Occupational Determinants of Health and Well-Being for Indigenous Populations in the United States: Findings From the National Health Interview Survey, 2020-2022.

Objectives. To characterize occupational determinants of health and well-being for American Indian/Alaska Native (AIAN) populations in the United States using a nationally representative data set. Methods. We conducted a descriptive analysis and multivariable logistic regression using National Health Interview Survey data (2020-2022) to compare demographic and work characteristics across 3 groups of AIAN individuals: non-Hispanic (n = 558), Hispanic (n = 304), and those with at least 1 other racial identity (n = 653). The total unweighted sample was 88 701. Results. The 3 subgroups portrayed contrasting profiles by urbanicity, employment, region, and immigrant status. Specific groups had significantly lower odds of working and participating in the labor force and were more likely to have a family income below 200% of the poverty line, adjusting for age, education, and sex. Conclusions. Differences among the groups highlight the need for future health research to account for cultural, social, spiritual, mental, and physical health factors across Indigenous nations. Expanding beyond broad AIAN classifications could improve the specificity of occupational health research. Public Health Implications. The current definitions of Indigenous groups proposed by the US government directly impedes appropriate public health analysis to inform future work to address ongoing social, structural, and health disparities owing to colonization. (Am J Public Health. Published online ahead of print March 6, 2025:e1-e11. https://doi.org/10.2105/AJPH.2024.307959).