LGBP+ AIAN adults in California with hypertension are twice as likely to have uncontrolled high blood pressure (37%), compared with heterosexual AIAN adults (16%).
AIAN adults in California have diabetes, similar to all California adults (11%).
Summary
Published Date: July 23, 2026
American Indian and Alaska Native (AIAN) populations face significant chronic disease and substance use burdens compared to other populations. However, the differences that exist within this broader population remain understudied in California. Using combined 2020–2024 California Health Interview Survey (CHIS) data for AIAN adults, this policy brief highlights variations in chronic conditions and substance use across AIAN subpopulation groups.
Selected Findings
- American Indian and Alaska Native (AIAN) adults in California experience substantial burdens of chronic conditions, including diabetes, heart disease, hypertension, and uncontrolled blood pressure, and of substance use including smoking, marijuana use, and binge drinking.
- These burdens are not shared equally across AIAN subpopulations, those with lower incomes or lower educational attainment reported higher rates of living with diabetes and uncontrolled blood pressure.
- Among AIAN adults living with hypertension, those identifying as lesbian, gay, bisexual, pansexual, or another nonheterosexual identity (LGBP+) were more than twice as likely as heterosexual adults to have uncontrolled blood pressure.
- Substance use also differed by income, with smoking more common among lower-incomes AIAN adults and binge drinking more common among higher-income adults.
- Marijuana use was markedly higher among LGBP+ and transgender and gender-expansive AIAN adults than their heterosexual and cisgender peers.
