Tribal Environmental Health

ASTHO’s Tribal Environmental Health Project

American Indian (AI) and Alaska Native (AN) populations are a rich tapestry of diverse and resilient cultures. Their population is growing, and they number in the millions. However, they are among the most marginalized communities with some of the poorest health outcomes in the country. They suffer from low life expectancy, high infant mortality, and other adverse health outcomes, many of which are associated with changes to the natural environmental, and a loss of access to traditional, life-sustaining, natural resources such as land, clean water, and food. 

Many states are working hard to provide high quality public health services to AI/AN communities, but it is not without its challenges. Cultural differences, historical distrust, and evolving disputes over jurisdiction and sovereignty, as well as remote geography, are just a few factors that can further complicate relationships between state health departments, tribal communities, and individual AI/AN. 

ASTHO is committed to helping states build their capacity to serve these historically underserved communities. Over the last two years, ASTHO’s environmental health team, with support from CDC/ATSDR, has been learning how some states are engaging tribal communities. Many states have a State-Tribal Liaison, staff whose primary role is to engage and build relationships with tribal communities and triage their public health needs. ASTHO has been fortunate to learn from these unique staff and better understand how to support their work. State-Tribal Liaisons identified the need to bring together state health department staff and tribal representatives to share information, and strengthen working relationships. To that end, ASTHO has supported two state tribal summits so that state health department staff and tribal communities can come together.

These summits have helped states learn about tribal environmental health needs and priorities, as well as the unique relationships they have with the natural environment. The summits have also provided an opportunity for tribal communities to learn about state resources, initiatives, and projects that they can participate in in order to address their most pressing environmental health challenges. ASTHO has also begun to convene a State-Tribal Liaison peer group wherein these dedicated public health professionals can share their experiences, learn from one another, collectively address growing tribal environmental health issues, and share information about how best to consult with tribes and assist them as they work to improve public health outcomes. 

ASTHO would like to thank CDC/ATSDR without whom this work would not be possible.

2018 Washington State Tribal Environmental Public Health Summit

The Washington State Tribal Environmental Summit, which was attended by members from the 29 federally recognized tribes across the state, featured presentations from a mix of public health professionals covering a variety of environmental health issues important to the region’s tribal nations. These topics included safe drinking water, food safety, and the built environment. Co-convened with the Washington State Department of Health, the National Conference of State Legislatures, the American Indian Health Commission, and the Northwest Portland Area Indian Health Board, the summit opened with a keynote address from John Wiesman, ASTHO president and secretary of health for the Washington State Department of Health.


This video, produced by the Tribal Public and Environmental Health Think Tank, depicts tobacco prevention efforts in Wisconsin Tribal communities and highlights the importance of reclaiming traditional tobacco.

Additional summit materials:

2018 Minnesota Tribal Environmental Health Meeting: Responding to a Changing Environment

The Minnesota Tribal Environmental Health Meeting, which was attended by members from the 11 tribes across the state, featured presentations from tribal members and non-tribal public health professionals. Participants discussed a wide array of environmental health topics, including tribal specific exposure pathways, safe drinking water, food safety, health impact assessments, and tribal specific climate vulnerability assessments and adaptation plans. Co-convened with the Minnesota State Department of Health, the National Conference of State Legislatures, and the Lower Sioux Indian Community, the summit began with opening remarks from Paul Allwood, Assistant Commissioner at the Minnesota Department of Health.