ABSTRACT
There are 5.2 million American Indians and Alaska Natives (AI=AN) living in the United States, representing approximately 1.7% of the U.S. total population (U.S. Census, 2010). The AI=AN population is heterogeneous, comprised of 566 federally recognized tribes that speak more than 200 different languages (U.S. Department of the Interior, 2014). Approximately 22% live on reservations or trust land, which are frequently located in isolated rural areas;
60% live in metropolitan areas (Artiga, Arguello, & Duckett, 2013); and 18% live in rural areas. In addition to differences in living environments, there are differences in acculturation, religious and spiritual beliefs, illness causation, and help-seeking behaviors for health care. In regard to health issues, there is limited information available, and even less on chronic pain and disabilities for this population (Altman & Rasch, 2003).
