A Look at End-of-Life Care Issues for Native Americans More than
4 million people in the United States identify themselves as
either American Indian or Alaska Native (AI/AN), a diverse group
of people who come from more than 500 tribes. Access to quality
health care by AI/AN is often compromised by poverty, lack of
health insurance, and the fact that many live in isolated
regions. Although as a group, AI/AN have a lower incidence of
most types of cancer than non-Hispanic white Americans, they are
more likely to be diagnosed with late-stage disease, and their
cancer survival is generally poorer than that of other groups.
Yet despite this burden, their access to palliative care,
hospice, and end-of-life services lags behind the rest of the
nation. The AI/AN populations need these services not only for
cancer patients, but also for patients with other diseases that
are more common in the AI/AN population than the white
population—diseases such as diabetes, tuberculosis, pneumonia
and influenza, and gastrointesti