The nearest IHS facility is more than a two-hour drive into another state for most of the roughly 55,000 Lumbee citizens living in Robeson County, according to KFF Health News, which reported the story with NPR. The Funding Path Voters RejectedThe revenue source many tribes have used to build health systems is not currently available here, because Lumbee citizens voted it down. Research on gaming and tribal health shows facilities, staffing and social services improve, while unhealthy substance use and smoking tend to increase. Brooks also identified what she considers the deeper barrier: whether people feel they can trust the health care system at all. The nearest facility is more than a two-hour drive out of state for most citizens in Robeson County.