Tribal-Run Health Systems [Letters]

from Health Affairs at on July 5, 2017 at 08:28PM

Tribal-Run Health Systems

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Jessica Bylander (Apr 2017) reported on the desire of the Rosebud Sioux Tribe in South Dakota to run their health system independently
from the Indian Health Service. Bylander mentioned as an example of an “impressive success story” and an inspiration to the
Rosebud Sioux the health systems of Alaska Native tribes—which adopted tribal governance in 1998.1

However, data from the Alaska Department of Health and Social Services show poor health outcomes for Alaska Native people
despite the tribal takeover. For example, during the period 2000–15, infant mortality worsened by 80 percent,2 while alcohol-induced mortalities increased by 22 percent.3 During the same period there was a 22 percent increase in adults claiming that cost was a barrier to health care.4 In light of these unsatisfactory health outcomes, it appears that the Alaska Native tribes’ health systems cannot be considered
impressive success stories of tribal-run health systems.