The health status of urban Indian elders
Nearly equal numbers of American Indian and Alaska Native (AI/AN) elders live in urban and in rural reservation areas, yet the specific issues of the urban population have not been addressed. Urban AI/ANs may not benefit from special federal or tribal health and supportive services; however, a National Indian Council on Aging (NICOA) study found that even in middle age, AI/ANs suffer physical, emotional and social impairments that are more characteristic of the general U.S. population age 65 or older. Most of the information available on the overall health of urban AI/AN elders was collected in surveys conducted in Los Angeles, Phoenix, and in a multi-site survey of Pittsburgh, Tulsa, Denver, Minneapolis, and Tacoma. This article focuses mostly on the results of the Los Angeles surveys. These particular surveys reveal that health care is the number one concern of elders in that area. Self-reporting showed that the incidence of chronic diseases varied from the results of other surveyed populations. The surveys also assessed behavioral health and involvement in daily living activities. Significant health risks emerged for women. The Los Angles project also documented the services which elders deemed important. These included health screenings, exercise classes, rehabilitation, and health counseling. The elders also wanted improved social services to enhance the quality of their lives and to address the problem of isolation. A large portion of this article explains the problems of data collection and interpretation in AI/AN surveys. Addressing these problems is necessary in order to develop a systematic and efficient database that will allow for the assessment of morbidity and mortality and for the development of projections for demands on health care systems. Equally important is the need to develop health services models that will optimize care for aging urban elders.