Specifically, improved cash flow has resulted in new wellness programs, community centers, places for recreation, and improved social services. Improvement of the tribal economy, through both job creation for tribal members and improved tribal cash flow, was perceived by participants to both influence health. Forming these pathways are a series of interrelated health determinants. ResultsĪmerican Indian-owned casinos are perceived to influence the health of tribal communities through three pathways: 1) improving the tribal economy 2) altering the built environment, and 3) disrupting the the social landscape. Data were managed and coded using Dedoose software. Then, focused codes were applied to identify salient themes, which we represented through exemplar quotes and an overall conceptual framework. We inductively analyzed textual data drawing from Grounded Theory, first using line-by-line coding to identify analytic categories from emergent themes in consideration of the study objective.

We conducted semi-structured, interviews with tribal leaders ( n =12) and tribal members ( n =24) from tribal communities ( n = 23) representing different regions of California. We sought to understand the perceived pathways by which casinos impact individual and community health through voices of the community. While casinos have improved the incomes of tribal communities, there have been both positive and negative findings in relation to health impacts. Three decades ago, casino gaming on sovereign American Indian lands was legalized with differential economic and social implications.

Native american casino quotes