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Stagnating Life Expectancy Among American Indians and Alaska Natives: Understanding the Drivers and Recommendations
Valarie Blue Bird Jernigan1, Tara L Maudrie2, Susanna V Lopez1
1Center for Indigenous Health Research and Policy, Center for Health Sciences, Oklahoma State University, Tulsa, Oklahoma, USA;
None:
Life expectancy among American Indians and Alaska Natives (AI/ANs) has declined from 72 years in 2019 to 68 years in 2021. This current life expectancy for AI/ANs is equivalent to the overall life expectancy in the United States population in the 1940s. The significant and persistent nature of AI/AN health inequities, and the lack of clarity around what is driving them, requires urgent action. The purpose of this article is threefold. First, we provide a comprehensive conceptual framework of health that presents Indigenous perspectives of health and recognizes settler colonialism as a key structural determinant of the health of AI/ANs. Second, we underscore the importance of Tribal self-determination and sovereignty in public health research and practice and identify successful initiatives centering these efforts. Finally, we conclude with recommendations for future research, practice, and policy.
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