U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Fact Sheets

SAFE WATER AND WASTE DISPOSAL FACILITIES

ISSUE

Gastrointestinal Disease Death Rate per 100,000
	  Years: mid 1960's - 2000
	  Rate: 12 - 2
	  Percent of Homes: 48% - 8%
	  
Postneonatal Mortality Rate
	  Years: mid 1960's - 2003
	  Rate: 21 - 4
	  Percent of Homes: 82% - 17%
	  
% of AI / AN Homes with potable water
	  Years: mid 1960's - 2007
	  Rate: 6 - 23
	  Percent of Homes: 23% - 89%Safe and adequate water supply and/or waste disposal facilities are lacking in approximately 12% of American Indian and Alaska Native homes, compared to less than 1% of homes for the U.S. general population.

BACKGROUND

Families with satisfactory environmental conditions in their homes, which include safe water and sewerage systems, require appreciably fewer medical services and place fewer demands on the Indian Health Service (IHS) and tribal primary health care delivery system. The Indian Sanitation Facilities Act, P.L. 86-121, authorizes the IHS to provide essential sanitation facilities, such as safe drinking water and adequate sewerage systems, to Indian homes and communities.

The IHS Sanitation Facilities Construction Program is a preventative health program that yields positive benefits. A recent cost benefit analysis indicated that for every dollar IHS spends on sanitation facilities to serve eligible existing homes; at least a twentyfold return in health benefits is achieved. The IHS Sanitation Facilities Construction Program has been the primary provider of these services since 1960.

STATUS

There is a backlog of almost 3,500 needed sanitation facilities construction projects. The cost to provide all American Indians and Alaska Natives with safe drinking water and adequate sewerage systems in their homes is estimated to be almost $2.9 billion. With inflation, new environmental requirements, and population growth, the current sanitation appropriations are not reducing the backlog. In addition to providing safe sanitation facilities to existing homes, the IHS also provides sanitation facilities to new homes.

OPTIONS/PLANS

The IHS, in consultation with Tribes, continues to identify sanitation facilities needs. The IHS and Tribes will continue to collaborate with other federal agencies, states, and organizations to provide needed resources for these essential sanitation facilities. The additional resources would help to reduce the backlog of sanitation facilities needed to serve existing homes and would also address the need for sanitation facilities for eligible new homes being constructed annually.

ADDITIONAL INFORMATION

For referral to the appropriate spokesperson, contact the IHS Public Affairs Staff at 301-443-3593.

January 2013

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