This paper uses data from the 1997 and 1999 National Survey of America's Families to compare access and utilization between American Indians/Alaska Natives (AI/ANs) and non-Hispanic whites. We used multivariate regressions to adjust odds ratios for access and utilization and to estimate the effects of the Indian Health Service (IHS). AI/ANs had less insurance coverage and worse access and utilization than whites. However, among the low-income population, AI/ANs with only IHS access fared better than uninsured AI/ANs and as well as insured whites for key measures but received less preventive care. Over half of low-income uninsured AI/ANs do not have access to the IHS. The IHS partially offsets lack of insurance for some uninsured AI/ANs, but important needs were potentially unmet. (American Journal of Public Health 94(1): 5359, January 2004.)
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