Document Type
Article
Publication Date
5-2026
Abstract
The Indian Self-Determination and Education Assistance Act (PL 93-638) serves as a critical policy mechanism enabling Tribes to exercise sovereignty and self-determination in health care delivery. American Indian and Alaska Native (AI/AN) communities face significant disparities in oral health outcomes, driven by systemic and structural racism, geographic isolation, and inadequate access to health care professionals. This policy paper examines the historical context and implementation of PL 93-638 and explores how the law empowers Tribes to address health inequities on their own terms. Drawing on case studies and insights from the Fort Peck Assiniboine and Sioux Tribes, this paper highlights how the community leveraged PL 93-638 to assume control of oral health services from Indian Health Services (IHS). The discussion underscores how the policy improves oral health outcomes and offers critical lessons and recommendations for future applications of tribal self-determination in oral health care.
DOI
10.1057/s41271-026-00623-y
Rights
This article was originally published in the Journal of Public Health Policy: https://link.springer.com/article/10.1057/s41271-026-00623-y
Recommended Citation
Adriann Ricker and Shawnda Schroeder. "Utilizing the Indian Self Determination Act to Enhance and Improve Health Outcomes in a Tribal Communities" (2026). Indigenous Health Faculty Publications. 52.
https://commons.und.edu/ih-fac/52