Politics of Indigenous Health: Acting in Good Faith

Qualitative methods are employed in this research to investigate how the quality of the tribal-state relationship affects the development of law and policy to improve tribal health.  The research explores how certain principles might be applied to improve those relationships and thus improve the prospects for positive health outcomes.

An in-depth case study examining the context within which a state legislature resolved to address tribal health disparities and the roles of formal institutional intergovernmental structures in that effort are investigated. A critical examination of the structural limitations of those political institutions and the policy environment indicates that the extant models used to explain health disparities are insufficient to capture the some of the fundamental drivers of persistent tribal health inequities embedded in the policy environment.  Certain legal parameters define and circumscribe the relationship.

The health in all policies approach implies that policy solutions will apply equally to all populations and denies the complex legal and political relationships between tribes and the state and federal governments. The concept of health equity in all policies is interrogated to assess how health equity can be achieved within the context of compound disadvantage experienced by indigenous peoples whose access to health equity is mediated by certain legal and political parameters.