Health care coverage and unemployment in the Bemidji Area: A profile on American Indians and Alaska Natives

Health insurance greatly increases a person’s ability to care for, and prevent many chronic diseases. The lack of health insurance can cause individuals to delay or avoid medical attention which can lead to uncontrolled health conditions such as type 2 diabetes or hypertension which can cause further deterioration of health. Unemployment can also affect an individual’s ability to obtain health insurance as well as lead to other behaviors, such as poor nutrition, that could have negative health consequences. By examining the ACS data regarding employment and health insurance valuable associations between these two variables can be made at the population level. There are very few AI/AN statistics regarding health insurance and employment in the Great Lakes region. These two factors can greatly affect various aspects of physical, mental, and emotional health. The data used was from the American Community Survey (ACS), a supplement to the census, the data specifically used were from 2011-2015. Overall the ACS data showed what was expected, that AI/AN had higher unemployment rates and higher uninsured rates when compared to white Americans. Wisconsin, the only one of the three states that did not expand Medicaid, surprisingly had higher insurance rates than Minnesota. Further exploration of literature showed that both Wisconsin and Minnesota have additional public health programs to provide insurance for up to 200% of the federal poverty level. Although these programs have decreased uninsured rates, large disparities exist between white Americans and AI/AN. Further work needs to be done to eliminate these disparities, possibly minority specific public health insurance programs could be introduced to decrease these gaps. The Indian Health Service could possibly expand their insurance program to be more widely accepted at general primary care physicians to encourage more AI/AN to enroll. Another possible solution is creating more urban tribal centers that accept IHS insurance.