Rachel Joseph has seen entire Native American families living in just one room, children huddled in housing so poorly insulated that shafts of light could be seen through the flimsy wooden walls.

Now a report by the National American Indian Housing Council highlights what Joseph, chairwoman of the Lone Pine Paiute Tribe in California, has known all along, that substandard and overcrowded housing contributes to a plethora of health, social and family problems within her community.

Joseph, co-chairwoman of the national steering committee for reauthorization of the Indian Health Care Improvement Act, says the federal government has, over decades, failed to address the needs of Native Americans.

"What do we have to do for our voices to be heard?" she said yesterday at a news conference to release the housing report.

Launching the report on the eve of the official opening of the National Museum of the American Indian in the District, Chester Carl, chairman of the NAIHC, said the timing was fitting.

"The opening of the museum is a cause to celebrate -- but it is also a reminder that there are issues such as health and housing that continue to plague Indian people," Carl said.

While proposing a multifaceted approach toward solving the housing crisis, the NAIHC said the federal government has a trust responsibility to support tribal development. The organization called for federal legislation to create a block grant for infrastructure funding.

"Very few places in our nation have children hurting as much as on our Indian reservations," Carl said. "It is up to the federal government to uphold the trust responsibility -- an obligation it has made to tribes through treaties and laws -- and make good on promises ratified centuries ago. We, as Native people, will also continue to work together to make a better life for our children."

The survey of 246 NAIHC housing authority members found that 59 percent of respondents reported overcrowded housing on their reservation, and 83 percent described housing as substandard, with problems such as inadequate insulation, lack of proper sewage treatment, mold and lack of clean water.

A total of 94 percent indicated that such poor conditions affected tribal members' health and the well-being of their children, linking an increase in cases of colds, flu and skin disorders to overcrowding and substandard housing.

Almost 90 percent of the respondents said that poor housing contributed to social problems such as alcoholism and abuse.

The U.S. Commission on Civil Rights last year published a study that estimated that 200,000 new housing units are needed to ease the housing crisis in Indian Country.

The civil rights commission study had found that 14.7 percent of the dwellings in tribal areas are overcrowded. It also reported that about 90,000 Native American families are homeless or lack adequate housing.

"Native Americans living on reservations have some of the worst housing conditions in the United States," Carl said. "Native Americans are three times more likely to live in overcrowded housing. Native Americans are more likely than other Americans to have a lack of sewage and water systems, telephone lines and electricity."

The NAIHC report compared the amount spent by the federal government on health care for prisoners to the funds allocated to Indian communities.

"The government spends $3,803 per inmate per year compared with $1,914 per Native American. That's a crime," Carl said. "The federal government has not done its share."

Of particular concern was the effect of overcrowding on Indian children, said Deborah Cutler-Ortiz of the Children's Defense Fund, who participated in the news conference.

More than 80 percent of those surveyed for the NAIHC report raised concerns that physical and psychological difficulties arising from poor housing were hampering Native American children's educational progress.

"Failure to address these interwoven issues will only assure the continued cycle of hardship faced by American Indian children," Cutler-Ortiz said.

In this house on the Navajo reservation in eastern Arizona, tires are used to hold the roof down when the wind blows. The barrels in front contain water because the nearest water supply is 11/2 miles away. Chester Carl, National American Indian Housing Council chairman, and Rachel Joseph, of the Lone Pine Paiute Tribe, called on the government to address the unhealthy conditions in which many Indians live.