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Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
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Changing Numbers,
Changing Needs

American Indian Demography and Public Health

Gary D. Sandefur, Ronald R. Rindfuss
and Barney Cohen, Editors

Committee on Population

Commission on Behavioral and Social Sciences and Education

National Research Council

NATIONAL ACADEMY PRESS
Washington, D.C. 1996

Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
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NATIONAL ACADEMY PRESS 2101 Constitution Ave., N.W. Washington, D.C. 20418

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

Support for this project was provided principally by the Public Health Service of the U.S. Department of Health and Human Services. The National Institute of Aging also provided funding to the Committee on Population for this project.

Library of Congress Catalog Card No. 96-70052

International Standard Book Number 0-309-05548-2

Changing Numbers, Changing Needs: American Indian Demography and Public Health is available for sale from the National Academy Press, 2101 Constitution Avenue, N.W., Box 285, Washington, D.C. 20055. Call 800-624-6242 or 202-334-3313 (in the Washington Metropolitan Area). Order electronically via Internet at http://www.nap.edu.

Copyright 1996 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
×

Contributors

ANNIE C. ABELLO, Economics Program, Research School of Social Sciences, Australian National University

BARNEY COHEN, Committee on Population, National Research Council

PETER J. CUNNINGHAM, Center for Studying Health System Change, Washington, D.C.

EUGENE P. ERICKSEN, Departments of Sociology and Statistics, Temple University

ROBERT G. GREGORY, Economics Program, Division of Economics and Politics, Research School of Social Sciences, Australian National University

ROBERT JOHN, Minority Aging Research Institute, University of North Texas

JAMIE JOHNSON, Department of Economics, University of Chicago

CAROLYN A. LIEBLER, Center for Demography and Ecology, University of Wisconsin, Madison

PHILIP A. MAY, Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico

K.M. VENKAT NARAYAN, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services

JEFFREY S. PASSEL, The Urban Institute, Washington, D.C.

RONALD R. RINDFUSS, Carolina Population Center, University of North Carolina, Chapel Hill

GARY D. SANDEFUR, Department of Sociology, University of Wisconsin, Madison

C. MATTHEW SNIPP, Department of Rural Sociology, University of Wisconsin, Madison

RUSSELL THORNTON, Department of Anthropology, University of California, Los Angeles

RONALD L. TROSPER, Native American Forestry Program, Northern Arizona University

T. KUE YOUNG, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba

Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
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Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
×

Committee On Population

RONALD D. LEE (Chair),

Departments of Demography and Economics, University of California, Berkeley

CAROLINE H. BLEDSOE,

Department of Anthropology, Northwestern University

JOSE-LUIS BOBADILLA,

The World Bank, Washington, D.C.

JOHN BONGAARTS,

The Population Council, New York

JOHN B. CASTERLINE,

The Population Council, New York

LINDA G. MARTIN,

RAND, Santa Monica, California

ROBERT A. MOFFITT,

Department of Economics, Brown University

MARK R. MONTGOMERY,

The Population Council, New York

W. HENRY MOSLEY,

Department of Population Dynamics, Johns Hopkins University

ALBERTO PALLONI,

Department of Sociology, University of Wisconsin, Madison

ANNE R. PEBLEY,* RAND,

Santa Monica, California

RONALD R. RINDFUSS,

* Carolina Population Center, University of North Carolina, Chapel Hill

JAMES P. SMITH,

RAND, Santa Monica, California

BETH J. SOLDO,

Department of Demography, Georgetown University

MARTA TIENDA,

Population Research Center, University of Chicago

AMY O. TSUI,

Carolina Population Center, University of North Carolina, Chapel Hill

JOHN G. HAAGA, Director

BARNEY COHEN, Program Officer

TRISH DeFRISCO, Senior Project Assistant

KAREN A. FOOTE, Program Officer

JOEL A. ROSENQUIST, Project Assistant

JOYCE E. WALZ,** Administrative Associate

*  

through October 1995

**  

through May 1996

Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is interim president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and interim vice chairman, respectively, of the National Research Council.

Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
×

Preface

The Committee on Population was established by the National Research Council in 1983 to bring the knowledge and methods of the population sciences to bear on major issues of science and public policy. The committee's mandate is to conduct scientific assessments of major population issues and to provide a forum for discussion and analysis of important public policy issues related to population.

The papers in this volume were first presented at a Committee on Population workshop on the demography of American Indians and Alaska Natives. The workshop, which was held in May 1995 at the request of the Public Health Service, brought together researchers from different disciplines to discuss recent issues in American Indian demography and their implications for health service delivery. At that time, a number of alternative plans for reforming healthcare were being considered, each of which offered explicitly and implicitly different options for providing healthcare to beneficiaries of the IHS. The papers prepared for the workshop were not designed to present the needed information directly, but to provide background data that could be used by the Public Health Service and the IHS in preparing such estimates for their deliberations.

A major challenge for demographers concerned with American Indian and Alaska Native populations is to differentiate between changes in the size, characteristics, and distribution of these populations caused by fertility, mortality, and migration trends and changes caused by the increased tendency of people to identify themselves as Indians in response

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Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
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to census or survey questions on race, ethnicity, and ancestry. Over the last 20 years, changes in self-identification have been substantial and have affected estimates of birth and death rates, as well as estimates of the geographic and income distributions of American Indians.

Changes in self-identification and eligibility affect the estimates and projections, particularly the long-range projections, of the population relevant to Indian Health Service (IHS) and other agencies that provide services for American Indians. Many of the people newly identifying themselves as American Indian are unlikely to have been served in the past by the IHS. Hence, designing plans for coverage of eligible IHS beneficiaries, projecting enrollments, and estimating utilization and premiums, requires up-to-date estimates of the size, composition, distribution, economic characteristics, and health care needs of the potentially eligible populations.

This volume pulls together information on the demography and health status of American Indians. The work would not have been possible without the efforts of several people, but two deserve special recognition. First, the committee was extremely fortunate in being able to enlist the services of Gary D. Sandefur, a distinguished scholar of American Indian demography, to collaborate on the project and ensure that it was a success. Second, committee member Ronald R. Rindfuss worked diligently to organize the workshop and share the editorial duties for this volume. The committee expresses its heartfelt appreciation to both of them for contributing so much of their valuable time and expertise.

The committee is grateful to the Public Health Service for its financial support and to staff members Susanne Stoiber and Maruta Zitans for their interest and efforts during the development of the workshop. The Committee would also like to thank the National Institute on Aging for providing funding for this project.

Finally, we thank the staff at the National Research Council, who made it all possible. The work took place under the general direction of John Haaga, director of the Committee on Population. Barney Cohen, program officer, provided a constant intellectual and managerial presence for the project, from the organization of the workshop to the publication of this volume. Trish DeFrisco, senior project assistant, efficiently and diligently took care of all the logistical arrangements and prepared the papers for publication. We also thank Rona Briere for her skillful editing of the manuscript. We are grateful to them all.

Ronald D. Lee, Chair
Committee on Population

Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
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Suggested Citation:"Front matter." National Research Council. 1996. Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, DC: The National Academies Press. doi: 10.17226/5355.
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The reported population of American Indians and Alaska Natives has grown rapidly over the past 20 years. These changes raise questions for the Indian Health Service and other agencies responsible for serving the American Indian population. How big is the population? What are its health care and insurance needs?

This volume presents an up-to-date summary of what is known about the demography of American Indian and Alaska Native population—their age and geographic distributions, household structure, employment, and disability and disease patterns. This information is critical for health care planners who must determine the eligible population for Indian health services and the costs of providing them. The volume will also be of interest to researchers and policymakers concerned about the future characteristics and needs of the American Indian population.

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