Public Health Indian Country Capacity Scan
(PHICCS) Project (updated October 2019)


Click here to view a copy of the scan instrument.

Click here to read the Dear Tribal Leader letter.

Click here to view the recording from the PHICCS Pre-launch Webinar.

Click here to view the slides.

As sovereign nations, Tribes are responsible for the overall health and well-being of their members which has led to an increase in the types of public health activities occurring across Indian Country. Although the definition of public health in Indian Country includes a diverse set of activities and services that vary by tribe and region, public health is ultimately the work that is done to improve and maintain the overall health and well-being within Tribal communities as a whole.

Tribes have a vested interest to provide valuable public health services to the communities they serve. Therefore, it is important to understand the capacity, or range of public health activities occurring among Tribal public health departments and Indian health organizations across the nation to inform the allocation of resources, policy development and advocacy to improve health outcomes among American Indians and Alaska Natives.

Nationally, a great deal of work has been done to assess capacity and performance of local and state public health systems, but little is known about Tribal public health capacity. The last time an assessment of Tribal health department was conducted was in 2009. This assessment resulted in the 2010 Tribal Public Health Profile: Exploring Public Health Capacity in 2010 Tribal Public Health Profile: Exploring Public Health Capacity in Indian Country. Additional research and assessments were completed by the National Opinion Research Center (NORC) through thePublic Health Services and System Research Project. The results of these two projects will be used to improve and guide the Public Health in Indian Country Capacity Survey Project.

Public Health Indian Country Capacity Scan Project

In July, 2015 the National Indian Health Board (NIHB) received funding from the Centers for Disease Control and Prevention (CDC) Office for State, Tribal, Local, and Territorial Support (OSTLTS) to conduct a Tribal Public Health Infrastructure Scan to describe the current public health services provided nationally by

  • Tribal Health Departments
  • Indian Health Service (IHS)
  • Area Indian Health Boards
Some of the important public health infrastructure components to be explored include, but are not limited to, the following:
  • Tribal public health activities that promote wellness and prevent disease
  • Public health priorities
  • Community involvement in priority setting and problem solving

  • Tribal health policy and regulation
  • Workforce capacity and development strategies
  • Program evaluation and efforts to improve the quality of programs and services
  • Partnerships with local, state, federal, and Tribal agencies and health departments
  • Efforts around strategic planning and public health accreditation

Tribal Participation in the Scan is Essential

NIHB will gather the information from the scan to create a report to Tribal leadership that would move beyond identifying health disparities, but examining the workforce, systems, and infrastructure that exists among American Indian and Alaska Native Tribes to address these health disparities and provide public health services. The end result will be a comprehensive picture of the landscape, and areas of collective strengths and weaknesses.

The report will include important information that will support and guide much of our advocacy work in the areas of policy, funding, technical support, and research on issues related to improving Indian health. Participation of each tribe in the infrastructure survey is critical to provide information about public health activities occurring across Indian Country.

Progress To Date and Next Steps

Following extensive engagement and outreach with representatives from the Area Indian Health Boards to help inform the project and scan design, NIHB received approval from the Office of Management and Budget (OMB) and launched the Public Health in Indian Country Capacity Scan (PHICCS) instrument in November 2018. Data collection officially closed September 2019. NIHB received close to a 50% response rate from Tribal health directors and public health directors across Indian Country and is now working on data analysis. A report detailing results of the scan and a comprehensive profile of Tribal public health is anticipated to be released mid-2020.

NIHB Contact:

Carolyn Angus-Hornbuckle, JD
Director of Public Health Policy and Programs

National Indian Health Board
910 Pennsylvania Ave, SE
Phone: 202-507-4089
Washington, DC 20003
[email protected]