Author (Your Name)

Karolina A. SerhanFollow

Date of Award


Document Type

Honors Thesis (Open Access)


Colby College. Global Studies Program


Nadia El-Shaarawi

Second Advisor

Daniel Tortora

Third Advisor

Gail Carlson


This honors thesis explores the complex interplay between health status, healthcare, and tribal sovereignty among native communities in the United States. These relationships are explored through analyzing the paradoxical and condescending nature of the Federal Trust Responsibility in relation to government-organized healthcare programs for natives. In establishing this relationship, the thesis goes on to illustrate how native communities have effectively fought to regain sovereignty through reclaiming autonomy of their healthcare systems through the use of the 1975 Indian Self-Determination and Education Assistance Act. The impact of tribal-led healthcare systems is further explored through an in-depth case study conducted regarding the healthcare system of the Eastern Band of Cherokee Indians in Cherokee, North Carolina. Ultimately, this thesis argues that tribal healthcare autonomy has significantly contributed to the fight to reclaim tribal sovereignty because it breaks the condescending nature of the federal trust responsibility and it serves as an effective model to improve health trends among native communities.


This thesis was in fact done in the Department of Independent Majors at Colby College. Professor Nadia El-Shaarawi, the primary advisor, is an Assistant Professor in the Global Studies Program at Colby College.


Tribal Sovereignty, Native Americans, United States, Federal Indian Law, Federal Trust Responsibility, Healthcare, Health Status, Eastern Band of Cherokee Indians, Self-Determination, Self-Governance