Healthcare access, utilization, and care experiences for American Indian and Alaska Native populations

Despite targeted health reforms, differences in healthcare access, utilization, and mortality have persisted between American Indian and Alaska Native (AI/AN) and non-AI/AN people and within the AI/AN population.

Using the 2015-2019 Medical Expenditure Panel Survey Household Component (MEPS-HC), we examined healthcare access, utilization, and care experiences for AI/AN people relative to non-AI/AN people and disaggregate the AI/AN population by race (ie, single race and one or more races) and ethnicity (ie, Hispanic and non-Hispanic).

We found that AI/AN people had a lower probability of at least one dental and ambulatory visit annually than non-Hispanic White people. Conversely, non-Hispanic AI/AN people were more likely than non-Hispanic White people to have at least one emergency-department (ED) visit. Non-Hispanic AI/AN people who reported multiple races had higher rates of delayed or unmet needs due to cost than non-Hispanic White people. People solely identifying as AI/AN reported worse care experiences, and non-Hispanic AI/AN people rated their healthcare lower than non-Hispanic White people.

Our findings highlight the importance of efforts to improve healthcare access and care experiences of AI/AN people and shed light on how decisions about disaggregating race and ethnicity may affect study results.