Today, as we observe Day 3 of Tribal Public Health Week, we echo the message of the American Public Health Association: Health Equity Starts Here. But for Tribal Nations, “here” isn’t just a place. It’s a lived experience – one shaped by history, resilience, and the ongoing fight for justice in health.
At the National Indian Health Board (NIHB), we know that health equity in Indian Country doesn’t happen by accident. It’s built through bold leadership, culturally rooted programs, and advocacy that centers the sovereign rights and lived realities of American Indian and Alaska Native peoples.
The Reality: Tribal Health Disparities Are Worsening
Right now, American Indian and Alaska Native (AI/AN) people are navigating some of the deepest health disparities in the United States:
- Native communities face the highest rates of diabetes, suicide, and youth depression.
- Life expectancy for AI/AN people has declined sharply, with a drop of over 6.6 years since 2019.
- Many Tribal communities still lack access to clean water, safe housing, and reliable transportation, all of which are critical for health.
Recent events – from the winding down of COVID-19 emergency funding to the loss of environmental health support and threats to Medicaid and the Indian Health Service budget – continue to widen the gap in health access and outcomes.
Yet, through it all, Tribal Nations are taking action. And NIHB is here to stand beside them.
Our Role: Advancing Health Equity Through Sovereignty and Support
NIHB works every day to support Tribal-driven public health. That means:
- Advocating for full and mandatory funding for the Indian Health Service,
- Fighting for Tribal Medicaid parity and protections,
- Uplifting Native-led and Native-focused mental health solutions,
- Building Tribal public health infrastructure,
- And ensuring that Tribal voices lead conversations on climate, youth health, emergency preparedness, and health equity.
We are working with Tribal leaders and federal partners to push for policy changes that recognize the unique needs of Tribal Nations – and respect their right to design solutions that reflect their cultures, languages, and community priorities.
Health Equity Requires Systems Change – and Cultural Change
Tribal health equity isn’t just about better services. It’s about shifting the narrative – from one of deficiency to one of sovereignty and strength. It’s about correcting the policies that created the disparities in the first place. And it’s about honoring the knowledge, values, and traditions that have kept Native people strong for generations.
We can’t achieve health equity without Tribal equity. That includes equity in funding, in data collection, in policymaking, and in visibility.
Standing Together for Equity
This Tribal Public Health Week, we recommit to building a future where Tribes are not an afterthought, they are a priority. A future where every Tribal community has the resources, respect, and authority to protect their own people’s health.
We invite you to join us by:
- Supporting Tribal-led public health initiatives
- Calling on lawmakers to fully fund Indian health and honor trust and treaty obligations
- Sharing your stories of resilience and advocacy using #TribalPublicHealthWeek2025 and #NPHW2025
- Holding space for truth, accountability, and collective action
Because health equity starts with listening. It starts with justice. It starts here – with Tribes.
