Dotted primarily across the west, these 43 counties are marked by large Native American populations – more than half the people who live in these counties overall are indigenous Americans.
The Native American Lands are one of the smallest community types, housing only 823,000 people. These are not wealthy places, with a median household income of about $44,900. Health behaviors fare worse here than across the other types. About 29% of adults in the Native American Lands are current smokers, 13% more than the national average. Obesity is also a problem in these communities, with cases of adult obesity rising above the national average by 7 percentage points. The people in these areas have limited access to exercise opportunities, with only 37% of the population receiving adequate access to facilities for physical activity. Likely due to the poor health behaviors, more than one quarter of the population reports fair or poor health, well above the national average of 17%.