Tribes & Tribal Organizations
What is a tribal nation?
Legally speaking, a tribe is a sovereign nation with control over its own laws and resources that has a special legal and political relationship with the United States government. Federally-recognized tribal nations are administratively equivalent to the U.S. federal government.
It is important to remember that a tribe is different from other entities that public health officials often work with. Although there might be some overlap, Tribes are not:
- Racial or ethnic minority populations
- Local government agencies
- Stakeholder or advocacy groups
Indian Health Overview
American Indian and Alaska Natives (AI/AN) face significant health disparities compared to the U.S. population as a whole. Compared to the general U.S. population, the AI/AN population is younger 1, lives shorter lives 2, experiences higher rates of unemployment 3, and experiences higher rates of poverty 4. These disparities are a result of ongoing racism, a lack of access to resources and services, government policies and programs that ignore or go against AI/AN needs, and a complex history of oppression and colonization.
Tribes still deal every day with the direct consequences of historical events and have to fight to protect their rights and to secure the resources and services promised to them. It is important that anyone interested in working with tribes seek to understand this history as well as recognize how it relates to tribal government practices and tribal health.
Key Concepts
Sovereignty refers to tribes’ right to govern themselves. As sovereign nations, tribes have the ability to make and enforce laws, and set policy relating to their members and lands.
Tribal sovereignty is recognized in federal law as an inherent right—one that goes back to the beginning of history and can’t be given or taken away, rather than a right given by the U.S. government or federal law. Treaties that the U.S. government made with ribes in the 1700s and 1800s are based on and confirm this idea of inherent sovereignty. To learn more about treaties, follow these links: Northwest-specific treaties or all U.S. treaties.
Tribal governments are administratively equivalent to the U.S. federal government. Therefore, tribes and the federal government have a government-to-government relationship. In practice, this means that any policy decisions affecting a tribe must be negotiated and coordinated with the tribal government.
The federal trust responsibility refers to the legal obligation that the U.S. government has to protect federally recognized tribes' treaty rights, lands, assets and resources, as well as their right to govern themselves as sovereign nations . Tribes gave up lands in return for certain safeguards for their members, and the government is still responsible for providing these protections and services. The provision of health care through the Department of Health and Human Services is also protected under the fedreal trust responsibility as a treat right. The right to health care provision and services is adressed in many individual tribal treaties as well as in the Snyder Act of 1921 and the Indian Health Care Improvement Act.