. Findings support the continued need to address health disparities among AIANs regardless of SR or MR identification.