The Navajo Nation Healthy Diné Nation Act: A Description of Community Wellness Projects Funded by a 2% Tax on Minimal-to-No-Nutritious-Value Foods.
The Navajo Nation Healthy Diné Nation Act: A Description of Community Wellness Projects Funded by a 2% Tax on Minimal-to-No-Nutritious-Value Foods.
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DOI：
10.1097/phh.0000000000001371
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发表时间：
2022-03-01
期刊：
影响因子：
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通讯作者：
de Heer HD
中科院分区：
文献类型：
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作者：
Yazzie D;Tallis K;Curley C;Sanderson PR;Eddie R;Shin S;Behrens TK;George C;Antone-Nez R;Jumbo-Rintila S;Begay GA;de Heer HD
文本中提供了补充数字内容。为了促进纳瓦霍人的健康，纳瓦霍族于 2014 年通过了《健康饮食民族法案》(HDNA)。该法案包括对“最低营养价值至无营养价值”食品征收 2% 的税，并免除健康食品 5% 的销售税，这是美国和任何主权部落国家中首个此类政策。与部落政府结构独特地一致，收入直接分配给 110 个小型地方政府实体（分会），用于自主决定的健康项目。为了描述 HDNA 资助的健康项目的特征，测试项目类型以及资金数额随时间的变化（按地区和社区规模划分）。纵向研究评估从税收开始到 2019 年资助的健康项目。纳瓦霍族。一百十个纳瓦霍族分会接受自主健康项目的资助。按地区和社区规模划分的 4 年来健康项目的类别和具体类型以及资金。在 2015 年至 2018 年收集的收入中，超过 99.1% 已在 2019 年支付给 1315 个健康项目（每个社区 12 个）（460 万美元，每个社区每年 13 385 美元）。建成休闲环境类别获得了 38.6% 的资金，设备/用品 16.5%，指导 15.7%，食品和水倡议 14.0%，社交活动 10.2%。最常见的具体项目是步道（648 470 美元）、健身器材（585 675 美元）、活动食品（288 879 美元）、游乐场（287 471 美元）和温室（275 554 美元）。只有分配给教学的比例随着时间的推移发生了显着变化（每年增加 2%，P = .02）。较小的社区（人口<1000）分配给传统、农业和代际项目的比例明显较高，而分配给建筑环境的比例则较少。截至 2019 年，超过 99% 的 HDNA 收入已成功支付给 110 个农村部落社区。社区选择了与促进建成的休闲环境、农业和健身/营养教育相关的项目，较小的社区则强调文化和代际项目。这些发现可以为其他考虑类似政策和资金分配的土著国家提供参考。
Supplemental Digital Content is Available in the Text. To promote the health of the Navajo people, the Navajo Nation passed the Healthy Diné Nation Act (HDNA) in 2014. The HDNA included a 2% tax on “minimal-to-no-nutritional-value” foods and waived 5% sales tax on healthy foods, the first such policy in the United States and any sovereign Tribal nation. Uniquely aligned with Tribal government structures, revenue was directly allocated to 110 small local government entities (Chapters) for self-determined wellness projects. To characterize HDNA-funded wellness projects, test for variation in project type, and funding amount over time by region and community size. Longitudinal study assessing funded wellness projects from tax inception through 2019. The Navajo Nation. One hundred ten Navajo Nation Chapters receiving funding for self-determined wellness projects. The categories and specific types of wellness projects and funding over 4 years by region and community size. Of revenue collected in 2015-2018, more than 99.1% was disbursed through 2019 ($4.6 million, $13 385 annually per community) across 1315 wellness projects (12 per community). The built recreational environment category received 38.6% of funds, equipment/supplies 16.5%, instruction 15.7%, food and water initiatives 14.0%, and social events 10.2%. Most common specific projects were walking trails ($648 470), exercise equipment ($585 675), food for events ($288 879), playgrounds ($287 471), and greenhouses ($275 554). Only the proportion allocated to instruction changed significantly over time (increased 2% annually, P = .02). Smaller communities (population <1000) allocated significantly higher proportions to traditional, agricultural, and intergenerational projects and less to the built environment. Through 2019, more than 99% of HDNA revenue was successfully disbursed to 110 rural, Tribal communities. Communities chose projects related to promoting the built recreational environment, agriculture, and fitness/nutrition education, with smaller communities emphasizing cultural and intergenerational projects. These findings can inform other indigenous nations considering similar policies and funding distributions.