Navajo Nation Healthy Diné Nation Act: An Implementation Study

In November 2014, the Healthy Diné Nation Act (HDNA) was signed into law by the Navajo Tribal Council and the Navajo Nation President. The enactment placed a 2% sales tax on all foods of “little-to-no nutritional value,” and also exempted healthy foods (fresh fruits, vegetables, nuts and water) from Navajo’s 5% sales tax at all grocery stores, convenience stores, restaurants, food courts and retail establishments within Navajo Nation borders. HDNA was indeed a historic act: one of a kind of all tribal nations in the U.S. and one of a few, globally.

Revenue from the “junk food tax” has gone into Community Wellness Projects (CWPs) to promote healthier living for all members of the Navajo Nation. From 2014 to 2019, a total of $7.58 million HDNA revenue was disbursed to all 110 Chapters, each receiving on average $13,171 annually for 5 years. These funds have helped Navajo Nation to combat the high rates of chronic health issues (like diabetes and heart disease) by promoting healthy lifestyles. Funded projects that will be made possible in the coming years include: walking trails, exercise equipment, playgrounds, greenhouses, wellness centers, food demos, basketball/volleyball courts, picnic grounds, fitness classes, agricultural projects, social events, skate parks, traditional arts and crafts and recycling initiatives.

In December 2020, the Navajo Nation Council had to decide whether HDNA should continue. Based on the evaluation and revenue data, they decided to reauthorize HDNA indefinitely. The HDNA evaluation came together by a collaborative team including the Navajo Epidemiology Center, Navajo Division of Community Development, Office of the Navajo Tax Commission, Northern Arizona University, Diné College, and Brigham & Women’s Hospital (BWH). As part of this evaluation, the BWH team – which partners closely with COPE on all of its research activities – surveyed 76 Navajo stores to learn if prices and availability of healthy foods had changed since HDNA was passed. They found that healthy fruits were more actually affordable in 2019 compared with 2013, and a growing number of stores offered traditional foods (Figure 1). The team also found that 87% of stores correctly applied the “junk food tax,” while 55% of stores correctly applied the tax exemption on healthy foods (Figure 2).

Since it first began in 2009, Community Outreach and Patient Empowerment Program (COPE) has had a long-standing partnership with BWH as its research arm. COPE has worked alongside the BWH research team to support many small stores on Navajo Nation, providing posters, recipe cards, food demos and other ways to promote many of the healthy foods and beverages that are more affordable thanks to HDNA.

Our research team continues to collect data and will work in a respectful partnership with our collaborative team (Navajo Epidemiology, Navajo Community Development, Navajo Tax Commission and NAU) to find ways the HDNA tax can be implemented in a way that can support wellness in our communities for our Navajo people.

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