Author ORCID Identifier


Document Type


Publication Date



The COVID-19 pandemic brought national attention to challenges that tribal communities have been facing for decades, such as limited health services and lack of water access. Although the end to the pandemic seems to be in sight, climate change will continue to threaten the public health and survival of tribal communities. Since time immemorial, Native Americans have recognized the sanctity of water. Water is life. However, climate change impacts are shifting the landscape across the country and many tribes lack the necessary infrastructure to protect their communities. For example, located in the Southwest, approximately 30-40 percent of homes on the Navajo Nation lack plumbing and drinking water access. These households must haul water long distances from wells and other community point sources. Due to climate change, the region is experiencing prolonged droughts in the region and groundwater supplies are drying up. As a result, residents must increasingly compete for limited water resources to fulfill all of the community’s needs—from agricultural to domestic.

The lack of infrastructure in Indian country is the direct result of federal policies. Stemming from treaty obligations, the federal government is responsible for providing health services to Native Americans. Recognizing the intrinsic connection between access to clean water and public health, the Indian Health Service (IHS) Sanitation Facilities Construction Program was established in 1959 to support drinking water and sanitation projects in tribal communities. However, IHS (including the sanitation program) has been historically underfunded and understaffed, hindering the federal agency’s ability to fulfill its mission to raise the physical, mental, social and spiritual health of Native Americans to the highest level. Climate change presents another challenge that must be addressed in efforts that seek to promote tribal public health.

With a special emphasis on water, this article identifies climate-change related health threats to tribal communities and analyzes the federal government’s treaty and trust responsibility to protect Native Americans from those threats. It also explores how the federal government can better support tribes in exercising self determination to the fullest to be drivers of their own future.