Barriers and Survival: A Study of an Urban Indian Health Center

Abstract

Today slightly over half of the 1.5 million American Indians and Alaska Natives live in towns, cities, and other off-reservation communities in the United States.' This migration to the urban areas has increased dramatically during the last two decades. The increase began during the 1950s and 1960s with the relocation of Indians to the cities, and was partially financed by the federal government. Indian families were encouraged to leave the reservations and migrate to the cities to obtain jobs and to avail themselves of other economic opportunities.21 3 In many instances, leaving the reservation meant also leaving behind the support of kin and access to free medical care. Once in the cities, most Indian families found themselves living in urban ghettos with few resources to cope with the new environment and its foreign institutions and rules. In time of sickness, many Indian relocatees found themselves denied, declared ineligible for, andlor unable to afford medical care in the cities. As more and more Indians migrated to the cities, their health problems increased, and concerns over their access to health care escalated. Fortunately, with the advent of consumer health move