Date of Award


Document Type

Open Access Dissertation


Health Services and Policy Management

First Advisor

S. Melinda Spencer


Drug-related violence (DRV) impacts the over-all wellbeing of communities, with disparate health outcomes observable in many poor, minority communities. The purpose of this study was to better understand the multi-level social and environmental factors influencing elevated rates and prevention of DRV within the Lumbee, a southeastern American Indian Tribe. This was accomplished via in-depth, one-on-one interviews with 37 Lumbee Tribal Members and Key Leaders. The findings align with existing research, revealing the influence of such factors as poor socioeconomic conditions, coping strategies, broken family structures, and the influence of federal policy. Of interest was the substantial influence of the local Christian church on the beliefs, attitudes, and practices of the Lumbee community surrounding DRV. The findings of this study indicate that social-environmental factors, seemingly independent of prevention and treatment, play an integral role in the Lumbee community’s ability to recover from the long-term consequences of DRV. Identifying these unique barriers to and facilitators of prevention and treatment will be critical to improving the welfare of tribal communities.