Family structure matters for children’s health, and for their economic and developmental well-being. Some research finds that AIAN children in single-parent families show poorer health outcomes than their AIAN peers with two married parents. However, recent research highlights that protective and risk factors can change disparities in child outcomes across family structures. For example, access to extended family and traditional culture is linked with strong developmental outcomes; on the other hand, socioeconomic stress and perceived discrimination are associated with decreased well-being among AIAN children.

The diversity of AIAN family structures reflects AIAN families’ historical and contemporary cultural assets and structural barriers. Historical oppression (e.g., forced relocationand boarding schools) undermines AIAN families and transmits its impact to future generations. A continuing lack of health infrastructure and economic opportunity limits AIAN caregivers’ access to resources needed to stabilize their families and support their children’s needs. These challenges are present in multiple systems, including education, employment, housing, child care, and health care. In collectivist AIAN cultures—in which members of a clan share resources across actual and perceived kinship ties—many AIAN families extend support beyond biological parents, often to grandparents and other relatives, in the upbringing of their children. Some of these caregiving relationships are only partially captured in the ACS, as the survey collects information solely from individuals who live in the same household.

Effective policies that strengthen access to supports for parents and caregivers, such as those that increase access to the labor market and targeted income supports, can help reduce health and economic disparities across AIAN family structures by strengthening protective factors for all children, especially those in single-parent and non-parent families. This approach also has the potential to mitigate racial/ethnic disparities in undesirable outcomes between AIAN and other children, through reduced inequality by family structure.