Prevalence and Risk for Negative Disability Outcomes Between American Indians-Alaskan Natives and Other Race-Ethnic Groups in the Southwestern United States

In the USA, some race-ethnic minorities are unjustly relegated to the margins of society. As a consequence, these groups are more frequently found to have risk profiles associated with adverse health than individuals from the majority group (non-Hispanic Whites). Limited research has been devoted to investigating how American Indians and Alaska Natives (AIANs) differ from other race-ethnic minorities and the majority group with regard to prevalence and risk for self-care, independent living, and ambulatory disabilities. Our investigation attempts to quantify both of these tracks by accounting for race-ethnic and poverty status. Our crosssectional analysis used nationally representative data from the American Community Survey (ACS) 5-year (2009-2013) Public Use Microdata Sample (PUMS) file to address this literature gap. We selected survey participants from the four states with the largest concentration of AIANs in the USA (Arizona, California, New Mexico, and Oklahoma). We used information on 2,428,233 individuals to generalize prevalence of and risk for disability to 49,994,332 individuals in the Southwest US. We found disability (self-reported) prevalence differed between our six race-ethnic groups in statistically significant and complex ways. Population-weighted logistic regression analyses adjusting for age, sex, and citizenship found AIANs have a higher risk for disability than non-Hispanic Whites, non-Hispanic Asians, and Hispanics. In order to impact public health and build a more equitable society, efforts should continue to identify health disparities. Researchers should continue to advance conceptual frameworks on plausible causal mechanisms between markers of social stratification and disablement processes.