The American Indian or Alaska Native (AIAN) population are persons having origins in any of the original populations of North, Central, or South America who maintain tribal affiliation or community attachment. The 2000U.S. Census showed that 4.3 million (1.5%) adults in the United States wereAIAN. Approximately 56% (2.4 million) of AIAN adults are of one race or ethnicity, whereas the remaining 44% are AIAN in combination with one or more other races. The AIAN population is heterogeneous, with 569 federally recognized tribes, as well as numerous other tribes not federally recognized (1). Although AIAN persons live throughout the United States, they are more likely to live in some areas of the country than others. According to the 2000 census, 43% of AIAN population lived in the West, 31% lived in the South, 17% lived in the Midwest, and 9% lived in the Northeast.