In 1996, amid growing concern about the lack of adequate public health surveillance and data for disease control for AI/AN populations, Tribal Epidemiology Centers (TECs) were established under the reauthorization of the Indian Health Care Improvement Act (IHCIA).
A cornerstone to improved public health capacity is ensuring the existence of valid and reliable data. Data analysis and information communication is needed by AI/AN communities and/or organizations in order for tribal leadership to have facts and tools needed to better prioritize their community health improvement decisions.
TECs operate on funding provided through cooperative agreements with the IHS, other federal agencies (such as the CDC, NIH and OMH), and other organizations. TECs play a critical role in building public health capacity among AI/AN communities. Working with tribal entities and urban AI/AN communities, TECs provide a variety of public health services including: data dissemination, surveillance, applied epidemiologic studies, training, responses to public health emergencies, technical assistance, and disease control and prevention activities. TECs also support national public health goals by working to improve data for GPRA (Government Performance and Results Act) reports and by monitoring the Healthy People 2020 objectives at the tribal level.
IHCIA was permanently reauthorized in 2010. This reauthorization defined TECs as “public health authorities” for purposes of the HIPAA Privacy Rule for data sharing. The permanent reauthorization of IHCIA directs the Secretary of the Department of Health and Human Services (DHHS) to grant each TEC access to use of the data, data sets, monitoring systems, delivery systems, and other protected health information (PHI) in the possession of the Secretary. It also requires that the Centers for Disease Control and Prevention (CDC) provide technical assistance, and that CDC work closely with each TEC in strengthening AI/AN disease surveillance.
Each of the 12 TECs in the U.S. is designated to serve AI/AN populations within the 12 IHS administrative areas, and one serves urban AI/ANs across the nation. TECs are striving to maintain a strong core of data collection, dissemination, surveillance, and epidemiologic studies. Through these efforts, each TEC is uniquely positioned to evaluate tribal and community-specific health status, enhancing the ability of IHS to better understand and further develop the link between public health problems and behavior, socioeconomic conditions, and geography.