Service (IHS) is a federal agency responsible for providing medical care to those who live on or near reservations. IHS estimates that it serves about 60 percent of the Native American or Alaska Native population. IHS data reveal that death rates for this population vary considerably from state to state, with rates being higher in states that have larger concentrations of Native Americans or Alaska Natives (IHS, 1997). In addition, there is considerable tribal-specific variation within a given state.

Similarly, the Hispanic category consists of more than 25 national-origin groups that share a common language, religion, and traditions, but vary dramatically in terms of the timing of immigration, regional concentration, incorporation experiences, and socioeconomic status. It is not surprising that there is also considerable variation in health status within the Hispanic group (Sorlie et al., 1993; Vega and Amaro, 1994).

The Asian or Pacific Islander population in the United States consists