Native American Life Expectancy Increases but Still Lowest Among U.S. Populations

New health data released last week showed that life expectancy rates for American Indian and Alaska Natives increased by 4.5 years, the largest increase among racial and ethnic groups,according to a new KFF analysis of mortality rates from 2021-2023.

American Indian and Alaska Natives (AI/AN) still have the lowest life expectancy of any racial group, at just 70.1 years.That’s eight years less than white people (78.4) and 15 years less than Asian populations (85.2), which has the highest life expectancy in the United States. The analysis points to several systemic factors driving the gap, including a lack of access to health care stemming from the chronically underfunded Indian Health Service  and higher rates of uninsured Native people.

COVID-19 Decline

The KFF analysis notes that life expectancy data is available through 2024. The most current demographic breakdown is from  2023.

In 1940, according to the National Council of Urban Indian Health (NCUIH), the life expectancy rate for Native people was 51.6 years. It climbed in each following decade, reaching 71.8 in 2019.

COVID-19, disproportionately affected Indian Country as Native communities saw the high rates of death from the virus. This caused a sharp decline in life expectancy rates that dipped to 65.2 by 2021. Healthier lifestyles and longer lives for Native people has since rebounded, 2024 estimates are signaling a return to pre-COVID-19 levels, according to KFF.

Falling rates of COVID-19 were not the only contributors of the increase in life expectancy among Native people, but also declines in chronic liver disease, heart disease, diabetes, and accidents, according to the new data.The leading cause of death in Indian Country, and most Americans, is heart disease.

The Driving Factors

Native communities face poorer health outcomes than other populations due to long-standing systemic racism and barriers that restrict access to care.

The IHS, which provides healthcare for millions of Native peoples across Indian Country, has never been fully funded. The agency’s current budget is $54 billion short of the recommended amount to fully fund it. For decades, the agency has operated with an average staffing shortage of 25%; in some areas, it has been as high as 46%.

Native people are also less likely to be insured than other populations. Research finds that uninsured people face a 40% higher mortality rate than those with coverage.

Medicaid is crucial for bridging the gap for Native people who need specialized care beyond what their IHS hospital can provide.

Changes to Medicaid work requirements in President Trump’s massive spending bill have  further strained the agency.Medicaid accounts for 30-60% of overall funding at many IHS facilities. In 2025, the IHS billed approximately $1.3 billion to Medicaid

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