Healthy Tribes

How CDC Promotes Health and Prevents Chronic Diseases for American Indian and Alaska Native people

woman holding baby

Fast Facts

  • Many American Indian and Alaska Native people are affected by poverty, discrimination, unemployment, and poor housing.
  • These factors have contributed to higher rates of disease, injury, and premature death compared to other population groups.
  • CDC works with American Indian and Alaska Native populations to strengthen connections to culture and traditional lifeways that improve health and wellness.

Across the life span, American Indian and Alaska Native people have higher rates of disease, injury, and premature death than other racial and ethnic groups in the United States.

Conflict with the US government and racial discrimination have compromised the culture, traditional lifeways, and wellness of American Indian and Alaska Native people. These challenges have contributed to poverty, unemployment, and poor housing—factors often associated with poor health behaviors and disease management. However, American Indian and Alaska Native traditions and culture can help strengthen evidence-based interventions and improve health outcomes.

CDC works with American Indian tribes, Alaska Native tribes, tribal organizations, Urban Indian Organizations, and Tribal Epidemiology Centers (TECs) to promote health, prevent disease, and strengthen connections to culture and lifeways that improve health and wellness.

Reducing Risk Behaviors That Lead to Chronic Diseases

CDC’s largest investment to improve tribal health is the Good Health and Wellness in Indian Country (GHWIC) program, a $15.6 million per year initiative. From 2014 to 2019, the program funded 23 tribes, tribal organizations, and TECs across the United States. Specifically:

  • 11 tribes worked on community-chosen and culturally adapted strategies designed to reduce commercial tobacco use and exposure, improve nutrition and physical activity, increase health literacy, and strengthen team-based health care and links between community programs and clinical services.
  • 12 tribal organizations worked to provide leadership, assistance, and resources to over 100 tribes and tribal organizations in their Indian Health Service (IHS) area, as well as to GHWIC-funded tribes.

For example, for the past 4 years, the Albuquerque Area Indian Health Board has partnered with Project ECHOexternal icon at the University of New Mexico to lead the Partners in Good Health and Wellness Training Program. This effort has mobilized more than 100 tribal paraprofessionals to focus greater attention on heart disease, stroke, kidney disease, commercial tobacco use, and breastfeeding.

Strengthening Tribal Public Health Capacity

Many federal and state agencies have excluded American Indian and Alaska Native people from routine disease and risk factor reporting because of the relatively small size of these populations and widespread race misclassification. To address this gap, CDC supports tribal organizations to improve data collection, analysis, interpretation, and dissemination in ways that respect tribal sovereignty and ownership.

The Tribal Epidemiology Centers Public Health Infrastructure (TECPHI) program, launched in September 2017, seeks to increase the ability of TECs to deliver public health services to and with the tribal communities in their IHS area and Urban Indian Organizations. The program builds public health capacity and infrastructure in Indian Country to collect data and study chronic diseases that affect tribal communities; prevent and control chronic disease, injury, and disability; and monitor and evaluate activities.

With a budget of $8.5 million per year, this 5-year program supports 12 TECs and 1 Network Coordinating Center. The coordinating center oversees and provides project organization, logistics, communication, and performance evaluation support for the funded TECs.

Among American Indian and Alaska Native people:
feet on scale


compared to
31% of White people.
glucose meter


compared to
8% of White people.
cigarette in ash tray smoking and lighter


commercial tobacco
products compared
to 16% of White people.

Improving Tribal Wellness

children by raised bed for planting

Launched in May 2018, the 3-year Tribal Practices for Wellness in Indian Country program supports tribal cultural practices that promote wellness in American Indian and Alaska Native communities. This program awards about $5 million a year to 21 American Indian tribes and Alaska Native villages or tribally designated organizations that work with tribes and 15 Urban Indian Organizations. For American Indian and Alaska Native tribes, cultural and traditional teachings and practices are important protective factors that build strength and resilience and support healthy lives.

This funding award is designed to support the following strategies:

  • Connect cultural teachings to health and wellness.
  • Support seasonal cultural practices that support health and wellness.
  • Develop social and cultural activities that promote community wellness.
  • Establish and maintain collaborations that strengthen well-being.
  • Support intergenerational learning about well-being and resilience.
  • Promote traditional healthy foods and traditional and contemporary physical activities.
Page last reviewed: November 8, 2021