As concerns continue to rise about the future of rural America—its economy, healthcare access, housing availability, and job opportunities, a critical truth remains too often overlooked: Native American communities are not just a part of rural America. In many places, they are its quiet backbone, sustaining and revitalizing entire regions.
While many rural communities wait on outside investors or federal assistance, Tribal Nations are already leading the way. Through sovereignty and self-direction, they are building what others still hope for: strong economies, healthcare systems, workforce pipelines, and housing solutions. These efforts are not isolated. They are intentional, rooted in cultural values, and growing in scale.
When you light a fire, you do it not just to warm yourself, but to warm the whole village. That spirit of shared benefit defines the approach Tribal Nations take in economic development.
In northeastern Oklahoma, the Cherokee Nation employs over 11,000 people, making it one of the largest employers in the region. Its business ventures—ranging from gaming and hospitality to aerospace manufacturing and federal contracting—generate over $3.04 billion annually. These enterprises support Native citizens and non-Native families alike throughout the area (Cherokee Nation Impact Report, 2023).
Similarly, the Otoe–Missouria Tribe in north-central Oklahoma generates more than $156 million annually through its diverse business operations. These efforts support over 1,100 jobs in a region where large-scale employment can be hard to find (Oklahoma Indian Gaming Association, 2022).
This pattern repeats across Indian Country. Native-owned businesses have become regional anchors in areas where major corporations have either never invested or have since left. These enterprises provide employment, vendor contracts, infrastructure, and regional economic stability.
One of the most significant challenges in rural America today is the collapse of healthcare access. According to the Sheps Center for Health Services Research, more than 170 rural hospitals have closed since 2005, and over 600 more are at risk of shutting down due to financial instability, staffing shortages, and lack of Medicaid expansion (UNC Sheps Center, 2023; Chartis Group, 2023).
In response, many Tribal Nations have built healthcare systems that serve not just their citizens but the broader population. In Alaska, Tribal health organizations led one of the nation’s most effective COVID-19 vaccine distribution efforts. They provided timely, coordinated care in some of the most remote areas of the country, serving both Native and non-Native residents (Alaska Native Tribal Health Consortium, 2022).
In Oklahoma, the Choctaw Nation operates a hospital and several clinics that provide care to a 10-county area. Many of their patients are non-Native, illustrating how Tribal health systems have become regional safety nets. According to the National Indian Health Board, some Tribal clinics now serve populations where over 60% of patients are non-Tribal (NIHB, 2023).
Rural America faces a severe housing shortage, particularly in areas where population growth or workforce expansion has outpaced development. In many of these regions, Tribal Nations have stepped in as housing developers and partners.
The Mille Lacs Band of Ojibwe has expanded housing options not only for its citizens but also for teachers, healthcare workers, and law enforcement officers who serve surrounding towns. These homes provide essential infrastructure that supports the entire region.
In California, the Yurok Tribe and the Yocha Dehe Wintun Nation have tackled issues of overcrowding and substandard housing while partnering with local counties to expand development. According to a 2021 report by the U.S. Department of Housing and Urban Development, Native American housing projects frequently benefit both Tribal citizens and non-Native residents in rural communities (HUD, 2021).
Long-term prosperity requires education and career development. Tribal Nations are investing in both. The Coeur d’Alene Tribe has partnered with community colleges and vocational programs to create job pipelines that serve Native and non-Native populations alike.
Nationwide, 37 Tribal Colleges and Universities (TCUs) serve around 20,000 students each year. These institutions often sit in rural regions and train professionals in fields such as healthcare, law enforcement, natural resources, and education (AIHEC Fact Book, 2023).
In addition, Tribal enterprises frequently offer scholarship programs and tuition reimbursement. Grand Casino Mille Lacs and Grand Casino Hinckley provide financial assistance to employees pursuing associate, bachelor’s, and master’s degrees. These investments grow the local workforce while strengthening loyalty and long-term economic outcomes.
Tribal sovereignty allows for flexibility that state and local governments often lack. This legal and political independence enables Tribes to act quickly, build creatively, and invest strategically. Sovereignty makes it possible to launch housing authorities, invest in utility infrastructure, establish clinics, and diversify businesses without the same bureaucratic hurdles faced elsewhere.
Where other rural communities are forced to wait for a corporation to invest or for a grant to be approved, Tribal Nations are moving forward—reinvesting gaming revenues, forming public-private partnerships, and creating new models of self-sufficiency.
Their ability to act, grounded in cultural principles and intergenerational planning, is transforming rural development across the country.
The dominant story of rural America often focuses on decline—lost industries, struggling hospitals, aging infrastructure. But there is another story already unfolding. In Tribal Nations across the country, rural revitalization is not a dream for the future. It is happening now.
Through jobs, healthcare, housing, and education, Tribal governments and enterprises are sustaining their communities and strengthening the regions around them. These successes are not anomalies. They are the product of sovereignty, vision, and a commitment to generations to come.
As more of the nation turns its attention to rebuilding rural America, it would be wise to learn from those who are already doing it, with strategy, culture, and care.