Tribal Practices for Wellness in Indian Country (TPWIC)

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Tribal Practices for Wellness in Indian Country (TPWIC) supports tribal practices as a path to prevention and wellness promotion in American Indian and Alaska Native (AI/AN) communities.

TPWIC Mission

TPWIC encourages and supports tribal practices that build resiliency and connections to community, family, and culture. Over time, these can reduce risk factors for chronic disease and promote wellness among AI/AN. The Centers for Disease Control and Prevention (CDC) funds 36 Tribes and Urban Indian Health Centers through the TPWIC program.


AI/AN communities have many strengths and resiliency on the basis of tribal culture and traditional ways of life. However, AI/AN culture and traditions have been severely disrupted by colonialism, loss of land, and policies, such as assimilation, relocation, and tribal termination, resulting in historical trauma, which has contributed to higher rates of chronic disease and underlying risk factors, such as obesity and commercial tobacco use.

For AI/AN tribes and communities, cultural and traditional teachings and practices build strength and resilience and support healthy lives. Tribal leaders suggested these practices are not widely understood nor supported by federal agencies. To better understand these approaches, CDC’s National Center for Chronic Disease Prevention and Health Promotion hosted convenings with tribal cultural leaders where seven strategies were identified that strengthen connections to community, family, and culture that can reduce risks for chronic disease among AI/AN. These practices are the basis of the TPWIC strategies for awardees to put into action.

About the TPWIC Program

The TPWIC  strategies fall into the following three general areas:

  • Health Promotion: Increased traditional physical activity, traditional foods, and overall healthy living practices
  • Cultural Practices: Increased knowledge and sharing of tribal history and cultural practices
  • Social and Emotional Wellbeing: Increased sense of belonging to tribe, sense of connection to culture and intergenerational interactions, are having a positive impact on wellbeing

TPWIC is a 4-year cooperative agreement (fiscal year 2018–2021). American Indian Tribes and Alaska Native Villages, or tribally designated organizations that work with tribes, and 15 Urban Indian Organizations receive a total of approximately $5 million per year.

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TPWIC Map: Awardees for 2018–2020

Full list of Tribes and Urban Indian Health Organizations and their locations within the TPWIC program

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Funding Totals for Tribal Practices for Wellness in Indian Country

Funding totals for the Tribal Practices for Wellness in Indian Country program.

TPWIC Strategies
  • Connect cultural teachings to health and wellness
  • Support seasonal cultural practices that support health and wellness
  • Implement social and cultural activities that promote community wellness
  • Establish and maintain collaborations that strengthen well-being
  • Support inter-generational learning for well-being and resilience
  • Promote traditional healthy foods
  • Promote traditional and contemporary physical activities
Matter of Fact: TPWIC

Printable summary sheet pdf icon[PDF – 424 KB] of the Tribal Practices for Wellness in Indian Country program at a glance.