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 populationâ€"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.

HUD has traditionally provided federal housing assistance to Native Americans through many of the same programs that have provided public housing to the nation's low-income families. However, this changed significantly on October 26, 1996, when the President signed the Native American Housing Assistance and Self-Determination Act of 1996 (NAHASDA) into law. This act separated Indian housing programs from public housing programs and provides federal housing assistance for Indian tribes in a manner that recognizes the tribes' right of self-determination and self-governance. This report examines certain aspects of HUD's implementation of NAHASDA.

If you want to know why American Indians have the highest rates of poverty of any racial group, why suicide is the leading cause of death among Indian men, why native women are two and a half times more likely to be raped than the national average and why gang violence affects American Indian youth more than any other group, do not look to history. There is no doubt that white settlers devastated Indian communities in the 19th, and early 20th centuries. But it is our policies today—denying Indians ownership of their land, refusing them access to the free market and failing to provide the police and legal protections due to them as American citizens—that have turned reservations into small third-world countries in the middle of the richest and freest nation on earth. The tragedy of our Indian policies demands reexamination immediately—not only because they make the lives of millions of American citizens harder and more dangerous—but also because they represent a microcosm of everything that has gone wrong with modern liberalism. They are the result of decades of politicians and bureaucrats showering a victimized people with money and cultural sensitivity instead of what they truly need—the education, the legal protections and the autonomy to improve their own situation. If we are really ready to have a conversation about American Indians, it is time to stop bickering about the names of football teams and institute real reforms that will bring to an end this ongoing national shame.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.