California Tribal Epidemiology Center

Improving American Indian and Alaska Native Health in California


Epidemiology is the study of the trends, causes, and distribution of health and disease conditions in defined populations. Epidemiologists assist with research study design, data collection, survey instruments design, statistical analyses of data, and interpretation of study results. In order to do this, epidemiologists use techniques from a combination of scientific disciplines including biology, social sciences, and statistics. The California Tribal Epidemiology Center (CTEC) was established in 2005 to assist in collecting and interpreting health information for American Indians and Alaska Natives (AIAN) in California. CTEC is 1 of 12 Indian Health Service (IHS) Division of Epidemiology and Disease Prevention-funded Tribal Epidemiology Centers that provide epidemiologic support to each IHS region and often partner with local IHS area offices to provide these services. CTEC receives core funding from IHS along with supplemental grants. Our mission is to work directly with Tribes and Indian Health Programs (Tribal Health Programs and Urban Indian Health Organizations) to monitor the health status of AIAN in California and develop effective public health services that respect the cultural values and traditions of our communities. CTEC aims to align its activities with the strategic plan of its parent organization, the California Rural Indian Health Board, Inc. (CRIHB).

Mission Statement

Our mission is to improve AIAN health in California to the highest level by engaging American Indian communities in collecting and interpreting health information to establish health priorities, monitoring health status, and developing effective public health services that respect cultural values and traditions of the communities. CTEC services are available to all Tribes and Indian Health Programs in California through Data Sharing Agreements. For more information, contact


Data Sharing

Technical Assistance

CTEC is available to provide technical assistance to tribal health programs (member and non-member) as well as individual tribes. Technical assistance requests include, but are not limited to, gathering relevant health statistics, reviewing sections of grant applications that discuss collecting health data, helping develop data collection instruments, and providing assistance analyzing data.   Can CTEC assist your tribe or health program with services? Let us know!

Outbreak Investigation/Response

CTEC monitors reported disease clusters/outbreaks through national and state health alert networks and maintains a capacity to conduct cluster investigations on behalf of tribes, including collaborative efforts with other public health entities.  CTEC also promotes Tribal community readiness by participating in the California Health Alert Network.


Health Priorities Assessment

CTEC seeks to conduct projects guided by the health priorities of the communities we serve. In order to determine community health priorities, CTEC disseminates the Health Priorities Assessment survey at the beginning of every cooperative agreement with IHS. The survey asks respondent to rank the top 10 health priorities in their respective community as well as provide basic demographic information such as age group, and Tribal affiliation. For the 2016-2021 cooperative agreement, a total of 1,404 adults participated in the Health Priorities Survey throughout California. Through the survey process, individuals provided demographic information; an overall rating of self and community health; and tallies and rankings of a variety of health concerns.”Other” describes health priorities such as cancer(s) (unspecified type) and other access-related health issues (e.g., transportation). Top ten health priority rankings were similar across participants, regardless of their age, gender, role in the community, self and community health status, and geographic region.

  1. Diabetes
  2. Alcohol/Substance Abuse
  3. Obesity
  4. Mental/Emotional Health Issues
  5. High Blood Pressure
  6. Limited Access to Medical Care
  7. Chronic Pain
  8. Other
  9. Heart Disease
  10. Suicide

See the Full Report of CTEC Indian Health Priorities.

Supplemental Projects

  • Building Public Health Infrastructure (BPHI): Funding for a five-year Building Public Health Infrastructure grant has been awarded to Tribal Epidemiology Centers (TECs) by the National Center for Chronic Disease Prevention and Health Promotion. Of the 12 TECs awarded, the California Tribal Epidemiology Center (CTEC), housed within the California Rural Indian Health Board (CRIHB), has been awarded $4 million for five years. The grant will increase the capacity of TECs to address a wide range of public health needs and accelerate improvements in health outcomes for American Indian and Alaska Native (AI/AN) populations across their Indian Health Service Administrative Area. Funding from the Centers for Disease Control and Prevention (CDC) will provide support to CTEC to enhance public health capacity and infrastructure for chronic disease prevention, health promotion and prevention and control of priority public health problems.

Advisory Council

Group photo of Advisory Council and CTEC Staff
Group photo of Advisory Council and CTEC staff at biannual meeting, Spring 2019.

The CTEC Advisory Council is comprised of community and health professional representatives from member Indian Health Programs and universities in California.  The Advisory Council assists CTEC staff in planning the use of gathered information, conducting epidemiologic studies, and reviewing publications prior to release.

Publications and Reports

Community Health Profiles


Technical Reports

Non-CTEC Reports



CTEC Brochure

CTEC Brochure

Cross-Jurisdictional Sharing of Emergency Management Services

National Policy Matrix: Cross-Jurisdictional Sharing Arrangements Between Tribes and Counties (2015)
National Policy Matrix: Cross-Jurisdictional Sharing Arrangements Between Tribes and Counties (2015)
Toolkit: Cross-Jurisdictional Sharing Between Tribes and Counties for Emergency Management (2017)
Toolkit: Cross-Jurisdictional Sharing Between Tribes and Counties for Emergency Management (2017)


Rosario Arreola Pro CRIHB Chief Operations Officer (916) 929-9761