ArticleSocial science & medicine (1982)2021
Producing insecurity: Healthcare access, health insurance, and wellbeing among American Indian elders.
Article in Social science & medicine (1982), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 39 citations in OpenAlex.
- Development and Validation of a Brief Healthcare Insecurity Scale in a Sample of US Adults Living With and Without HIV.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2026Article
- Risk factors and population attributable fraction for dementia in American Indians: The Strong Heart Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Epidemiological trends in diabetic renal complications in United States adults: A center for disease control and prevention wide-ranging online data for epidemiologic research analysis (1999-2020).World journal of nephrology · 2025Article
- Cultural Factors Predict Positive Caregiving Appraisal Among Racially and Ethnically Diverse Dementia Family Caregivers.Journal of gerontological social work · 2025Article
- Patterns of Health Care Access and Use in an Urban American Indian and Alaska Native Population.Journal of racial and ethnic health disparities · 2024Article
- Outcome Disparities in Total Knee and Total Hip Arthroplasty among Native American Populations.Journal of racial and ethnic health disparities · 2024Article
- Trusted Communicators: The Role of Navigation Support in Improving Health and Health Care Access for American Indian Elders.Journal of health care for the poor and underserved · 2024Article
- American Indians travel great distances for obstetrical care: Examining rural and racial disparities.Social science & medicine (1982) · 2023Article
- Diverse rural caregivers for individuals with Alzheimer's disease or related dementias: analysis of health factors at the individual, interpersonal, and community level.Aging & mental health · 2023Article
- "I Think [Western] Healthcare Fails Them": Qualitative Perspectives of State-recognized Women Tribal Members on Elders' Healthcare Access Experiences.American Indian and Alaska native mental health research (Online) · 2023Article
- "There's so much they don't cover:" Limitations of healthcare coverage for Indigenous women in a non-federally recognized tribe.SSM. Qualitative research in health · 2022Article
- Experiences of Health Insurance among American Indian Elders and Their Health Care Providers.Journal of health politics, policy and law · 2022Article
- Assessing researchers' capabilities, opportunities, and motivation to conduct equity-oriented dissemination and implementation research, an exploratory cross-sectional study.BMC health services research · 2022Article
- The Community as the Unit of Healing: Conceptualizing Social Determinants of Health and Well-Being for Older American Indian Adults.The Gerontologist · 2022Article
- Healthcare experiences of uninsured and under-insured American Indian women in the United States.Global health research and policy · 2022Article
- Causes and Consequences of Not Having a Personal Healthcare Provider Among American Indian Elders: A Mixed-Method Study.Frontiers in public health · 2022Article
- Getting to Know: American Indian Elder Health Seeking in an Under-funded Healthcare System.SSM. Qualitative research in health · 2021Article
- Macro- and meso-level contextual influences on health care inequities among American Indian elders.BMC public health · 2021Article
- Using Concept Mapping to Understand Gender- and Age-Specific Factors Influencing Health Care Access among American Indian Elders.American Indian and Alaska native mental health research (Online) · 2021Article
- Considerations for disclosing Alzheimer's disease risk and biomarker results in a Pueblo community in Southwest United States.Alzheimer's & dementia (Amsterdam, Netherlands)Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Although health care is a treaty-guaranteed right for members of federally recognized tribes, decades of research describe persistent disparities in health and access to health services for American Indians. Despite gains in insurance enrollment after the passage of the 2010 Affordable Care Act, underfunding of the Indian Health Service and national debate over the new health law contributes to insecurity, especially among the majority of American Indians aged 55 and older who rely on public insurance. We consider the production of insecurity surrounding health care for American Indian elders, analyzing its pragmatic and affective consequences. Between June 2016 and March 2017, we conducted 96 quantitative surveys and in-depth qualitive interviews with American Indian elders aged 55 and older in two states in the U.S. Southwest. Interviews were recorded, professionally transcribed, and analyzed iteratively using open and focused coding. We found that elders consistently shared discourses of doubt, fear, and uncertainty that centered on: 1) interactions with healthcare providers and facilities, especially the IHS; 2) calculations regarding health insurance and the potential costs of healthcare services; and 3) dynamics at the national level around health policy, particularly for American Indians. We argue that persistent perceptions of healthcare insecurity present a major barrier to wellbeing that remains unaddressed by existing health policy interventions for this population, which focus predominately on individual-level knowledge and behavior.
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Registered trials
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