Newswise — The Healthy Diné Nation Act (HDNA) was signed into law in 2014, mandating a 2 percent tax on all “foods of little-to-no-nutritious value” purchased in Navajo Nation retail stores. The law was designed to promote health and combat high rates of overweight and obesity—along with diseases such as heart disease and Type 2 diabetes. The tax applies to high-fat baked goods and high-sugar items with little or no nutritional value, including sweetened beverages, chips, candy, frozen desserts, pastries and fried foods. 

In 2017, a team of officials from the Navajo Tribal Epidemiology Center (NTEC) and the Navajo Nation collaborated with faculty members of Northern Arizona University’s Department of Health Sciences—professor Tim Behrens, associate professor Dirk de Heer and associate professor Priscilla R. Sanderson—to study the implementation of the tax. Leadership from the Navajo Nation included NTEC director Ramona Antone-Nez and epidemiologist Del Yazzie; Shirleen Jumbo-Rintila, legislative specialist from the Navajo Division of Community Development; Martin Ashley, executive director of the Office of the Navajo Tax Commission; Herbert Benally from Diné College; and Moroni Benally, vice president for Government Affairs and Public Relations at Diné College. Representatives from several chapters on the Navajo Nation and Kristen Tallis, a student in NAU’s new Master of Public Health program, also served as key contributors to the project.

During this initial one-year study, which was funded through a $225,000 grant from the Robert Wood Johnson Foundation (RWJF), the team gathered data to understand how the funds were collected, distributed to tribal chapters and invested to improve the health of tribal members.


Now, with a new $1.4 million R01 grant from the National Institutes of Health’s National Institute on Minority Health and Health Disparities, the team will embark on a four-year project to determine the impact of the HDNA.

“We will build on the work we started during the original project expanding this project with new collaborators and new data to gain insight into chapter wellness projects funded by the tax, the food store environment and nutrition-related health behavior,” de Heer, the principal investigator, said.

In addition to NAU assistant professor Sean Gregory, NTEC project manager Simental Francisco will join the team. Francisco and the NTEC team led the development and implementation of the Navajo Nation Health Survey, and they will develop a follow-up survey as one of the key tools for gathering data for this project.

The team will also partner with Sonya Shin, director of Community Outreach and Patient Empowerment (COPE), a community organization located in Gallup, New Mexico, that is affiliated with Harvard's Brigham and Women's Hospital. Shin, co-principal investigator of the project, will study the food environment in stores on and around the Navajo Nation.