This report from the U.S. Department of Housing and Urban Development examines a survey of 1,340 American Indian and Alaska Native (AIAN) households in 38 tribal areas to assess housing conditions. The analysis uncovered that AIAN housing conditions were much worse than U.S. households, with overcrowding a severe issue in these communities. The report suggests that limited funding is a key reason for limited housing production among many tribes.

Through statistics gathered from American Indian and Alaskan Native children living on or near reservations and comparing them with general population statistics, this report describes the scope of hunger, obesity, and Type II diabetes rates. It also discusses how federal nutrition programs can improve the lives of children living in tribal lands.

This report provides an overview of the implementation of a cross-agency federal initiative led by the White House Rural Council called Rural IMPACT. The demonstration initiative aimed to address rural child poverty and improve mobility of families in rural and tribal communities through increased service delivery coordination. Drawing from other place-based initiatives, the demonstration focused on providing intensive technical assistance to ten sites chosen through a competitive process. Each site was to develop a two-generation program model that would be driven by a “backbone” agency and a team of key partners. This report highlights key practice elements needed for site success, which included tailored technical assistance, numerous committed partner organizations including families themselves, strong leadership support, and plans to encourage wider implementation of two-generation efforts.

This factsheet from the Office of Child Support Enforcement discusses how employers can most effectively interact with the more than 560 federally recognized American Indian/Alaska Native tribes in the U.S. It covers family structure, frequently asked questions around payments, and basics of tribal government structure. It also includes contact information for further questions.

This practice brief introduces the Tribal HPOG 2.0 evaluation, provides a summary of the findings of the Tribal HPOG 1.0 evaluation, and examines how the evaluation of the first program informed the second. The Tribal HPOG 2.0 program encourages individuals to enter the healthcare field through supporting demonstration projects that equip those individuals with the necessary education and training. It is the first in a series of briefs that will be disseminated to share lessons learned and findings from the program evaluation.

Adverse childhood experiences (ACEs) are associated with numerous risk behaviors and mental health outcomes among youth. This study examines the relationship between the number of types of exposures to ACEs and risk behaviors and mental health outcomes among reservation-based Native Americans. In 2011, data were collected from Native American (N = 288; 15-24 years of age) tribal members from a remote plains reservation using an anonymous web-based questionnaire. We analyzed the relationship between six ACEs, emotional, physical, and sexual abuse, physical and emotional neglect, witness to intimate partner violence, for those <18 years, and included historical loss associated symptoms, and perceived discrimination for those <19 years; and four risk behavior/mental health outcomes: post-traumatic stress disorder (PTSD) symptoms, depression symptoms, poly-drug use, and suicide attempt. Seventy-eight percent of the sample reported at least one ACE and 40% reported at least two. The cumulative impact of the ACEs were significant (p < .001) for the four outcomes with each additional ACE increasing the odds of suicide attempt (37%), poly-drug use (51%), PTSD symptoms (55%), and depression symptoms (57%). To address these findings culturally appropriate childhood and adolescent interventions for reservation-based populations must be developed, tested and evaluated longitudinally. (author abstract)

This toolkit from the U.S. Department of Health and Human Services, Administration for Children and Families provides resources on trauma-informed care that are tailored to the needs of AI/AN communities. The resources are divided into sections based on the different stages of the process of implementing trauma-informed human services. For example, an agency in the beginning phases could use the resources in the “What do we mean by trauma-informed services and why is such an approach important?” section. An agency that has already started implementing trauma-informed services could find resources in the “We’ve begun working on theses, issues, but are trying to decide what to tackle next. How can I figure out next steps?” section. The toolkit also includes examples of treatments for trauma that have been adapted specifically for AI/AN communities.

These webinar slides from the Indian Health Service provide an overview of historical trauma and trauma-informed care in health and behavioral health systems. Historical trauma is prevalent among AI/AN individuals, and it can be transferred across generations. The webinar provides case examples of historical trauma, and discusses the secondary trauma or compassion fatigue that providers can experience when working with clients who have experienced trauma. The presenters also included examples of trauma-informed interventions specifically targeted to AI/AN populations.

American Indian and Alaska Native youth are 2.5 times more likely to experience trauma than their non-native peers, and this trauma can result in mental health disorders, substance abuse, violence, and suicide if not treated. This Mathematica Policy Research report, sponsored by the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, contains the results of an environmental scan of trauma-informed programs for AI/AN youth. The authors summarize three interventions that help AI/AN youth address traumatic stress and behavioral health concerns: Cognitive Behavioral Intervention for Trauma in Schools; Honoring Children, Mending the Circle; and Pathway to Hope. The report concludes with a discussion of the challenges of conducting research in tribal communities, including the need to bridge the gap between mainstream and Native conceptions of mental health and wellness.

This report presents a first-of-its-kind collaborative tribal-federal blueprint for improving the behavioral health of American Indians and Alaska Natives. This was developed in response to calls from tribal leaders for improved collaboration with federal agencies to address the behavioral health of their communities.