Supporting and Promoting Native American Health
In 1990, then President George H.W. Bush signed a joint Congressional resolution designating November as Native American Heritage Month. Native American communities and culture are strongly rooted in community health and healing, an emphasis that has supported generations of Native Americans, despite experiencing past systemic atrocities.
This November, in recognition of the annual observance, Trust for America’s Health (TFAH) urges federal lawmakers to address hardships within Native American communities caused by government actions of past eras and to renew its commitment to improving health outcomes for Native American peoples by removing barriers to federal funding and by fully respecting Tribal Nations’ right to self-determination.
TFAH’s Pathway to a Healthier America: A Blueprint for Strengthening Public Health for the Next Administration and Congress outlines several recommendations that the Administration and Congress taking office in January should act on to help promote healthier tribal communities and reduce health disparities that have long burdened Native American populations.
The well-documented history of forced removal from original homelands and assimilation away from cultural and generational ties, along with centuries of underinvestment and underfunding of tribal communities, have perpetuated the poor health outcomes seen in American Indian/Alaska Native populations. Nearly 30 percent of American Indian/Alaska Native high schoolers have obesity, according to TFAH’s 2024 State of Obesity report – the highest rate among populations groups in the United States. The report also noted that 45 percent of American Indian/Alaska Native adults had obesity, according to a self-reported study. That was higher than white adults at 34 percent.
American Indian/Alaska Native adults also have the highest rates of drug overdose, alcohol-related deaths, and suicide deaths as compared to other population groups, as noted in the latest edition of our Pain in the Nation report.
Despite the loss of much of cultural and ancestral homelands, many traditional Native American health practices are still used to this day. In October 2024, the Centers for Medicare & Medicaid Services announced an historic action for Medicaid and the Children’s Health Insurance Program to cover traditional health care practices when provided by Indian Health Service facilities.
TFAH’s Blueprint report details several additional recommendations to advance the federal government’s trust responsibility and treaty obligations to promote tribal self-government and support the health and well-being of Native populations. Those recommendations include removing barriers that currently exist to fully funding the programs identified in Executive Order 14112 – Reforming Federal Funding and Support for Tribal Nations to Better Embrace Our Trust Responsibilities and Promote the Next Era of Tribal Self-Determination.
The report also recommends that the federal government ensures more complete and accurate collection of health-related data across demographic characteristics to ensure that investments in health-promoting programs are made where they are most needed, including in Native communities. In addition, the report calls on all federal agencies to regularly update and report progress on their agency equity plans and to be more transparent about their progress toward meeting equity goals.
Federally funded, community driven programs have demonstrated effectiveness in improving the well-being of Native Americans. The Special Diabetes Program for Indians, for example, has provided $150 million annually for local prevention programs around the country for nearly 30 years and has been able to incrementally decrease diabetes prevalence in American Indian/Alaska Native communities, according to the latest report to Congress.
More recently, the Strengthening Public Health Systems and Services in Indian Country grant program facilitated by the Centers for Disease Control and Prevention (CDC) has supported dozens of tribal organizations’ efforts to reduce chronic disease and promote healthy living in American Indian and Alaska Native populations. One of the programs funded by this grant program is the CDC’s Tribal Suicide Prevention Program, which is using holistic, community and culturally-centered approaches to reduce deaths from suicide. Also, a partnership between the CDC and AmeriCorps, Public Health AmeriCorps, has launched the public health careers of more than 4,000 individuals, to work in underserved rural, tribal, and urban communities.
Since 2020, TFAH’s Age-Friendly Public Health Systems initiative has partnered with the Washington State Department of Health and the Northwest Washington Indian Health Board (NWWIHB), a coalition of six federally recognized tribes in Washington state, to support exploration of the needs of tribal elders so that the NWWIHB can better provide resources and supports to its tribal elders.
Investing and scaling these evidence-based strategies that prioritize prevention are key steps in leading the systemic change needed to eradicate health inequities and disparities, including in Native American communities.
