The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally recognized Native American Tribes including American Indian and Alaska Native people. IHS is the principal federal health care provider and health advocate for Native people in the United States.
The IHS provides health care in 37 states to approximately 2.2 million out of 3.7 million American Indians and Alaska Natives (AI/AN). As of April 2017, the IHS consisted of 26 hospitals, 59 health centers, and 32 health stations. Thirty-three urban Indian health projects supplement these facilities with various health and referral services. Several tribes are actively involved in IHS program implementation. Many tribes also operate their health systems independent of IHS.
Health services for American Indian and Alaska Natives in the United States were first assigned to the Department of War in 1803 and later the Office of Indian Affairs in 1824. With the creation of the Division of Indian Health in 1924, field nurses were hired and Public Health Service officers filled positions to address staffing shortages. Policy changes as a result of the Meriam Report (1928) led to funding and the first preventive medicine program. While resources increased in the 1930s, both staffing and funding declined with the start of World War II. Calls to improve health, sanitation, and facilities continued after the war as Indian termination policy shaped postwar debate. At the same time, former surgeon general Thomas Parran published a report which detailed health problems among Alaska Natives. The IHS's report to Congress in 1957 (known as the "Gold Book" for the color of its cover) and the Parran Report presented the first comprehensive study of health conditions and recommendations based on the findings. There were four priorities or functions identified: