... Indianhistory,healthissues,andchallengesexperiencedbythispopulationandtheUrbanIndianHealthOrganizationthatservethem.“Fewpeoplerealizethatthemajorityof American Indians andAlaskaNativesintheUnitedStatesarenowlivingin American cities,notonreservations.Yet,Federalhealthcarepolicytoward American Indians andAlaskaNativescontinuestofocuslargelyontheneedsofthoselivingonreservationsinruralareas—needsthat,despitedemonstrableprogresssincethecreationoftheIndianHealthService(I.H.S.)in1955,remainsubstantial(Kauffmanetal.,1997).ThepurposeofthisIssueBriefistodescribethelargeandgrowingurbanIndianpopulation,theirhealthstatus,andthemajorfederalhealthprograms(i.e.,I.H.S.andMedicare)andfederal‐stateprograms(i.e.,MedicaidandChildHealthInsuranceProgram)thatareavailabletoimproveNativeAmericans’accesstoneededhealthservices.Insettingforththecircumstancesofurban Indians, thisIssueBriefdoesnotintendtosuggestthatthehealthcareneedsofIndianpeoplelivinginruralareasareinanywaylesscompelling.AGrowingPopulationofUrban Indians In1990,overhalfofthe2million American Indians andAlaskaNativesintheUnitedStateslivedinurbanareas...Incontrast,anestimated430,000 Indians livedon279federalandstatereservationsthatyear,andanother40,000livedinAlaskaNativevillages(Snipp,1996).WhoareUrban Indians? Urban Indians aremembersof,ordescendantsofmembersof,oneofthemanyIndiantribesorotherorganizedgroupsofaboriginalinhabitantsoftheAmericaswholiveincities.TheIndianHealthCareImprovementActdefinestheterm“UrbanIndian”tomeananyindividualwho“residesinanurbancenter”…and“meetsoneormoreofthe four criteria”forqualifyingasan“Indian”undertheAct.Themigrationof Indians fromthereservationsto American citiesoccurredthroughoutthepastcenturyandisexpectedtocontinue.Theproportionof Indians livinginwhattheCensusBureaudefinesas“urbanizedareas”grewfrom45percentin1970to56percentin1990(U.S.CensusBureau,2001,personalcommunication).Historically,thismigrationreflectedfederalgovernment“relocation”policiesineffectduringthe1950’s.Over160,000 American Indians andAlaskaNativeswereforciblymovedfromtheirreservationsintocitiestopromoteassimilationintothedominantU.S.society(Kauffmanetal.,2000;Hall, ... OpportunitiesforChange:Improving the Health of American Indians/ Alaska Natives in Washington State American IndianHealthCareDeliveryPlan2010‐2013April2010 American Indian Health Commission ... Indianhistory,healthissues,andchallengesexperiencedbythispopulationandtheUrbanIndianHealthOrganizationthatservethem.“Fewpeoplerealizethatthemajorityof American Indians andAlaskaNativesintheUnitedStatesarenowlivingin American cities,notonreservations.Yet,Federalhealthcarepolicytoward American Indians andAlaskaNativescontinuestofocuslargelyontheneedsofthoselivingonreservationsinruralareas—needsthat,despitedemonstrableprogresssincethecreationoftheIndianHealthService(I.H.S.)in1955,remainsubstantial(Kauffmanetal.,1997).ThepurposeofthisIssueBriefistodescribethelargeandgrowingurbanIndianpopulation,theirhealthstatus,andthemajorfederalhealthprograms(i.e.,I.H.S.andMedicare)andfederal‐stateprograms(i.e.,MedicaidandChildHealthInsuranceProgram)thatareavailabletoimproveNativeAmericans’accesstoneededhealthservices.Insettingforththecircumstancesofurban Indians, thisIssueBriefdoesnotintendtosuggestthatthehealthcareneedsofIndianpeoplelivinginruralareasareinanywaylesscompelling.AGrowingPopulationofUrban Indians In1990,overhalfofthe2million American Indians andAlaskaNativesintheUnitedStateslivedinurbanareas...Incontrast,anestimated430,000 Indians livedon279federalandstatereservationsthatyear,andanother40,000livedinAlaskaNativevillages(Snipp,1996).WhoareUrban Indians? Urban Indians aremembersof,ordescendantsofmembersof,oneofthemanyIndiantribesorotherorganizedgroupsofaboriginalinhabitantsoftheAmericaswholiveincities.TheIndianHealthCareImprovementActdefinestheterm“UrbanIndian”tomeananyindividualwho“residesinanurbancenter”…and“meetsoneormoreofthe four criteria”forqualifyingasan“Indian”undertheAct.Themigrationof Indians fromthereservationsto American citiesoccurredthroughoutthepastcenturyandisexpectedtocontinue.Theproportionof Indians livinginwhattheCensusBureaudefinesas“urbanizedareas”grewfrom45percentin1970to56percentin1990(U.S.CensusBureau,2001,personalcommunication).Historically,thismigrationreflectedfederalgovernment“relocation”policiesineffectduringthe1950’s.Over160,000 American Indians andAlaskaNativeswereforciblymovedfromtheirreservationsintocitiestopromoteassimilationintothedominantU.S.society(Kauffmanetal.,2000;Hall,...