American Indian Culture and Research Journal

INTRODUCTION Today slightly over half of the 1.5 million American Indians and Alaska Natives live in towns, cities, and other off-reservation communities in the United States. This migration to the urban areas has increased dramatically during the last two decades. The increase began during the 1950s and 1960s with the relocation of Indians to the cities, and was partially financed by the federal government. Indian families were encouraged to leave the reservations and migrate to the cities to obtain jobs and to avail themselves of other economic opportunities. In many instances, leaving the reservation meant also leaving behind the support of kin and access to free medical care. Once in the cities, most Indian families found themselves living in urban ghettos with few resources to cope with the new environment and its foreign institutions and rules. In time of sickness, many Indian relocatees found themselves denied, declared ineligible for, and/or unable to afford medical care in the cities. As more and more Indians migrated to the cities, their health problems increased, and concerns over their access to health care escalated. Fortunately, with the advent of consumer health movements in the 1960s, a number of “store front” free clinics serving Indian clients sprang up in cities across the country. Over a period of time, many of these initial “store front” clinic operations became eligible for federal funding as part of a network of urban-based Indian health clinic.