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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

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Environmental Health Services

Food and Waterborne Disease Rates chart


American Indians and Alaska Natives (AI/AN) face a number of environmental hazards that affect their health status, such as living in remote and isolated locations that expose residents to severe climatic conditions, hazardous geography, and disease-carrying insects and rodents. Other factors include limited availability of housing and extensive use of sub-standard housing, unsanitary methods of sewage and waste disposal, and unsafe water supplies.


The Indian Health Service (IHS) Environmental Health Services (EHS) program includes the specialty areas of injury prevention and institutional environmental health. The IHS EHS program identifies environmental hazards and risk factors in tribal communities and proposes control measures to prevent adverse health effects. These measures include monitoring and investigating disease and injury in tribal communities; identifying environmental hazards in community facilities such as food service establishments, Head Start centers, community water supply systems, and health care facilities; and providing training, technical assistance, and project funding to develop the capacity of tribal communities to address their environmental health issues.


There are substantial disparities in health status between AI/ANs and the rest of the U.S. population, especially for illness and injury rates. For instance, in 2012 the rate of Spotted Fever Rickettsiosis in the AI/AN population was over 3 times higher than the rate for Whites and over 13 times higher than the rate for Blacks. Implementation of effective environmental health and injury prevention strategies can substantially reduce disease and injury rates. For example, from 2001 to 2012, the number of services provided by IHS to food service establishments and drinking water systems increased, as the incidence rate of food and waterborne diseases decreased (see graph).


Through shared decision making and sound public health measures, the IHS EHS program seeks to enhance the health and quality of life for AI/ANs by eliminating environmentally related diseases and injuries. The IHS works closely with Tribes and other partners to identify priorities and develop action plans to address environmental health issues such as food safety, children's environment (schools, foster care, day care facilities, etc.), vector-borne and communicable diseases, safe drinking water, and healthy homes.


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

January 2015

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