Amanda Day, Grants Development Consultant (State and Local Government)
Native American and Alaska Native (AI/AN) communities face significant and long-standing health disparities compared to other racial and ethnic groups in the United States. These disparities underscore the urgent need for robust and flexible funding mechanisms like grants.
Geographic isolation and the lack of nearby healthcare facilities pose substantial challenges to accessing care in rural areas. However, approximately 70% of Native people reside in urban areas. As a result, many urban Native individuals lack direct access to the resources offered by IHS or tribally operated facilities. Language and communication barriers, along with a lack of representation in the healthcare workforce and a history of discrimination, further limit access to healthcare and erode patient trust.
Grants play a pivotal role in bridging critical funding gaps, enabling tribes to address specific health challenges, develop essential infrastructure, and deliver culturally appropriate care. Grants can provide funding for services such as screening, prevention, treatment, and recovery programs tailored to tribal populations. Additionally, these grants are essential for supporting tribal self-determination and enabling Native nations to develop and oversee health programs that reflect their specific community needs and cultural traditions.
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KEY HEALTH CHALLENGES
The average estimated life expectancy at birth for AI/ANs was 67.9 years, a contrast to 77.5 years for non-Hispanic Whites.
Deaths due to chronic liver disease and cirrhosis are 4.6 times higher, diabetes mellitus deaths are 3.2 times higher, and heart disease are 3.2 times higher than in the U.S. Non-Hispanic White population.
Alcohol-induced deaths occur at a rate 6.6 times higher, while assault/homicide rates are 2.1 times higher, and intentional self-harm/suicide rates are 1.7 times higher than in the U.S. Non-Hispanic White population.
Source: U.S. Department of Health and Human Services Office of Minority Heath (OMH) https://minorityhealth.hhs.gov/american-indianalaska-native-health
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Although numerous grants fund healthcare infrastructure, some specifically aim to provide training to Native individuals in medicine, behavioral health, and public health, empowering tribes to build and sustain their own healthcare workforce. Grants also enable tribes to build epidemiology capacity, collect health data, and participate in research that informs policy and programming. This supports long-term planning and response, including during emergencies such as the COVID-19 pandemic.
While tribal governments are eligible for federally funded healthcare programs, sources of federal funding specifically for tribal organizations include the Indian Health Service (IHS), the Administration for Native Americans (ANA), and the Administration for Community Living (ACL), as well as state-run programs and private foundations.
One source of federal funding is the IHS Native Public Health Resilience Grant https://www.ihs.gov/dgm/funding/, which aims to enhance the capacity of Tribes, Tribal organizations, and Urban Indian Organizations to implement core public health functions, services, and activities, and to develop further and improve their public health management capabilities. This program seeks to build on and strengthen community resilience as part of the IHS mission to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.
Additionally, the Tribal Behavioral Health Grant Program aims to prevent and reduce suicidal behavior and substance use/misuse, reduce the impact of trauma, and promote mental health among American Indian/Alaska Native (AI/AN) youth, up to and including age 24. The goal of this program is to be a model for community change that integrates a community’s culture, resources, and readiness to address suicide prevention and substance use/misuse among AI/AN youth.
State-level programs can also be a good source of grant funding for healthcare facilities. The Minnesota Department of Health established the Indian Health Grant Program to provide assistance in delivering clinical health services, including culturally informed preventive, medical, dental, and mental health care services, to Native communities residing off reservations.
And finally, private foundations play a significant role in funding tribal healthcare initiatives. For example, The Wildhorse Foundation awards funds in several program areas that are fundamental to a thriving community in the area of the Cayuse, Umatilla, and Walla Walla people of Oregon. In New Mexico, the Con Alma Health Foundation offers multi-year grants to support New Mexico communities in leading healthy lives. Grants are awarded each year in support of nonprofits’ efforts to improve their community’s health.
Grants enable tribes to implement targeted programs for chronic disease management, mental health, substance abuse, and infrastructure development, often incorporating culturally relevant practices and traditional healing methods. Tribal grant funding is not just a financial lifeline; it is a tool for restoring health sovereignty, advancing justice, and closing decades-long gaps in healthcare access, outcomes, and cultural safety. When well-structured and adequately resourced, these grants provide targeted, comprehensive, and affordable health hcare for Native American and Alaska Native (AI/AN) populations.