School of Professional Studies

Date

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.

Worcester

No

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