Addressing Alcoholism on the Native American Reservation: An Investigative Portfolio on Native American Alcoholism and the Indian Health Services

Policy Problem Statement:
Native Americans comprise 1.2% of the American population. Of all Native Americans, 22% live on reservations. Native Americans are the smallest, most rural, and least politically powerful minority group in the US. Alcoholism is a grave health issue for Native Americans. According to the Indian Health Services (IHS), Native Americans experience alcoholism at six times the rate of average Americans. Native Americans continue to experience higher rates of binge drinking and alcohol related deaths than all other ethnic groups.

The current IHS funding and accreditation structures for alcoholism programs are not effectively combatting alcoholism in the Native American reservation context. These structures give the IHS final authority to accredit and fund alcoholism programs and do not include any community feedback components. Because western programs such as Alcoholics Anonymous have been historically implemented on reservations, these types of programs continue to receive accreditation and funding despite their lack of cultural relevance to many communities. The authoritative role the IHS occupies does not allow sufficient community participation and local control to enable the development of culturally relevant and effective interventions. Even though there are women who strive to revolutionize alcoholism interventions by incorporating traditional ceremonies into alcoholism interventions, these programs have not been sufficiently evaluated and therefore fail to receive IHS accreditation and funds. The IHS accreditation and funding schemes do not allow for the degree of local control and community-based services development necessary to effectively combat alcoholism.