Overview (Demographics): This population includes people having origins in any of the original peoples of North, South America, and Central America, who maintain tribal affiliation or community attachment. In 2020, an estimated 3.7 million people identified as American Indian and Alaska Native (AI/AN) alone, accounting for 1.1% of all people living in the United States. An additional 5.9 million people identified as American Indian and Alaska Native and another race group. Together, the AI/AN alone or in combination population comprised 9.7 million people (2.9% of the total U.S. population) in 2020.
As of 2022, there are 324 federally recognized American Indian reservations in the U.S. The 2020 Census reveals that 87 percent of those who identify as AI/AN alone or in combination population live outside of tribal statistical areas, 13 percent live on reservations or other trust lands.
60 percent of American Indians and Alaska Natives live in metropolitan areas, this is the lowest metropolitan percentage of any minority population. In 2020, 1 million American Indian and Alaska Natives alone were under the age of 18, which comprised 27 percent of this group in comparison to 18.9 percent of non-Hispanic whites. In 2019, ten states with the largest American Indian/Alaska Native populations were: Arizona, California, Oklahoma, New Mexico, Texas, North Carolina, Alaska, Washington, South Dakota, New York.
As of 2022, there are 574 federally recognized AI/AN tribes, and a number of tribes recognized at the individual state level. There are also many tribes that are not state or federally recognized. Federally recognized tribes are provided health and educational assistance through a government agency called Indian Health Service (IHS), an operating division within the U.S. Department of Health and Human Services. The IHS provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives who belong to 574 federally recognized tribes in 37 states. Typically, this urban clientele has less accessibility to hospitals, health clinics or contract health services provided by the IHS and tribal health programs. Studies on urban American Indian and Alaska Native populations have documented a frequency of poor health and limited health care options.
Since 1972, IHS has embarked upon a series of initiatives to fund health-related activities in off-reservation settings, which make health care services accessible to urban American Indians and Alaska Natives. Currently, the IHS funds 41 urban Indian health organizations, which operate sites located throughout the United States. Approximately 70 percent of American Indians and Alaska Natives live in urban areas, and are eligible to utilize this program. The programs administer medical services, dental services, community services, alcohol and drug use prevention, education and treatment, HIV and sexually transmitted disease education and prevention services, mental health services, nutrition education and counseling services, pharmacy services, health education, optometry services, social services, and home health care.
Language Fluency: In 2019, 26.7 percent of American Indians/Alaska Natives alone spoke a language other than English at home.
Educational Attainment: In 2019, 84.4 percent of American Indians and Alaska Natives alone or in combination had at least a high school diploma, as compared to 93.3 percent of non-Hispanic whites. 20.8 percent of American Indians and Alaska Natives age 25 and over had at least a bachelor's degree, in comparison to 36.9 percent of non-Hispanic whites. 7.6 percent of American Indians and Alaska Natives held an advanced graduate or professional degree, as compared to 13.9 percent of the non-Hispanic white population.
Economics: The median household income for American Indian and Alaska Natives is $49,906, as compared to $71,664 for non-Hispanic white households. 32.0 percent of American Indians and Alaska Natives age 16 and over work in management and professional occupations, in comparison to 44.8 percent of whites. Also in 2019, 20.3 percent of this population live at the poverty level, as compared to 9.0 percent of non-Hispanic whites. In 2019, the overall unemployment rate for American Indians/Alaska Natives was 7.9 percent, as compared to 3.7 percent for non-Hispanic whites.
Insurance Coverage: In 2019, 51.9 percent of American Indians and Alaska Natives alone or in combination had private health insurance coverage. 42.1 percent of AI/ANs relied on Medicaid or public health insurance coverage, and 14.9 percent of AI/ANs had no health insurance coverage. This compares to non-Hispanic whites by 74.7 percent, 34.3 percent, and 6.3 percent respectively.
Health: According to Census Bureau projections, the 2020 life expectancies at birth for American Indians/Alaska Natives are 78.4 years, with 81.1 years for women, and 75.8 years for men. For non-Hispanic whites the projected life expectancies are 80.6 years, with 82.7 years for women, and 78.4 years for men. It is significant to note that American Indians/Alaska Natives frequently contend with issues that prevent them from receiving quality medical care. These issues include cultural barriers, geographic isolation, inadequate sewage disposal, and low income.
Some of the leading diseases and causes of death among AI/AN are heart disease, cancer, unintentional injuries (accidents), diabetes, and stroke. American Indians/Alaska Natives also have a high prevalence and risk factors for mental health and suicide, unintentional injuries, obesity, substance use, sudden infant death syndrome (SIDS), teenage pregnancy, diabetes, liver disease, and hepatitis.
Other Health Concerns: The tuberculosis rate in 2019 was almost 7 times higher for American Indians/Alaska Natives, with an incidence rate of 3.4, as compared to 0.5 for the white population.1
Tribal Leader Letters
OMH CHAP Statement of Work Announcement [PDF | 73KB]
OMH CHAP Statement of Work Awardee Announcement [PDF | 51KB]
OMH & CDC Maternal Health Partnership Announcement [PDF | 213KB]
OMH CIIHE TAC Solicitation for Nomination Dear Tribal Leader Letter [PDF | 129KB]
- CIIHE Nomination Guidance [PDF | 106KB]
- CIIHE TAC Nomination Sample Letter (Elected Tribal Leader) [PDF | 148KB]
- CIIHE TAC Nomination Sample Letter (Individual Appointed by Tribal Leader) [PDF | 133KB]
OMH Center for Indigenous Innovation and Health Equity Feedback Listening Session:
Listening Session Announcement for Tribal Advisory Council (TAC) [PDF 62KB]
Listening Session Invitation [PDF 419KB]
Listening Session Presentation [PDF 887KB]
For more information about tribal health issues:
Indian Health Service
Bureau of Indian Affairs Tribal Leaders Directory
National Indian Health Board
Urban Indian Health Institute
Full Census Reports:
The American Indian and Alaska Native Population: 2010 [PDF | 2.9MB]
Native North American Languages Spoken at Home in the United States and Puerto Rico: 2006-2010 [PDF | 2.2MB]
Health Insurance Coverage in the United States: 2019 [PDF | 861KB]
Income and Poverty in the United States: 2019 [PDF | 1.45MB]
Projected Life Expectancy at Birth by Sex, Race, and Hispanic Origin for the United States: 2015 to 2060. Table 17
Census Bureau, 2021. 2019 American Community Survey 1-Year Estimates
1CDC, 2020. Tuberculosis Trends 2019.
Last Edited: 09/22/2023