School of Professional Studies
Date of Award
4-2024
Document Type
Capstone
Degree Name
Master of Public Administration (MPA)
Department
School of Professional Studies
Chief Instructor
Kerry Morris, MPA, Adjunct Professor
Second Reader
Kerry Morris
Third Reader
Clark University Writing Center
Keywords
substance abuse, Indian Health Service, American Indian/Alaska Native, tribal, inefficiencies, community, disadvantaged, government, socioeconomic, literature
Abstract
American Indian and Alaska Native (“AI/AN”) people either rank at the bottom, or next to the bottom, of every social, health, and economic indicator; one of these metrics includes substance abuse. Substance abuse is the number one health problem facing Native populations according to the Indian Health Service (IHS), as they face numerous tribal-specific risk factors. A comprehensive literature review revealed that this is a two-pronged problem. First, Tribal Nations face a variety of socioeconomic difficulties, including poverty, poor educational support, and historical trauma that was inflicted by colonialism and generations of forced assimilation. Second, they are sovereign entities which means they are largely expected to deal with their public health problems, with only supplemental assistance from the federal government. The problem is that the federal agency tasked with Tribal assistance (the Indian Health Service (IHS)) is inefficient. The IHS has long suffered from chronic underfunding and bureaucratic flaws, leading to inadequate support for Tribal Nations. As per the legal obligations outlined in Seminole Nation v. U.S. (1942) along with numerous other cases, the U.S. government is required to take action to guarantee the survival and welfare of Native American Tribes and people (The Administration for Children and Families, n.d.). The author of this paper ultimately recognizes that this is a complex issue with many elements that necessitate attention. Nonetheless, they propose various options for a physical deliverable (mobile drug unit, community center, etc.) rooted in the Tribal community, and outlines recommendations for improvements to the IHS.
Recommended Citation
Mauro, Allessia A., "Addressing the Dual Challenges of Substance Abuse and Systemic Inequities Among AI/AN Communities: A Call for Action and Reform in Tribal Healthcare" (2024). School of Professional Studies. 20.
https://commons.clarku.edu/graduate_school_professional_studies/20
Worcester
No