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. 2020 Sep 18;69(37):1283–1287. doi: 10.15585/mmwr.mm6937a2

FIGURE.

The figure is a U.S. map divided into six regions in which counties designated as Purchase/Referred Care Delivery Areas by the Indian Health Service during 2013–2017 are identified by shading.

Indian Health Service (IHS) Purchased /Referred Care Delivery Area (PRCDA)* counties, by region — United States, 2013–2017

Abbreviation: AI/AN = American Indian and Alaska Native.

* PRCDA consist of counties that contain federally recognized tribal lands or are adjacent to tribal lands. Race classification for the AI/AN population is more accurate in these counties. States that have at least one PRCDA-designated county, by region and percentage of total AI/AN population residing in PRCDA counties, include Alaska (100%) (Alaska), Pacific Coast (60.3%) (California, Idaho, Oregon, and Washington), Southwest (83.9%) (Arizona, Colorado, Nevada, New Mexico, and Utah), Northern Plains (54.3%) (Indiana, Iowa, Michigan, Minnesota, Montana, Nebraska, North Dakota, South Dakota, Wisconsin, and Wyoming), Southern Plains (56.7%) (Kansas, Oklahoma, and Texas), and East (16.8%) (Alabama, Connecticut, Florida, Louisiana, Maine, Massachusetts, Mississippi, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, and Virginia). In the United States, 53.3% of the AI/AN population reside in PRCDA counties.