Risk Factors Among Native American Children


by Dan Williams, R.Ph.

Retired from the Indian Health Service


These observations come from both experience in the Indian Health Service and his Indian background. Dan's mother was Cherokee and his father came from the Puyallup Tribe.


Children on Indian Reservations grow up under circumstances seen among other minority groups in the United States . There is a high rate of unemployment, there is a high incidence of alcoholism, and many children are raised by members of their extended families because their parents are unable or unwilling to do so. However, reservation life provides additional circumstances which hinder in identifying and assisting high-risk children.


The various tribes of Indians are each recognized as a sovereign nation by the Federal Government of the United States . In recent years the tribes have been given the responsibility of self-determination in deciding how the Federal Government will participate in activities on their respective reservations. This means that no government agency [Bureau of Indian Affairs (BIA), Indian Health Service (IHS), or any other] can direct the tribes in the management of their respective programs.


Therefore, assistance to high-risk children must occur with the approval and assistance of Tribal governments and the health and social service programs that operate under each government's control. Because there has long been a distrust of outside government(Federal, State, or County) trying to manage health programs on the reservations, it is not easy to establish new programs, even those with the best intentions of assisting members of a particular tribe.


Plans to assist a particular tribe depend on how much of the respective health and social services programs a given tribe controls. Those tribes that have assumed management of all of their health care programs need only have the respective governing body (most often a Tribal Council) convinced of the need for such a program.


However, to be effective, plans to assist those tribes that allow the BIA and IHS to manage the health and social service programs on their respective reservations must also be supported by the various health and social service programs delivering the services. This means that the non-tribal health and social service program managers must be convinced that there is an unmet need in order to commit their resources fully to a new program.


Assistance to high-risk children on Indian Reservations involves education of Tribal Councils, Tribal Health and Social Service Program managers, sometimes managers of non-tribal programs, public school officials, and finally, the most important group, tribal members themselves.


Only when a community proactively comes together in full support of its children and their health and welfare, can those children be expected to show the kind of resilience necessary to master the life skills so important to becoming a successful adult.