The relatively poor health and healthcare of Native Americans is well documented. However, the existing research does not adequately consider unique tribal experiences in shaping Native American health. Consequently, the purpose of this paper is to assess the role of tribes in explaining measures of healthcare and the perceptions of health-related problems. Employing interview data from 219 members of the Omaha Tribe and Santee Sioux Nation in rural Nebraska, it is found that significant tribal distinctions exist in terms of health status, health access, and the perceptions of community issues related to health and healthcare. These differences are linked with the unique experiences of the tribes as a way to illustrate the need for researchers and policy makers to consider the role tribes play in shaping health.

The economic fallout from the Great Recession has not been experienced similarly across the United States. Therefore, our understanding of well-being is enhanced by analyzing state-level data. This study employs survey data of Nebraskans compiled shortly after the recession to assess factors affecting healthcare affordability and access. Findings show that the affordability of health care for households is significantly affected by income (i.e., as income increases, problems with affordability decrease) and household size (i.e., as household size increases, problems with affordability increase). Someone in the single-and two-parent household being unemployed and having children in the household also are predictors of increased problems affording health care. Key predictors of individuals delaying health care due to costs are lower income, less education, and being younger. Other contributing factors toward delaying health care are being more affected by the economic downturn, being female, living in rural counties, having more people in the household, and not using a regular physician for routine care.