Epidemiology; Indians; Indians of North America; North American; Public health surveillance


Health Services Administration | Health Services Research | Immune System Diseases | Organizational Communication | Public Health | Virus Diseases


Improving the health of American Indian and Alaska Native (AI/AN) populations involves multiple agencies, levels of government, and jurisdictions. We assessed collaboration between state health departments and AI/AN Tribes and agencies through an online survey of State Epidemiologists. Frequencies and percentages of responses were examined by univariate and bivariate analyses. Among 39 states with federally recognized or state-recognized Tribes or federally funded urban Indian health centers, 25 (64%) participated. Nineteen had discussed public health surveillance with an AI/ AN government or nongovernment entity in the past 2 years (10 (53%) of these had ongoing, regular discussions about public health surveillance; nine (47%) had these discussions as needed). Nine (36%) responding states have a point person for working with AI/AN communities and/or agencies on public health surveillance. Four (16%) states have an active memorandum of understanding or other formal agreement with an AI/AN government or nongovernment entity regarding surveillance. To prepare for public health emergencies, six (24%) states involve the Indian Health Service, and eight (47%) involve another AI/AN entity. Functional relationships between state health departments and AI/AN agencies have not been consistently established. Strengthening these relationships will facilitate surveillance and response capacity to address continuing and emerging public health problems.