Abstract Since the time of first contact with European immigrants, American Indians/Alaska Natives (AI/AN) have endeavored to protect their traditional ways of life, well-being, land bases, populations and forms of government. The policies of the United States toward its first peoples have undergone many changes: treaty making, re-organization, assimilation, relocation, termination, re-recognition and currently, self-determination and self-governance. The trust and treaty responsibility of the United States government for the provision of health, education and general welfare for the people of our first nations is well documented by the United States Constitution, treaties, legislation and canons of construction for Indian law. These rights recognize the major contributions of millions of acres of land, mineral rights, waterways and natural resources by AI/AN governments. Why then does federal policy continue to severely underfund Indian Health resulting in diminished health status and quality of life with a life expectancy below that of mainstream America for our first peoples?
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